2023 - 2024 LEGISLATURE
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2023 ASSEMBLY BILL 9
February 7, 2023 - Introduced by Representatives SORTWELL, GOEBEN, SHANKLAND,
BRANDTJEN, BROOKS, CABRERA, KNODL, MOSES, MURPHY, ROZAR, SUBECK, TITTL,
TUSLER, WICHGERS and VINING, cosponsored by Senators JACQUE, BALLWEG,
COWLES, SPREITZER and WANGGAARD. Referred to Committee on Health, Aging
and Long-Term Care.
1 AN ACT to repeal 118.29 (1) (bm), 118.292 (1g) (b), 118.292 (1g) (bm), 118.2925
2 (1) (d), 118.2925 (1) (fm), 255.07 (1) (c) and 255.07 (1) (e); to amend 118.29 (2)
3 (a) 2m., 118.292 (1r) (intro.), 118.292 (1r) (a), 118.292 (2) (a), 118.292 (2) (b),
4 118.2925 (1) (h), 118.2925 (3), 118.2925 (4) (a), (b) and (c), 118.2925 (4m) (a),
5 118.2925 (4m) (b), 118.2925 (5), 255.07 (2) (a), 255.07 (2) (b), 255.07 (3), 255.07
6 (4), 255.07 (5) (a) 2., 255.07 (5) (a) 3., 255.07 (6) (a) (intro.), 255.07 (6) (a) 1., 2.
7 and 3., 255.07 (6) (b), 255.07 (6) (d), 255.07 (6) (e), 255.07 (6) (f), 448.03 (2) (q)
8 and 450.11 (4) (a) 5. d.; and to create 118.29 (1) (br), 118.292 (1g) (bg), 118.2925
9 (1) (dm) and 255.07 (1) (cm) of the statutes; relating to: use of epinephrine
10 delivery systems and standing orders for epinephrine.
Analysis by the Legislative Reference Bureau
This bill amends current law authority related to the possession,
administration, and dispensing of epinephrine auto-injectors and prefilled syringes
of epinephrine to instead include all epinephrine delivery systems. Under the bill,
“epinephrine delivery system” is defined to mean a device that is approved by the
federal Food and Drug Administration, that contains a dose of epinephrine, and that
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ASSEMBLY BILL 9
is used to administer epinephrine into the human body to prevent or treat a
life-threatening allergic reaction.
Current law allows designated school personnel, school nurses, and other
authorized entities and individuals who have completed a training program to
provide or administer epinephrine auto-injectors and prefilled syringes to pupils
and other individuals. “Authorized entities” are those entities or organizations that
operate or participate in a business, activity, or event where anaphylaxis-causing
allergens may be present. Authorized entities include restaurants, camps,
institutions of higher education, places of employment, amusement parks, and
sports leagues and arenas. The bill allows the same individuals and entities to
provide or administer any epinephrine delivery system.
Under current law, pupils are also allowed to possess and use an epinephrine
auto-injector or a prefilled syringe in certain circumstances while in school,
participating in a school-sponsored activity, or under supervision by a school. Under
the bill, pupils are allowed to possess and use any epinephrine delivery system under
those same circumstances.
In addition, current law allows prescribers to prescribe epinephrine
auto-injectors and prefilled syringes in the name of the school or the name of the
authorized entity or individual. The bill provides prescribing authority for any
epinephrine delivery system.
Finally, current law allows any prescriber to issue a standing order or a
statewide standing order for the dispensing of epinephrine auto-injectors or
prefilled syringes for use by trained individuals. The bill allows prescribers to issue
a standing order or statewide standing orders for any epinephrine delivery system
for use by trained individuals.
For further information see the state and local fiscal estimate, which will be
printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
1 SECTION 1. 118.29 (1) (bm) of the statutes is repealed.
2 SECTION 2. 118.29 (1) (br) of the statutes is created to read:
3 118.29 (1) (br) “Epinephrine delivery system” means a device that is approved
4 by the federal food and drug administration, that contains a dose of epinephrine, and
5 that is used to administer epinephrine into the human body to prevent or treat a
6 life-threatening allergic reaction.
7 SECTION 3. 118.29 (2) (a) 2m. of the statutes is amended to read:
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ASSEMBLY BILL 9 SECTION 3
1 118.29 (2) (a) 2m. Except for epinephrine administered under subd. 2., may use
2 an epinephrine auto-injector, or prefilled syringe, as defined in s. 118.292 (1g) (bm),
3 epinephrine delivery system to administer epinephrine to any pupil who appears to
4 be experiencing a severe allergic reaction if, as soon as practicable, the school bus
5 operator, employee or volunteer reports the allergic reaction by dialing the telephone
6 number “911" or, in an area in which the telephone number “911" is not available, the
7 telephone number for an emergency medical service provider.
8 SECTION 4. 118.292 (1g) (b) of the statutes is repealed.
9 SECTION 5. 118.292 (1g) (bg) of the statutes is created to read:
10 118.292 (1g) (bg) “Epinephrine delivery system” means a device that is
11 approved by the federal food and drug administration, that contains a dose of
12 epinephrine, and that is used to administer epinephrine into the human body to
13 prevent or treat a life-threatening allergic reaction.
