Authorizes students to carry prescribed auto-injectable epinephrine in school

Effects of present law which this bill would alter

Adds a new section 921 to the Education Law

Summary of specific provisions

New Section 921

1. a. School districts would allow pupils who have been diagnosed by a physician with a severe food or other allergy to carry and use the prescribed medication epinephrine and a device to self-administer epinephrine, such as an epinephrine auto-injector, during the school day and during school sponsored activities that occur after the regular school day or outside of the school, with the written permission of a physician or other duly authorized health care provider, and parental consent, based on such physician's or provider's determination that such pupil is subject to allergic attacks severe enough to debilitate such pupil. A record of such permission shall be maintained in the school office.

b. The district would prepare for EACH such student an emergency action plan and a severe allergy treatment plan with the assistance of the physician of the pupil. The Commissioner of Education, in consultation with the Commissioner of Health, would establish standards for the development of such plans.

2. The district would inform the parents of the pupil, in writing, that the district and its employees are not liable as a result of any injury arising from the self-administration of such medication by the pupil. The parents would sign a statement acknowledging the district was not liable.

3. Every school district would maintain an epinephrine auto-injector in the school nurse's office or in a similar accessible location. The commissioner would promulgate regulations for the use of a device to administer epinephrine by the school nurse or other person authorized by regulation. The regulations would require training for the school nurse and require information be provided to teaching and other school staff about students in the school who may suffer from severe allergies and the potential consequences, the availability of epinephrine, and the protocol to follow when a pupil experiences a severe allergic reaction.

Justification

The following information is taken from the American Academy of Asthma, Allergy and Immunology Position Statement on Anaphylaxis in Schools: Life-threatening severe allergic reactions can cause the condition Anaphylaxis which is a collection of symptoms including breathing difficulties and a drop in blood pressure or shock, which are potentially fatal. Common examples of potentially life-threatening allergies are those to foods and stinging insects.

Life-threatening allergic reactions may also occur to medications or latex rubber and in association with exercise. It is estimated that 1% to 2% of the general population is at risk for anaphylaxis from food allergies and insect stings, with a lower reported prevalence for drugs and latex. Asthmatic subjects are at particular risk. Approximately 50 anaphylactic deaths caused by insect stings and 100 food-related anaphylactic deaths are recognized each year in the U.S. School personnel should develop a system of identifying children with life-threatening allergies to prevent anaphylactic reactions, and they should also be prepared to deal with those that occur despite precautions. It is imperative that epinephrine be recognized as the drug of choice and that all efforts are directed toward its immediate use.

Data clearly shows that fatalities more often occur away from home and are associated with either not using epinephrine or a delay in the use of epinephrine treatment. All school personnel should be aware of those students who have been prescribed epinephrine. This information should be readily available and reviewed by all personnel. Staff members involved with the child's care should be instructed about the potentially severe nature and proper treatment of the allergic problem. This information should be reviewed with the student's parents before each school year or special activities (e.g., school trips). Any questions and possible treatment strategies should then be discussed with the parent, the child's physician, or both. If prescribed, every student should have the epinephrine auto-injector device clearly labeled with his or her name and classroom number. School personnel should be instructed about the location of the medication. Accidental food ingestion can occur despite avoidance measures. Treatment should be immediately available for these emergency situations. Treatment protocols need to be prescribed by a physician. The school staff should have written instructions from the child's physician and signed by the parents. providing easy to follow steps for recognizing a reaction and administering medication.

Several federal laws protect the rights of disabled children, which include those with life-threatening food allergies. Epinephrine injection is available in a number of self-administration delivery devices. There are no contraindications to the use of epinephrine for a life-threatening allergic reaction. Epinephrine should be kept in locations that are easily accessible and not in locked cupboards or drawers. All staff members should know these locations. Children old enough to self-administer epinephrine should carry their own kits. All students, regardless of whether they are capable of epinephrine self-administration, will still require the help of others because the severity of the reaction may hamper their attempts to inject themselves. Adult supervision is mandatory. All individuals entrusted with the care of children need to have familiarity with basic first-aid and resuscitative techniques. This should include additional formal training on how to use epinephrine devices. A school-wide food allergy awareness program for the staff, including an allergy emergency drill, should be developed to ensure that everyone will know what to do if a reaction occurs.

Legislative history

2004 - A1 1093 /2005 - A.2166 - Referred to Education 2007/2008 - A.3921 - Referred to Education 2009/2010 -

A.2471 - Referred to Education 2011-2012 S.5500/A.840-A - PASSED SENATE/Education

Fiscal implications for state and local governments

School districts will incur the cost of purchasing epinephrine-injector kits and providing training for staff.

Effective date

120 days after it becomes law; however, the Commissioner of Education is authorized immediately to promulgate rules and regulations for the implementation of this act on such effective date.