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ARIZONA STATE SENATE
Fifty-Sixth Legislature, Second 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.
Background
A school district governing board (governing board) or charter school governing body (governing body) may adopt policies and procedures according to certain requirements for a pupil to manage their diabetes in the classroom, on school grounds and at school-sponsored activities as authorized by the primary health professional who is a physician assistant (PA) or doctor of medicine (MD), osteopathy or naturopathic medicine, a nurse practitioner (NP) or a pharmacist in a collaborative practice agreement (pharmacist). Adopted policies and procedures may designate two or more employees to serve as voluntary diabetes care assistants (diabetes assistants) who may administer insulin or glucagon to a pupil in an emergency situation if: 1) a school nurse, doctor or pharmacist is not immediately available to attend the pupil; and 2) the diabetes assistant is authorized to administer glucagon or insulin and the pupil's parent or guardian provides a glucagon kit or insulin and all necessary supplies prescribed by a doctor, NP or pharmacist (A.R.S. § 15-344.01).
It is unprofessional conduct for a licensed MD 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 a governing board or governing body to annually request a standing order for glucagon from the chief medical officer of the Department of Health Services (DHS) or a county health department, a licensed MD or doctor of osteopathy, an NP or PA.
2. Authorizes a school to stock doses of glucagon at school sites for emergency administration to a pupil by a school nurse, nurse under contract with the school district or charter school, a licensed MD, doctor of osteopathy or doctor of naturopathic medicine, NP, PA or diabetes assistant.
3. Authorizes a governing board or governing body to adopt policies and procedures for the emergency administration of glucagon to a pupil whom the administrating person believes in good faith to be exhibiting symptoms of hypoglycemia while at school or at a school-sponsored activity, by a:
a) school nurse;
b) nurse under contract with the school district or charter school;
c) licensed MD, doctor of osteopathy or doctor of naturopathic medicine;
d) NP or PA; or
e) trained diabetes assistant.
4. Specifies that the authorization for the outlined individuals to administer glucagon applies regardless of whether or not the pupil has been diagnosed with diabetes or has a diabetes medical management plan on file with the school.
5. Determines that a diabetes assistant is trained in administering glucagon if the diabetes assistant provides the school district or charter school a written statement signed by a licensed health professional attesting that the diabetes assistant has received the prescribed training.
6. Authorizes a school district or charter school to:
a) apply to grants or accept monetary donations for purchasing glucagon; or
b) participate in third-party programs to obtain glucagon at no cost, at a fair market price or at a reduced price.
7. Immunizes from civil liability with respect to decisions made and actions taken based on good faith implementation of glucagon administration requirements:
a) the chief medical officers of DHS or a county health department;
b) licensed MD, doctor of osteopathy and doctor of naturopathic medicine;
c) licensed NPs and PAs;
d) volunteer health professionals;
e) trained diabetes assistants;
f) school districts; and
g) charter schools.
8. Excludes from the definition of unprofessional conduct for a licensed MD 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.
9. Excludes, from the definition of 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.
10. Becomes effective on the general effective date.
Prepared by Senate Research
February 12, 2024
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