SENATE FLOOR SUBSTITUTE FOR

SENATE JUDICIARY COMMITTEE SUBSTITUTE FOR

SENATE BILL 75 AND SENATE BILL 165

51st legislature - STATE OF NEW MEXICO - second session, 2014

AN ACT

RELATING TO PUBLIC HEALTH; REQUIRING THE DEPARTMENT OF HEALTH TO PROMULGATE RULES REGARDING THE USE OF ALBUTEROL TO TREAT RESPIRATORY DISTRESS AND THE USE OF EPINEPHRINE TO TREAT ANAPHYLACTIC REACTIONS IN SCHOOLS; PROVIDING FOR THE STOCK SUPPLY OF ALBUTEROL AND EPINEPHRINE IN SCHOOLS; PROVIDING FOR SCHOOL POLICIES AND RELATED LAWS TO COMPORT WITH FEDERAL GRANT REQUIREMENTS REGARDING EMERGENCY MEDICATION IN SCHOOLS.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

     SECTION 1. A new section of the Public School Code is enacted to read:

     "[NEW MATERIAL] SHORT TITLE.--Sections 1 through 4 of this act may be cited as the "Emergency Medication in Schools Act"."

     SECTION 2. A new section of the Public School Code is enacted to read:

     "[NEW MATERIAL] DEFINITIONS.--As used in the Emergency Medication in Schools Act:

          A. "albuterol" includes albuterol or another inhaled bronchodilator, as recommended by the department of health, for the treatment of respiratory distress;

          B. "albuterol aerosol canister" means a portable drug delivery device packaged with multiple premeasured doses of albuterol;

          C. "anaphylaxis" or "anaphylactic reaction" means a sudden, severe and potentially life-threatening whole-body allergic reaction;

          D. "emergency medication" means albuterol or epinephrine;

          E. "epinephrine" includes epinephrine or another medication, as recommended by the department of health, used to treat anaphylaxis until the immediate arrival of emergency medical system responders;

          F. "epinephrine auto-injector" means a portable, disposable drug delivery device that contains a premeasured single dose of epinephrine;

          G. "governing body" includes a governing body of a private school;

          H. "health care practitioner" means a person authorized by the state to prescribe emergency medication;

          I. "respiratory distress" includes impaired oxygenation of the blood or impaired ventilation of the respiratory system;

          J. "school" means a public school, charter school or private school;

          K. "spacer" means a holding chamber that is used to optimize the delivery of albuterol to a person's lungs;

          L. "stock supply" means an appropriate quantity of emergency medication, as recommended by the department of health; and

          M. "trained personnel" means a school employee, agent or volunteer who has completed epinephrine administration training documented by the school nurse, school principal or school leader and approved by the department of health and who has been designated by the school principal or school leader to administer epinephrine on a voluntary basis outside of the scope of employment."

     SECTION 3. A new section of the Public School Code is enacted to read:

     "[NEW MATERIAL] EMERGENCY MEDICATION--ALBUTEROL--EPINEPHRINE--STOCK SUPPLY--STORAGE.--

          A. Each local school board or governing body may obtain a standing order for and may provide to schools within its jurisdiction a stock supply of albuterol aerosol canisters and spacers prescribed in the name of the school or school district by a health care practitioner employed or authorized by the department of health. Each school that receives a stock supply of albuterol aerosol canisters and spacers pursuant to this subsection shall store them:

                (1) in a secure location that is unlocked and readily accessible to a school nurse to administer albuterol;

                (2) pursuant to board of pharmacy regulations; and

                (3) within the manufacturer-recommended temperature range.

          B. Each local school board or governing body

may obtain a standing order for and may provide to schools within its jurisdiction a stock supply of standard-dose and pediatric-dose epinephrine auto-injectors prescribed in the name of each school by a health care practitioner employed or authorized by the department of health. Each school that receives a stock supply of standard-dose and pediatric-dose epinephrine auto-injectors pursuant to this subsection shall store them:

                (1) in a secure location that is unlocked and readily accessible to trained personnel;

                (2) pursuant to board of pharmacy regulations; and

                (3) within the manufacturer-recommended temperature range.

          C. Each local school board or governing body shall dispose of expired emergency medication pursuant to board of pharmacy regulations or department of health rules.

          D. A local school board or governing body or a school within its jurisdiction may accept gifts, grants, bequests and donations from any source to carry out the provisions of the Emergency Medication in Schools Act, including the acceptance of albuterol aerosol canisters and spacers and epinephrine auto-injectors from a manufacturer or wholesaler."

