Senate Bill S5789

                                BILL NUMBER:S5789

TITLE OF BILL:  An act to amend the education law and the public
health law, in relation to on-site epinephrine auto-injectors

PURPOSE:  To authorize the use of epinephrine auto-injectors in
schools by trained school nurses and employees in emergency situations
involving students or staff experiencing life-threatening allergic or
anaphylactic reactions.

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.