14 SECTION 6. 118.292 (1g) (bm) of the statutes is repealed.
15 SECTION 7. 118.292 (1r) (intro.) of the statutes is amended to read:
16 118.292 (1r) (intro.) While in school, at a school-sponsored activity or under
17 the supervision of a school authority, a pupil may possess and use an epinephrine
18 auto-injector or prefilled syringe epinephrine delivery system if all of the following
19 are true:
20 SECTION 8. 118.292 (1r) (a) of the statutes is amended to read:
21 118.292 (1r) (a) The pupil uses the epinephrine auto-injector or prefilled
22 syringe epinephrine delivery system to prevent the onset or alleviate the symptoms
23 of an emergency situation.
24 SECTION 9. 118.292 (2) (a) of the statutes is amended to read:
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ASSEMBLY BILL 9 SECTION 9
1 118.292 (2) (a) A pupil as a result of using an epinephrine auto-injector or
2 prefilled syringe epinephrine delivery system under sub. (1r).
3 SECTION 10. 118.292 (2) (b) of the statutes is amended to read:
4 118.292 (2) (b) Any person as a result of a pupil possessing or using an
5 epinephrine auto-injector or prefilled syringe epinephrine delivery system under
6 sub. (1r).
7 SECTION 11. 118.2925 (1) (d) of the statutes is repealed.
8 SECTION 12. 118.2925 (1) (dm) of the statutes is created to read:
9 118.2925 (1) (dm) “Epinephrine delivery system” means a device that is
10 approved by the federal food and drug administration, that contains a dose of
11 epinephrine, and that is used to administer epinephrine into the human body to
12 prevent or treat a life-threatening allergic reaction.
13 SECTION 13. 118.2925 (1) (fm) of the statutes is repealed.
14 SECTION 14. 118.2925 (1) (h) of the statutes is amended to read:
15 118.2925 (1) (h) “Self-administer" means to administer an epinephrine
16 auto-injector or prefilled syringe epinephrine delivery system to one's own body.
17 SECTION 15. 118.2925 (3) of the statutes is amended to read:
18 118.2925 (3) PRESCRIPTIONS FOR SCHOOLS. A physician, an advanced practice
19 nurse prescriber, or a physician assistant may prescribe epinephrine auto-injectors
20 or prefilled syringes epinephrine delivery systems in the name of a school that has
21 adopted a plan under sub. (2) (a), to be maintained by the school for use under sub.
22 (4).
23 SECTION 16. 118.2925 (4) (a), (b) and (c) of the statutes are amended to read:
24 118.2925 (4) (a) Provide an epinephrine auto-injector or prefilled syringe
25 epinephrine delivery system to a pupil to self-administer the epinephrine
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ASSEMBLY BILL 9 SECTION 16
1 auto-injector or prefilled syringe epinephrine delivery system in accordance with a
2 prescription specific to the pupil that is on file with the school.
3 (b) Administer an epinephrine auto-injector or prefilled syringe epinephrine
4 delivery system to a pupil in accordance with a prescription specific to the pupil that
5 is on file with the school.
6 (c) Administer an epinephrine auto-injector or prefilled syringe epinephrine
7 delivery system to a pupil or other person who the school nurse or designated school
8 personnel in good faith believes is experiencing anaphylaxis in accordance with a
9 standing protocol from a physician, an advanced practice nurse prescriber, or a
10 physician assistant, regardless of whether the pupil or other person has a
11 prescription for an epinephrine auto-injector or prefilled syringe epinephrine
12 delivery system. If the pupil or other person does not have a prescription for an
13 epinephrine auto-injector or prefilled syringe, epinephrine delivery system, or the
14 person who administers the epinephrine auto-injector or prefilled syringe
15 epinephrine delivery system does not know whether the pupil or other person has a
16 prescription for an epinephrine auto-injector or prefilled syringe epinephrine
17 delivery system, the person who administers the epinephrine auto-injector or
18 prefilled syringe epinephrine delivery system shall, as soon as practicable, report the
19 administration by dialing the telephone number “911" or, in an area in which the
20 telephone number “911" is not available, the telephone number for an emergency
21 medical service provider.
22 SECTION 17. 118.2925 (4m) (a) of the statutes is amended to read:
23 118.2925 (4m) (a) The authority to self-administer an epinephrine
24 auto-injector or prefilled syringe epinephrine delivery system under sub. (4) (a) is
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1 independent of the authorized possession and use of an epinephrine auto-injector or
2 prefilled syringe epinephrine delivery system under s. 118.292 (1r).
3 SECTION 18. 118.2925 (4m) (b) of the statutes is amended to read:
4 118.2925 (4m) (b) The authority to administer an epinephrine auto-injector or
5 prefilled syringe epinephrine delivery system under sub. (4) (b) and (c) is
6 independent of the authority to administer an epinephrine auto-injector
7 epinephrine delivery system under s. 118.29 (2) (a) 2. and 2m.
