H.B. No. 4260

	AN ACT
	relating to the possession and administration of an epinephrine
	auto-injector by certain entities.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  The heading to Section 773.014, Health and
	Safety Code, is amended to read as follows:
	Sec. 773.014.  ADMINISTRATION OF EPINEPHRINE BY EMERGENCY
	MEDICAL SERVICES PERSONNEL.
	SECTION 2.  Subchapter A, Chapter 773, Health and Safety
	Code, is amended by adding Section 773.0145 to read as follows:
	Sec. 773.0145.  POSSESSION AND ADMINISTRATION OF
	EPINEPHRINE BY CERTAIN ENTITIES. (a) This section applies to:
	(1)  an amusement park, as defined by Section 46.035,
	Penal Code;
	(2)  a child-care facility, as defined by Section
	42.002, Human Resources Code;
	(3)  a day camp or youth camp, as defined by Section
	141.002;
	(4)  a private or independent institution of higher
	education, as defined by Section 61.003, Education Code;
	(5)  a restaurant, as defined by Section 17.821,
	Business & Commerce Code;
	(6)  a sports venue, as defined by Section 504.151,
	Local Government Code;
	(7)  a youth center, as defined by Section 481.134; or
	(8)  subject to Subsection (b), any other entity that
	the executive commissioner by rule designates as an entity that
	would benefit from the possession and administration of epinephrine
	auto-injectors.
	(b)  This section does not apply to a governmental entity.
	(c)  An entity described by Subsection (a) may adopt a policy
	regarding the maintenance, administration, and disposal of
	epinephrine auto-injectors.
	(d)  A policy adopted under Subsection (c) must provide that
	only an entity employee or volunteer who is authorized and trained
	may administer an epinephrine auto-injector to a person who is
	reasonably believed to be experiencing anaphylaxis on the premises
	of the entity.
	(e)  The executive commissioner shall adopt rules regarding
	the maintenance, administration, and disposal of an epinephrine
	auto-injector by an entity subject to a policy adopted under
	Subsection (c).  The rules must establish:
	(1)  the number of epinephrine auto-injectors and the
	dosages of the auto-injectors available at each entity;
	(2)  the process for each entity to verify the
	inventory of epinephrine auto-injectors at regular intervals for
	expiration and replacement; and
	(3)  the amount of training required for an entity
	employee or volunteer to administer an epinephrine auto-injector.
	(f)  Each entity that adopts a policy under Subsection (c)
	must have at least one entity employee or volunteer authorized and
	trained to administer an epinephrine auto-injector present during
	all hours the entity is open to the public or to the population that
	the entity serves, as applicable.
	(g)  The supply of epinephrine auto-injectors at each entity
	must:
	(1)  be stored in accordance with the manufacturer's
	instructions in a secure location; and
	(2)  be easily accessible to an entity employee or
	volunteer authorized and trained to administer an epinephrine
	auto-injector.
	(h)  Each entity that adopts a policy under Subsection (c) is
	responsible for training the entity's employees and volunteers in
	the administration of an epinephrine auto-injector.
	(i)  Employee and volunteer training under this section
	must:
	(1)  include information on:
	(A)  the signs and symptoms of anaphylaxis;
	(B)  the recommended dosages for an adult and a
	child;
	(C)  the administration of an epinephrine
	auto-injector;
	(D)  the implementation of emergency procedures,
	if necessary, after administering an epinephrine auto-injector;
	and
	(E)  the proper disposal of used or expired
	epinephrine auto-injectors; and
	(2)  be completed annually in a formal training session
	or through online education.
	(j)  Each entity shall maintain records on the training
	completed by each employee and volunteer under this section.
	(k)  A physician or person who has been delegated
	prescriptive authority under Chapter 157, Occupations Code, may
	prescribe epinephrine auto-injectors in the name of an entity.
	(l)  A physician or other person who prescribes epinephrine
	auto-injectors under Subsection (k) shall provide the entity with a
	standing order for the administration of an epinephrine
	auto-injector to a person reasonably believed to be experiencing
	anaphylaxis.
	(m)  The standing order under Subsection (l) is not required
	to be patient-specific, and the epinephrine auto-injector may be
	administered to a person without a previously established
	physician-patient relationship.
	(n)  Notwithstanding any other law, supervision or
	delegation by a physician is considered adequate if the physician:
	(1)  periodically reviews the order; and
	(2)  is available through direct telecommunication as
	needed for consultation, assistance, and direction.
	(o)  For purposes of Subsection (n)(2), a person who has been
	delegated prescriptive authority under Chapter 157, Occupations
	Code, is not engaged in the unauthorized practice of telemedicine
	or acting outside the person's scope of practice by consulting a
	physician as provided by that subdivision when prescribing an
	epinephrine auto-injector in accordance with this section.
	(p)  An order issued under this section must contain:
	(1)  the name and signature of the prescriber;
	(2)  the name of the entity to which the order is
	issued;
	(3)  the quantity of epinephrine auto-injectors to be
	obtained and maintained under the order; and
	(4)  the date of issue.
	(q)  A pharmacist may dispense an epinephrine auto-injector
	to an entity without requiring the name or any other identifying
	information relating to the user.
	(r)  A person who in good faith takes, or fails to take, any
	action under this section is immune from civil or criminal
	liability or disciplinary action resulting from that action or
	failure to act, including:
	(1)  issuing an order for epinephrine auto-injectors;
	(2)  supervising or delegating the administration of an
	epinephrine auto-injector;
	(3)  possessing, maintaining, storing, or disposing of
	an epinephrine auto-injector;
	(4)  prescribing an epinephrine auto-injector;
	(5)  dispensing an epinephrine auto-injector;
	(6)  administering, or assisting in administering, an
	epinephrine auto-injector;
	(7)  providing, or assisting in providing, training,
	consultation, or advice in the development, adoption, or
	implementation of policies, guidelines, rules, or plans; or
	(8)  undertaking any other act permitted or required
	under this section.
	(s)  The immunities and protections provided by this section
	are in addition to other immunities or limitations of liability
	provided by law.
	(t)  Notwithstanding any other law, this section does not
	create a civil, criminal, or administrative cause of action or
	liability or create a standard of care, obligation, or duty that
	provides a basis for a cause of action for an act or omission under
	this section.
	(u)  A cause of action does not arise from an act or omission
	described by this section.
	(v)  An entity and entity employees or volunteers are immune
	from suit resulting from an act, or failure to act, under this
	section, including an act or failure to act under related policies
	and procedures.
	(w)  An act or failure to act by entity employees or
	volunteers under this section, including an act or failure to act
	under related policies and procedures, is the exercise of judgment
	or discretion on the part of the entity employee or volunteer and is
	not considered to be a ministerial act for purposes of liability of
	the entity.
	SECTION 3.  This Act takes effect September 1, 2019.
	______________________________	______________________________
	President of the Senate	Speaker of the House
	I certify that H.B. No. 4260 was passed by the House on May 3,
	2019, by the following vote:  Yeas 134, Nays 6, 2 present, not
	voting; and that the House concurred in Senate amendments to H.B.
	No. 4260 on May 24, 2019, by the following vote:  Yeas 133, Nays 7,
	3 present, not voting.
	______________________________
	Chief Clerk of the House
	I certify that H.B. No. 4260 was passed by the Senate, with
	amendments, on May 22, 2019, by the following vote:  Yeas 31, Nays
	0.
	______________________________
	Secretary of the Senate
	APPROVED: __________________
	Date
	__________________
	Governor