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An Act To Establish Guidelines for the Stocking and Administration of Epinephrine Autoinjectors in Schools
Mandate preamble.  This measure requires one or more local units of government to expand or modify activities so as to necessitate additional expenditures from local revenues but does not provide funding for at least 90% of those expenditures. Pursuant to the Constitution of Maine, Article IX, Section 21, 2/3 of all of the members elected to each House have determined it necessary to enact this measure.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  20-A MRSA §6305  is enacted to read:
§ 6305. Epinephrine autoinjectors; guidelines; emergency administration
 
1.  Definitions.     As used in this section, unless the context otherwise indicates, the following terms have the following meanings.
 
A.  "Collaborative practice agreement" means a written and signed agreement between a physician licensed in this State or a school health advisor under section 6402-A and a school nurse under section 6403-A that provides for the prescription of epinephrine autoinjectors by the physician or school health advisor and administration of epinephrine autoinjectors by a school nurse or designated school personnel to students during school or a school-sponsored activity under emergency circumstances involving anaphylaxis.
 
B.  "Designated school personnel" means those employees, agents or volunteers of a school administrative unit or an approved private school designated by a collaborative practice agreement between a physician licensed in this State or a school health advisor under section 6402-A and a school nurse under section 6403-A who have completed the training required by rule to provide or administer an epinephrine autoinjector to a student.
 
C.  "Epinephrine autoinjector" means a device that automatically injects a premeasured dose of epinephrine.
 
D.  "School" means a public or approved private school.
 
2.  Collaborative practice agreement; adoption authorized.     A school administrative unit or an approved private school may authorize adoption of a collaborative practice agreement for the purposes of stocking and administering epinephrine autoinjectors as provided under this section. The administration of an epinephrine autoinjector in accordance with this section is not the practice of medicine.
 
3.  Collaborative practice agreement; authority.     A collaborative practice agreement permits a physician licensed in this State or school health advisor under section 6402-A to prescribe an epinephrine autoinjector and direct a school nurse under section 6403-A to administer an epinephrine autoinjector in good faith to any student experiencing anaphylaxis during school or a school-sponsored activity. Pursuant to a collaborative practice agreement, a physician licensed in this State or school health advisor under section 6402-A may authorize the school nurse under section 6403-A during school or a school-sponsored activity to designate other school personnel with training required by rule to administer an epinephrine autoinjector if the school nurse is not present when a student experiences anaphylaxis.
 
4.  Collaborative practice agreement; terms and provisions.     A collaborative practice agreement must include the following information:
 
A.  Name and physical address of the school;
 
B.  Identification and signatures of the physician or school health advisor under section 6402-A and school nurse under section 6403-A who are parties to the collaborative practice agreement, the dates the agreement is signed by each party and the beginning and end dates of the period of time within which the agreement is in effect; and
 
C.  Any other information considered appropriate by the physician or school health advisor under section 6402-A and school nurse under section 6403-A.
 
5.  Use of epinephrine autoinjectors without a collaborative practice agreement.     The governing body of a school administrative unit or an approved private school may authorize a school nurse under section 6403-A and designated school personnel to administer an epinephrine autoinjector to a student in accordance with a prescription specific to the student on file with the school nurse and in accordance with section 254, subsection 5. The administration of an epinephrine autoinjector in accordance with this subsection is not the practice of medicine.
 
6.  Manufacturer or supplier arrangement.     A school administrative unit or an approved private school may enter into an arrangement with a manufacturer of epinephrine autoinjectors or a 3rd-party supplier of epinephrine autoinjectors to obtain epinephrine autoinjectors at fair market prices or reduced prices or for free.
 
7.  Purchase from licensed pharmacies.     A collaborative practice agreement under this section may provide that a school administrative unit or an approved private school may purchase epinephrine autoinjectors from a pharmacy licensed in this State.
 
8.  Guidelines.     By December 1, 2015 and as needed after that date, the department in consultation with the Department of Health and Human Services shall develop and make available to all schools guidelines for the management of students with life-threatening allergies. The guidelines must include, but are not limited to:
 
A.  Guidelines regarding education and training for school personnel on the management of students with life-threatening allergies, including training related to the administration of an epinephrine autoinjector;
 
B.  Procedures for responding to life-threatening allergic reactions;
 
C.  A process for the development of individualized health care and allergy action plans for students with known life-threatening allergies; and
 
D.  Protocols to prevent exposure to allergens.
 
9.  Plan.     By September 1, 2016 and as needed after that date, the governing body of a school administrative unit or an approved private school shall:
 
A.  Implement a protocol based on the guidelines developed pursuant to subsection 8 for the management of students with life-threatening allergies enrolled in the schools under its jurisdiction; and
 
B.  Make the protocol under paragraph A available on the governing body's publicly accessible website or the publicly accessible website of each school under the governing body's jurisdiction or, if those websites do not exist, make the protocol publicly available through other means as determined by the governing body.
 
The governing body of the school administrative unit or the approved private school shall annually attest to the department that the schools under its jurisdiction are implementing the protocol in accordance with the provisions of this subsection.
Sec. 2. Rules. By December 1, 2015, the Department of Education, in consultation with the Department of Health and Human Services, shall amend their rules relating to medication administration in schools in the State to carry out the provisions of the Maine Revised Statutes, Title 20-A, section 6305. Rules adopted pursuant to this section are major substantive rules as defined in Title 5, chapter 375, subchapter 2-A. The rules must:
1. Encourage each school administrative unit and approved private school to submit to the Department of Education, on a form developed by the Department of Education, a report of each incident in the school administrative unit or the approved private school or at a school event involving a severe allergic reaction or the administration of an epinephrine autoinjector;
2. Provide for the development and publication, without disclosing personally identifying information, of an annual report by the Department of Education compiling, summarizing and analyzing all incident reports submitted pursuant to subsection 1; and
3. Establish detailed standards for training programs overseen by school nurses that must be completed by designated school personnel in order to provide or administer an epinephrine autoinjector in accordance with Title 20-A, section 6305. The training program may be conducted online and must, at a minimum, cover:
A. Techniques on how to recognize symptoms of severe allergic reactions, including anaphylaxis;
B. Standards and procedures for the storage and administration of epinephrine autoinjectors; and
C. Emergency follow-up procedures.
 
Effective 90 days following adjournment of the 126th Legislature, Second Regular Session, unless otherwise indicated.