Senate Bill S5500A

                                BILL NUMBER:S5500

TITLE OF BILL:
An act
to amend the education law, in relation to the use of epinephrine by
students

PURPOSE OF BILL:
This bill would allow pupils who have been diagnosed
with severe food or other allergies to carry and use the prescribed
medication epinephrine and a device to self-administer epinephrine
during the school day and during school sponsored activities.

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      - A.11093
2005      - A.2166 - Referred to Education
2007-08   - A.3921 - Referred to Education
2009/10   - A.2471 - Referred to 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 if 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.