8 SECTION 19. 118.2925 (5) of the statutes is amended to read:
9 118.2925 (5) IMMUNITY FROM CIVIL LIABILITY; EXEMPTION FROM PRACTICE OF
10 MEDICINE. A school and its designated school personnel, and a physician, advanced
11 practice nurse prescriber, or physician assistant who provides a prescription or
12 standing protocol for school epinephrine auto-injectors or prefilled syringes
13 epinephrine delivery systems, are not liable for any injury that results from the
14 administration or self-administration of an epinephrine auto-injector or prefilled
15 syringe epinephrine delivery system under this section, regardless of whether
16 authorization was given by the pupil's parent or guardian or by the pupil's physician,
17 physician assistant, or advanced practice nurse prescriber, unless the injury is the
18 result of an act or omission that constitutes gross negligence or willful or wanton
19 misconduct. The immunity from liability provided under this subsection is in
20 addition to and not in lieu of that provided under s. 895.48.
21 SECTION 20. 255.07 (1) (c) of the statutes is repealed.
22 SECTION 21. 255.07 (1) (cm) of the statutes is created to read:
23 255.07 (1) (cm) “Epinephrine delivery system” means a device that is approved
24 by the federal food and drug administration, that contains a dose of epinephrine, and
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1 that is used to administer epinephrine into the human body to prevent or treat a
2 life-threatening allergic reaction.
3 SECTION 22. 255.07 (1) (e) of the statutes is repealed.
4 SECTION 23. 255.07 (2) (a) of the statutes is amended to read:
5 255.07 (2) (a) A health care practitioner may prescribe an epinephrine
6 auto-injector or prefilled syringe epinephrine delivery system in the name of an
7 authorized entity or an authorized individual for use in accordance with this section.
8 A health care practitioner may issue to one or more persons a standing order
9 authorizing the dispensing of epinephrine auto-injectors or prefilled syringes
10 epinephrine delivery systems for use under sub. (4) by an authorized individual or
11 by an employee or agent of an authorized entity who has completed the training
12 required by sub. (5).
13 SECTION 24. 255.07 (2) (b) of the statutes is amended to read:
14 255.07 (2) (b) A health care provider with prescribing authority who is
15 employed by or under contract with the department may issue a statewide standing
16 order for the dispensing of epinephrine auto-injectors or prefilled syringes
17 epinephrine delivery systems for use under sub. (4) by authorized individuals or by
18 employees or agents of authorized entities who have completed the training required
19 by sub. (5).
20 SECTION 25. 255.07 (3) of the statutes is amended to read:
21 255.07 (3) AUTHORIZED ENTITIES OR INDIVIDUALS PERMITTED TO MAINTAIN SUPPLY.
22 An authorized entity or an authorized individual may acquire and maintain a supply
23 of epinephrine auto-injectors and prefilled syringes epinephrine delivery systems
24 pursuant to a prescription issued in accordance with this section. The authorized
25 entity or authorized individual shall store an epinephrine auto-injector or prefilled
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1 syringe epinephrine delivery system in a location readily accessible in an emergency
2 and in accordance with the epinephrine auto-injector's or prefilled syringe's
3 epinephrine delivery system's instructions for use. An authorized entity shall
4 designate an employee or agent who has completed the training required in sub. (5)
5 to be responsible for the storage, maintenance, control, and general oversight of
6 epinephrine auto-injectors or prefilled syringes epinephrine delivery systems
7 acquired by the authorized entity.
8 SECTION 26. 255.07 (4) of the statutes is amended to read:
9 255.07 (4) USE OF EPINEPHRINE. An employee or agent of an authorized entity
10 who has completed the training required by sub. (5) or an authorized individual may
11 use an epinephrine auto-injector or prefilled syringe epinephrine delivery system
12 prescribed under sub. (2) to do any of the following:
13 (a) Provide one or more epinephrine auto-injectors or prefilled syringes
14 epinephrine delivery systems to any individual who the employee, agent, or
15 authorized individual believes in good faith is experiencing anaphylaxis, or to the
16 parent, guardian, or caregiver of that individual for immediate administration,
17 regardless of whether the individual has a prescription for an epinephrine
18 auto-injector or prefilled syringe epinephrine delivery system or has previously been
19 diagnosed with an allergy.
20 (b) Administer an epinephrine auto-injector or prefilled syringe epinephrine
21 delivery system to any individual who the employee, agent, or authorized individual
22 believes in good faith is experiencing anaphylaxis, regardless of whether the
23 individual has a prescription for an epinephrine auto-injector or prefilled syringe
24 epinephrine delivery system or has previously been diagnosed with an allergy.
25 SECTION 27. 255.07 (5) (a) 2. of the statutes is amended to read:
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ASSEMBLY BILL 9 SECTION 27
1 255.07 (5) (a) 2. Standards and procedures for the storage and administration
2 of an epinephrine auto-injector and, if applicable, a prefilled syringe epinephrine
3 delivery system.
4 SECTION 28. 255.07 (5) (a) 3. of the sta