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ARIZONA STATE SENATE
Fifty-Sixth Legislature, First Regular Session
school personnel; emergency glucagon administration
Purpose
Authorizes specified health professionals and trained school district or charter school employees to administer glucagon pursuant to a standing order to a person believed to be exhibiting symptoms of hypoglycemia while at school or at a school-sponsored activity. Requires the State Board of Education (SBE) to prescribe policies and procedures for school districts and charter schools that elect to administer glucagon as outlined.
Background
A school district governing board (governing board) or charter school
governing body (governing body) must prescribe policies for the emergency
administration of epinephrine
auto-injectors by a trained employee. A governing board or governing body may
prescribe policies for the emergency administration of inhalers by a trained
employee or a nurse under contract with the school district or charter school
(A.R.S. §§ 15-189.04;
15-341;
and 15-342).
The SBE must adopt rules for school districts and charter schools
relating to the emergency administration of epinephrine auto-injectors and
inhalers, including: 1) annual training requirements; 2) procedures for
emergency administration, requesting standing orders; and
3) reporting or notifying a parent of the administration (A.R.S.
§ 15-203).
It is unprofessional conduct for a licensed doctor of medicine or doctor of osteopathy to prescribe, dispense or furnish a prescription medication to a person without conducting an examination or having a previously-established doctor-patient relationship. It is unprofessional conduct for a licensed pharmacist or pharmacy intern to knowingly dispense a prescription order issued through the business of dispensing drugs pursuant to a diagnosis by mail or the internet. Statute outlines exemptions from the definitions of unprofessional conduct relating to prescriptions for epinephrine auto-injectors written or dispensed for a school district or charter school to be stocked for emergency use (A.R.S. §§ 32-1401; 32-1800; and 32-1901.01).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Authorizes the following individuals, pursuant to a standing order issued by a county health department's chief medical officer, to administer, or assist in the administration of, glucagon to a student or adult whom the employee, in good faith, believes to be exhibiting symptoms of hypoglycemia while at school or at a school-sponsored activity:
a) a licensed doctor of medicine or doctor of osteopathy; and
b) a licensed nurse practitioner, nurse under contract with a school district or charter school or a school district or charter school employee trained in the administration of glucagon.
2. Authorizes a governing board or governing body to prescribe and enforce policies and procedures for the emergency administration of glucagon by either or both of the following:
a) a trained school district or charter school employee; and
b) a nurse under contract with the school district or charter school.
3. Immunizes from civil liability with respect to decisions made and actions taken based on good faith implementation of glucagon administration requirements:
a) chief medical officers of county health departments;
b) licensed doctors of medicine or doctors of osteopathy;
c) licensed nurse practitioners;
d) school districts; and
e) charter schools.
4. Excludes, from civil immunity, cases of gross negligence, wilful misconduct or intentional wrongdoing.
5. Requires the SBE to adopt rules that prescribe the following for school districts and charter schools that elect to administer glucagon:
a) annual training in procedures to follow when assisting a student with diabetes, in accordance with good clinical practice, including specified training;
b) requirements for school districts and charter schools that elect to administer glucagon to designate at least two employees at each school to receive the annual training;
c) procedures for glucagon administration in emergency situations, as directed on the prescription protocol;
d) procedures for annually requesting a standing order for glucagon from the chief medical officer of a county health department, a doctor of medicine, doctor of osteopathy or nurse practitioner; and
e) procedures for calling 911 and notifying a parent once glucagon has been administered.
6. Requires the SBE-prescribed annual training to include training to:
a) check blood glucose and record results;
b) recognize and respond to the symptoms of hypoglycemia;
c) recognize and respond to symptoms of hyperglycemia;
d) estimate the number of carbohydrates in a snack or lunch; and
e) administer glucagon, as directed on the prescription protocol, by designated medical school personnel.
7. Requires the SBE, when adopting glucagon administration rules, to consult with:
a) the Arizona Department of Education;
b) medical professionals;
c) school health professionals;
d) school administrators; and
e) an organization that represents school nurses in Arizona.
8. Authorizes a school district or charter school to accept:
a) monetary donations for or apply for grants to purchase glucagon; or
b) donations of glucagon directly from the product manufacturer.
9. Excludes, from unprofessional conduct relating to a licensed doctor of medicine or doctor of osteopathy, writing or dispensing glucagon prescriptions without an examination or established doctor-patient relationship, if the prescription is for a school district or charter school to be stocked for emergency use.
10. Exempts, from unprofessional conduct relating to disciplining a licensed pharmacist or pharmacy intern, knowingly dispensing a prescription order issued through the business of dispensing drugs pursuant to a diagnosis by mail or the internet, if the order is for glucagon that is written or dispensed for a school district or charter school and that is to be stocked for emergency use.
11. Makes technical and conforming changes.
12. Becomes effective on the general effective date.
Prepared by Senate Research
February 13, 2023
LB/slp