Authorizes the use of epinephrine auto-injectors in schools and by trained school nurses and employees

SUMMARY OF PROVISIONS:.

Section 1: Adds a new section 919-a to the Education Law to provide the authority to school districts, boards of cooperative educational services, county vocational education and extension boards, charter schools and non-public elementary and secondary schools in this state to maintain epinephrine auto-injectors on the premises in quantities and types deemed by the commissioner of education in consultation with the commissioner of health to be adequate to ensure ready and appropriate access for use during emergencies for any student or staff member having anaphylactic symptoms whether or not there is a previous history of severe allergic reaction. to provide and maintain epinephrine auto-injectors for use during emergencies.

Section 2: Amends section 3000c of the Public Health Law to include eligible school districts, boards of cooperative educational services, county vocational education and extension boards, charter schools, and non-public elementary and secondary schools in this state. The definition of eligible entities is also amended to include nurses or any persons employed by such entities who may administer auto-injectors contingent on the individual or entity completing the appropriate training and having a collaborative agreement with a physician or hospital.

Section 3: Provides that notwithstanding any other provision of law, no party shall have a cause of action for personal injury or any other claim based on the use of an epinephrine auto injector device by a school nurse, eligible individual, or other individual at the school or a school-sponsored function, provided that such use was performed reasonably and in good faith. This section also authorizes the commissioner to promulgate regulations for implementation of this section

Section 4: Sets forth an effective date of 120 days after becoming law

Justification

Recent years have shown an increased awareness of the dangers of severe allergic reactions to foods and stinging insects. Such severe reactions can lead to potentially fatal anaphylaxis According to the American Academy of Asthma, Allergy and Immunology, approximately 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. Additionally, according to a study in the Archives of Internal Medicine, anaphylaxis causes approximately 1500 deaths a year. A study reported in the Journal of Allergy and Clinical Immunology indicated there are 90,000 emergency room visits each year due to food allergies alone. Furthermore, a Massachusetts survey of schools showed that 24% of anaphylactic

reactions at school occurred in individuals not known to have a history of life-threatening allergies. Therefore, it is imperative that school personnel be prepared and authorized to respond to life-threatening allergies and anaphylactic reactions that occur despite precautions.

Currently, New York State laws and regulations (Education Law §§ 6527, 6900; 8 NYCRR 64.7) allow a school district medical director, a licensed physician or certified nurse practitioner to write a non-patient specific order for anaphylaxis treatment agent for a school nurse (a registered professional nurse) to administer in the event of an unanticipated anaphylactic episode. Under current law, the school district medical director is legally required to provide protocols for administration of this medication and must adhere to state regulatory guidance, board of education policy, and best practice information. Furthermore, schools are required to have an Emergency Care Plan (ECP) initiated by the school nurse that is based on board of education policy, designated for use by both nursing and school personnel for those with life-threatening conditions. The ECP requires schools to have a plan in place if there is no school nurse available.

New York State Public Health Law § 3000-c allows certain trained individuals to use epinephrine auto-injector devices in life threatening emergencies providing there is collaboration agreement with a physician or a hospital. Public Health Law § 3000(a) further provides Good Samaritan protections for certain entities. In addition, the New York City Department of Education has regulations in place (A-715) that allow for standing orders for the administration of epinephrine for health care professionals working in New York City schools to students without a student-specific medical order on file for epinephrine.

While there are policies and procedures in place for the emergency administration of epinephrine they do not consider the likelihood that a school may not have a school nurse with the authority to provide such emergency medication. This bill would align state law with existing regulations by authorizing school nurses and other trained personnel (through a collaborative agreement with a physician or a hospital) to administer epinephrine when there are symptoms of anaphylaxis. Under the bill, nurses and other individuals who administer epinephrine in emergency situations would be exempt from liability, provided the use was performed reasonably and in good faith. Finally, approximately 25% of New York State schools currently participate in an existing program which provides auto-injectors free of charge to public and private schools. This permissive legislation clarifies that public and private schools without school nurses in New York State may participate in such a program.

Legislative history

New bill.

Fiscal implications

None.

Effective date

The act shall take effect one hundred twenty days after it becomes law; however, the commissioner of education is authorized to promulgate rules and regulations for the implementation of the act immediately.