Bill Summary – FastDemocracy

Enrolled Copy                                                                            H.B. 475
                          SCHOOL PRESCRIPTION AMENDMENTS
                                           2024 GENERAL SESSION
                                                 STATE OF UTAH
                                        Chief Sponsor: Mark A. Strong Senate Sponsor: Jen Plumb
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  LONG TITLE
  General Description:
      This bill modifies provisions related to certain prescription drugs and schools.
  Highlighted Provisions:
      This bill:
      ▸ defines terms;
      ▸ allows certain health care providers to provide a prescription upon request to certain
  school employees or a school nurse for epinephrine and albuterol;
      ▸ requires the Department of Health and Human Services to issue standing prescription
  drug orders for epinephrine and albuterol;
      ▸ waives liability for certain persons; and
      ▸ makes technical and conforming changes.
  Money Appropriated in this Bill:
      None
  Other Special Clauses:
      This bill provides a special effective date.
  Utah Code Sections Affected:
  AMENDS:
      26B-4-401, as renumbered and amended by Laws of Utah 2023, Chapter 307
      26B-4-409, as renumbered and amended by Laws of Utah 2023, Chapter 307
      26B-4-410, as renumbered and amended by Laws of Utah 2023, Chapter 307
      58-17b-1005, as last amended by Laws of Utah 2020, Fifth Special Session, Chapter 4
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  Be it enacted by the Legislature of the state of Utah:
        Section 1. Section 26B-4-401 is amended to read:
     H.B. 475                                                                               Enrolled Copy
         26B-4-401 . Definitions.
     As used in this part:
   (1) "Agent" means a coach, teacher, employee, representative, or volunteer.
   (2) (a) "Amateur sports organization" means, except as provided in Subsection (2)(b):
            (i) a sports team;
            (ii) a public or private school;
            (iii) a public or private sports league;
            (iv) a public or private sports camp; or
            (v) any other public or private organization that organizes, manages, or sponsors a
                sporting event for its members, enrollees, or attendees.
       (b) "Amateur sports organization" does not include a professional:
            (i) team;
            (ii) league; or
            (iii) sporting event.
   (3) "Anaphylaxis" means a potentially life-threatening hypersensitivity to a substance.
       (a) Symptoms of anaphylaxis may include shortness of breath, wheezing, difficulty
            breathing, difficulty talking or swallowing, hives, itching, swelling, shock, or asthma.
       (b) Causes of anaphylaxis may include insect sting, food allergy, drug reaction, and
            exercise.
   (4) "Asthma action plan" means a written plan:
       (a) developed with a school nurse, a student's parent or guardian, and the student's health
            care provider to help control the student's asthma; and
       (b) signed by the student's:
            (i) parent or guardian; and
            (ii) health care provider.
   (5) "Asthma emergency" means an episode of respiratory distress that may include
       symptoms such as wheezing, shortness of breath, coughing, chest tightness, or breathing
       difficulty.
   (6) "Child" means an individual who is under the age of 18.
   (7) "Department health care provider" means a health care provider who is acting in the
       capacity of a health care provider during employment for the department.
   [(7)] (8) "Epinephrine auto-injector" means a portable, disposable drug delivery device that
       contains a measured, single dose of epinephrine that is used to treat a person suffering a
       potentially fatal anaphylactic reaction.
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     Enrolled Copy                                                                                 H.B. 475
  [(8)] (9) "Health care provider" means an individual who is licensed as:
      (a) a physician under Title 58, Chapter 67, Utah Medical Practice Act;
      (b) a physician under Title 58, Chapter 68, Utah Osteopathic Medical Practice Act;
      (c) an advanced practice registered nurse under Section 58-31b-302; or
      (d) a physician assistant under Title 58, Chapter 70a, Utah Physician Assistant Act.
  [(9)] (10) "Pharmacist" means the same as that term is defined in Section 58-17b-102.
  [(10)] (11) "Pharmacy intern" means the same as that term is defined in Section 58-17b-102.
  [(11)] (12) "Physician" means the same as that term is defined in Section 58-67-102.
  (13) "Public school" means a district school or a charter school.
  [(12)] (14) "Qualified adult" means a person who:
      (a) is [18 years of age or older] at least 18 years old; and
      (b) (i) for purposes of administering an epinephrine auto-injector, has successfully
          completed the training program established in Section 26B-4-407; and
          (ii) for purposes of administering stock albuterol, has successfully completed the
              training program established in Section 26B-4-408.