     SECTION 4. A new section of the Public School Code is enacted to read:

     "[NEW MATERIAL] LOCAL SCHOOL BOARD OR GOVERNING BODY--EMERGENCY MEDICATION--PROTOCOLS AND POLICIES--TRAINING.--

          A. Each local school board or governing body that provides to schools within its jurisdiction a stock supply of albuterol aerosol canisters and spacers shall develop policies, based on department of health rules and recommendations, for a school nurse to administer albuterol to a student who is perceived to be in respiratory distress, regardless of whether the student has been identified or documented as having asthma, has a prescription for albuterol or has supplied the school with albuterol. Such policies shall include procedures to:

                (1) recognize the symptoms of respiratory distress;

                (2) administer albuterol using a spacer;

                (3) call 911 to initiate an emergency medical system;

                (4) continue to monitor the student's condition and deliver any additional treatment indicated until an emergency medical system responder arrives;

                (5) notify the parent, guardian or legal custodian of the student having respiratory distress; and

                (6) take any other necessary actions based on training completed pursuant to the Emergency Medication in Schools Act.

          B. Each local school board or governing body that provides to schools within its jurisdiction a stock supply of standard-dose and pediatric-dose epinephrine auto-injectors shall develop policies based on the protocols in this section and department of health rules and recommendations, publish the policies on its web site and receive documentation that trained personnel have received training to:

                (1) administer epinephrine to a student who is reasonably believed to be having an anaphylactic reaction, regardless of whether the student has been identified or documented as having a severe allergy, has a prescription for epinephrine or has supplied the school with epinephrine auto-injectors; and

                (2) follow an anaphylaxis action protocol to:

                     (a) recognize symptoms of anaphylaxis;

                     (b) administer an epinephrine auto- injector to a student reasonably believed to be having an anaphylactic reaction;

                     (c) call 911 to initiate an emergency medical system;

                     (d) continue to monitor the student's condition and deliver any additional treatment indicated until an emergency medical system responder arrives;

                     (e) notify the parent, guardian or legal custodian of the student having an anaphylactic reaction; and

                     (f) take any other necessary actions based on training completed pursuant to the Emergency Medication in Schools Act.

          C. Each school that receives a stock supply of standard-dose and pediatric-dose epinephrine auto-injectors shall:

                (1) develop and implement a plan to have one or more trained personnel on the school premises during operating hours; and

                (2) follow an anaphylactic reaction prevention protocol, as recommended by the department of health, to minimize an allergic student's exposure to food allergies."

     SECTION 5. A new section of the Public Health Act is enacted to read:

     "[NEW MATERIAL] EMERGENCY MEDICATION IN SCHOOLS--ALBUTEROL--EPINEPHRINE--RULES--RECOMMENDATIONS.--

          A. By July 1, 2014, the department shall promulgate rules and make recommendations to each school district and governing body of a school for the prevention and treatment of respiratory distress and the administration of albuterol, or such other medication as the department deems appropriate, by a school nurse.

          B. By July 1, 2014, the department shall promulgate rules and make recommendations to each school district and governing body of a school for the prevention and treatment of anaphylaxis occurring in schools and for the use of epinephrine, or such other medication as the department deems appropriate, by a person who has received training approved by the department and is authorized to administer epinephrine pursuant to the Emergency Medication in Schools Act. The rules shall address:

                (1) the provision or administration of epinephrine, or such other medication as the department deems appropriate, to a person reasonably believed to be having an anaphylactic reaction;

                (2) the requirement that one or more trained persons be available on school premises during operating hours to treat a person reasonably believed to be having an anaphylactic reaction;

                (3) the maintenance of a stock supply of standard-dose and pediatric-dose epinephrine auto-injectors, or such other medication as the department deems appropriate, pursuant to a standing order prescribed in the name of the school or school district by a health care practitioner employed or authorized by the department;

                (4) the storage of a stock supply of standard-dose and pediatric-dose epinephrine auto-injectors, or such other medication as the department deems appropriate, in a secure location that is unlocked and readily accessible to trained persons and stored pursuant to board of pharmacy regulations; and

                (5) the disposal of expired emergency medication pursuant to board of pharmacy regulations or department rules.

          C. A health care practitioner employed or authorized by the department may prescribe a stock supply of albuterol aerosol canisters and spacers or a stock supply of standard-dose and pediatric-dose epinephrine auto-injectors in the name of a school or school district for use in accordance with the Emergency Medication in Schools Act.

          D. A pharmacist may dispense a stock supply of albuterol aerosol canisters and spacers or a stock supply of standard-dose and pediatric-dose epinephrine auto-injectors pursuant to a standing order prescribed in accordance with this section.

          E. A school or school district may maintain a stock supply of albuterol aerosol canisters and spacers or a stock supply of standard-dose and pediatric-dose epinephrine auto- injectors for use in accordance with this section. 

          F. The department may obtain and receive grants, appropriations, gifts and donations from any source, including the acceptance of epinephrine and albuterol, or such other medication as the department deems appropriate, and albuterol spacers from a manufacturer or wholesaler of such medication in accordance with this section."

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