  [(13)] (15) "Qualified epinephrine auto-injector entity":
      (a) means a facility or organization that employs, contracts with, or has a similar
          relationship with a qualified adult who is likely to have contact with another person
          who may experience anaphylaxis; and
      (b) includes:
          (i) recreation camps;
          (ii) an education facility, school, or university;
          (iii) a day care facility;
          (iv) youth sports leagues;
          (v) amusement parks;
          (vi) food establishments;
          (vii) places of employment; and
          (viii) recreation areas.
  [(14)] (16) "Qualified health care provider" means a health care provider who:
      (a) is licensed under Title 58, Occupations and Professions; and
      (b) may evaluate and manage a concussion within the health care provider's scope of
          practice.
  [(15)] (17) "Qualified stock albuterol entity" means a public or private school that employs,
      contracts with, or has a similar relationship with a qualified adult who is likely to have
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      H.B. 475                                                                                    Enrolled Copy
       contact with another person who may experience an asthma emergency.
   [(16)] (18) (a) "Sporting event" means any of the following athletic activities that is
       organized, managed, or sponsored by an organization:
            (i) a game;
            (ii) a practice;
            (iii) a sports camp;
            (iv) a physical education class;
            (v) a competition; or
            (vi) a tryout.
       (b) "Sporting event" does not include:
            (i) the issuance of a lift ticket or pass by a ski resort, the use of the ticket or pass, or a
                ski or snowboarding class or school at a ski resort, unless the skiing or
                snowboarding is part of a camp, team, or competition that is organized, managed,
                or sponsored by the ski resort;
            (ii) as applied to a government entity, merely making available a field, facility, or
                other location owned, leased, or controlled by the government entity to an amateur
                sports organization or a child, regardless of whether the government entity charges
                a fee for the use; or
            (iii) free play or recess taking place during school hours.
   [(17)] (19) "Stock albuterol" means a prescription inhaled medication:
       (a) used to treat asthma; and
       (b) that may be delivered through a device, including:
            (i) an inhaler; or
            (ii) a nebulizer with a mouthpiece or mask.
   [(18)] (20) "Traumatic head injury" means an injury to the head arising from blunt trauma,
       an acceleration force, or a deceleration force, with one of the following observed or
       self-reported conditions attributable to the injury:
       (a) transient confusion, disorientation, or impaired consciousness;
       (b) dysfunction of memory;
       (c) loss of consciousness; or
       (d) signs of other neurological or neuropsychological dysfunction, including:
            (i) seizures;
            (ii) irritability;
            (iii) lethargy;
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      Enrolled Copy                                                                                H.B. 475
          (iv) vomiting;
          (v) headache;
          (vi) dizziness; or
          (vii) fatigue.
        Section 2. Section 26B-4-409 is amended to read:
        26B-4-409 . Authority to obtain and use an epinephrine auto-injector or stock
  albuterol.
  [(1) A qualified adult who is a teacher or other school employee at a public or private
      primary or secondary school in the state, or a school nurse, may obtain from the school
      district physician, the medical director of the local health department, or the local
      emergency medical services director a prescription for:]
      [(a) epinephrine auto-injectors for use in accordance with this part; or]
      [(b) stock albuterol for use in accordance with this part.]
  (1) The school district physician, a department health care provider, the medical director of
      the local health department, or the local emergency medical services director may
      provide a prescription for the following if requested by a qualified adult, who is a
      teacher or other school employee at a public or private primary or secondary school in
      the state, or a school nurse:
      (a) epinephrine auto-injectors for use in accordance with this part; or
      (b) stock albuterol for use in accordance with this part.
  (2) (a) A qualified adult may obtain an epinephrine auto-injector for use in accordance
      with this part that is dispensed by:
          (i) a pharmacist as provided under Section 58-17b-1004; or
          (ii) a pharmacy intern as provided under Section 58-17b-1004.
      (b) A qualified adult may obtain stock albuterol for use in accordance with this part that
          is dispensed by:
          (i) a pharmacist as provided under Section 58-17b-1004; or
          (ii) a pharmacy intern as provided under Section 58-17b-1004.
  (3) A qualified adult:
      (a) may immediately administer an epinephrine auto-injector to a person exhibiting
          potentially life-threatening symptoms of anaphylaxis when a physician is not
          immediately available; and
      (b) shall initiate emergency medical services or other appropriate medical follow-up in
          accordance with the training materials retained under Section 26B-4-407 after
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      H.B. 475                                                                                Enrolled Copy
            administering an epinephrine auto-injector.
   (4) If a school nurse is not immediately available, a qualified adult:
       (a) may immediately administer stock albuterol to an individual who:
            (i) has a diagnosis of asthma by a health care provider;
            (ii) has a current asthma action plan on file with the school; and
            (iii) is showing symptoms of an asthma emergency as described in the student's
                asthma action plan; and
       (b) shall initiate appropriate medical follow-up in accordance with the training materials
            retained under Section 26B-4-408 after administering stock albuterol.
   (5) (a) A qualified entity that complies with Subsection (5)(b) or (c), may obtain a
       supply of epinephrine auto-injectors or stock albuterol, respectively, from a
       pharmacist under Section 58-17b-1004, or a pharmacy intern under Section
       58-17b-1004 for:
            (i) storing:
                (A) the epinephrine auto-injectors on the qualified epinephrine auto-injector
                    entity's premises; and
                (B) stock albuterol on the qualified stock albuterol entity's premises; and
            (ii) use by a qualified adult in accordance with Subsection (3) or (4).
       (b) A qualified epinephrine auto-injector entity shall:
            (i) designate an individual to complete an initial and annual refresher training
                program regarding the proper storage and emergency use of an epinephrine
                auto-injector available to a qualified adult; and
            (ii) store epinephrine auto-injectors in accordance with the standards established by
                the department in Section 26B-4-411.
       (c) A qualified stock albuterol entity shall:
            (i) designate an individual to complete an initial and annual refresher training
                program regarding the proper storage and emergency use of stock albuterol
                available to a qualified adult; and
            (ii) store stock albuterol in accordance with the standards established by the
                department in Section 26B-4-411.
         Section 3. Section 26B-4-410 is amended to read:
         26B-4-410 . Immunity from liability.
   (1) The following, if acting in good faith, are not liable in any civil or criminal action for
       any act taken or not taken under the authority of Sections 26B-4-406 through 26B-4-411
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      Enrolled Copy                                                                                 H.B. 475
      with respect to an anaphylactic reaction, or asthma emergency:
      (a) a qualified adult;
      (b) a physician, pharmacist, or any other person or entity authorized to prescribe or
          dispense prescription drugs;
      (c) a person who conducts training described in Section 26B-4-407 or 26B-4-408;
      (d) a qualified epinephrine auto-injector entity; [and]
      (e) a qualified stock albuterol entity[.] ;
      (f) the department;
      (g) a local health department;
      (h) a local education agency; and
      (i) a local emergency medical services entity.
  (2) Section 53G-9-502 does not apply to the administration of an epinephrine auto-injector
      or stock albuterol in accordance with this part.
  (3) This section does not eliminate, limit, or reduce any other immunity from liability or
      defense against liability that may be available under state law.
        Section 4. Section 58-17b-1005 is amended to read:
        58-17b-1005 . Standing prescription drug orders for epinephrine auto-injectors
  and stock albuterol.
  [(1) A physician acting in the physician's capacity as an employee of the Department of
      Health or as a medical director of a local health department may issue a standing
      prescription drug order authorizing the dispensing of an epinephrine auto-injector under
      Section 58-17b-1004 in accordance with a protocol that:]
      [(a) requires the physician to specify the persons, by professional license number,
          authorized to dispense the epinephrine auto-injector;]
      [(b) requires the physician to review at least annually the dispensing practices of those
          authorized by the physician to dispense the epinephrine auto-injector;]
      [(c) requires those authorized by the physician to dispense the epinephrine auto-injector to
          make and retain a record of each dispensing, including:]
          [(i) the name of the qualified adult or qualified epinephrine auto-injector entity to whom
              the epinephrine auto-injector is dispensed;]
          [(ii) a description of the epinephrine auto-injector dispensed; and]
          [(iii) other relevant information; and]
      [(d) is approved by the division by administrative rule made in accordance with Title 63G,
          Chapter 3, Utah Administrative Rulemaking Act, in collaboration with the Physicians
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      H.B. 475                                                                               Enrolled Copy
            Licensing Board created in Section 58-67-201 and the Board of Pharmacy.]
   (1) As used in this section:
       (a) "Epinephrine protocol" means a protocol that:
            (i) requires a physician to specify the persons, by professional license number,
                authorized to dispense the epinephrine auto-injector;
            (ii) requires a physician to review at least annually the dispensing practices of the
                persons authorized by the physician to dispense the epinephrine auto-injector;
            (iii) requires those authorized by a physician to dispense the epinephrine auto-injector
                to make and retain a record of each dispensing, including:
                (A) the name of the qualified adult or qualified epinephrine auto-injector entity to
                    whom the epinephrine auto-injector is dispensed;
                (B) a description of the epinephrine auto-injector dispensed; and
                (C) other relevant information; and
            (iv) is approved by the division through rule made in ac