2014 -- H 7576

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LC004745

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2014

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A N   A C T

RELATING TO HEALTH AND SAFETY - EPINEPHRINE

     

     Introduced By: Representatives Serpa, and Fellela

     Date Introduced: February 26, 2014

     Referred To: House Health, Education & Welfare

     It is enacted by the General Assembly as follows:

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     SECTION 1. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby

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amended by adding thereto the following chapter:

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CHAPTER 6.4

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LIFE-SAVING ALLERGY MEDICATION - STOCK SUPPLY OF EPINEPRHINE AUTO-

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INJECTORS - EMERGENCY ADMINISTRATION

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     23-6.4-1. Definitions. -- As used in this chapter:

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     (1) “Administer” means the direct application of an epinephrine auto-injector to the body

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of an individual.

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     (2) “Authorized entity” means any entity or organization at or in connection with where

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allergens capable of causing anaphylaxis may be present, including, but not limited to, restaurants

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recreation camps, youth sports leagues, amusement parks, and sports arenas; provided, however,

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a school described in § 16-21-22.1 is an authorized entity for purposes of § 23-6.4-5.

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     (3) “Authorized health care provider” means a physician, nurse or other person duly

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authorized by law in the state in which they practice to prescribe drugs.

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     (4) “Epinephrine auto-injector” means a single-use device used for the automatic

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injection of a premeasured dose of epinephrine into the human body.

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     (5) “Provide” means the supplying of one or more epinephrine auto-injectors to an

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individual.

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     (6) “Self-administration” means a person’s discretionary use of an epinephrine auto-

 

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injector.

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     23-6.4-2. Prescribing to an authorized entity permitted. – An authorized health care

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provider may prescribe epinephrine auto-injectors in the name of an authorized entity for use in

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accordance with this section, and pharmacists may dispense epinephrine auto-injectors pursuant

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to a prescription issued in the name of an authorized entity.

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      23-6.4-3. Designated entities permitted to maintain supply. – An authorized entity

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may acquire and stock a supply of epinephrine auto-injectors pursuant to a prescription issued in

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accordance with this chapter. Such epinephrine auto-injectors shall be stored in a location readily

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accessible in an emergency and in accordance with the epinephrine auto-injector’s instructions for

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use and any additional requirements that may be established by the department of health. An

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authorized entity shall designate employees or agents who have completed the training required

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by § 23-6.5-6 to be responsible for the storage, maintenance, and general oversight of epinephrine

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auto-injectors acquired by the authorized entity.

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     23-6.4-4. Use of epinephrine auto-injectors. – An employee or agent of an authorized

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entity, or other individual, who has completed the training required by § 23-6.5-6 may, on the

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premises of or in connection with the authorized entity, use epinephrine auto-injectors prescribed

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pursuant to § 23-6.4-2 to:

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     (1) Provide an epinephrine auto-injector to any individual who the employee, agent, or

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other individual believes in good faith is experiencing anaphylaxis for immediate self-

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administration, regardless of whether the individual has a prescription for an epinephrine auto-

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injector or has previously been diagnosed with an allergy.

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     (2) Administer an epinephrine auto-injector to any individual who the employee, agent,

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or other individual believes in good faith is experiencing anaphylaxis, regardless of whether the

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individual has a prescription for an epinephrine auto-injector or has previously been diagnosed

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with an allergy.

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     23-6.4-5. Expanded availability. – An authorized entity that acquires a stock supply of

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epinephrine auto-injectors pursuant to a prescription issued in accordance with this chapter may

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make such epinephrine auto-injectors available to individuals other than those trained individuals

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described in § 23-6.5-4, and such individuals may administer such epinephrine auto-injector to

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any individual believed in good faith to be experiencing anaphylaxis, if the epinephrine auto-

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injectors are stored in a locked, secure container and are made available only upon remote

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authorization by an authorized health care provider after consultation with the authorized health

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care provider by audio, televideo, or other similar means of electronic communication.

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Consultation with an authorized health care provider for this purpose shall not be considered the

 

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practice of telemedicine or otherwise be construed as violating any law or rule regulating the

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authorized health care provider’s professional practice.

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     23-6.4-6. Training. – An employee, agent, or other individual described in § 23-6.5-4

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must complete an anaphylaxis training program prior to providing or administering an

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epinephrine auto-injector made available by an authorized entity. Such training shall be

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conducted by a nationally recognized organization experienced in training laypersons in

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emergency health treatment, or an entity or individual approved by the department of health.

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Training may be conducted online or in person and, at a minimum, shall cover:

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     (1) Techniques on how to recognize symptoms of severe allergic reactions, including

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anaphylaxis;

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     (2) Standards and procedures for the storage and administration of an epinephrine auto-

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injector; and

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     (3) Emergency follow-up procedures.

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     The entity that conducts the training shall issue a certificate, on a form developed or

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approved by the department of health, to each person who successfully completes the anaphylaxis

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training program.

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     23-6.4-7. Good Samaritan protections. – An authorized entity that possesses and makes

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available epinephrine auto-injectors and its employees, agents, and other trained individuals; a

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person that uses an epinephrine auto-injector made available pursuant to § 23-6.5-5; an authorized

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health care provider that prescribes epinephrine auto-injectors to an authorized entity; and an

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individual or entity that conducts the training described in § 23-6.5-6 shall not be liable for any

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civil damages that result from the administration or self-administration of an epinephrine auto-

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injector, the failure to administer an epinephrine auto-injector, or any other act or omission taken

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pursuant to this chapter; provided, however, this immunity does not apply to acts or omissions

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constituting gross negligence or willful or wanton conduct. The administration of an epinephrine

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auto-injector in accordance with this chapter is not the practice of medicine. This section does not

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eliminate, limit, or reduce any other immunity or defense that may be available under state law.

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An entity located in this state shall not be liable for any injuries or related damages that result

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from the provision or administration of an epinephrine auto-injector by its employees or agents

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outside of this state if the entity or its employee or agent:

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     (1) Would not have been liable for such injuries or related damages had the provision or

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administration occurred within this state; or

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     (2) Are not liable for such injuries or related damages under the law of the state in which

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such provision or administration occurred.

 

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     23-6.4-8. Reporting. – An authorized entity that possesses and makes available

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epinephrine auto-injectors shall submit to the department of health, on a form developed by the

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department of health, a report of each incident on the authorized entity’s premises that involves

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the administration of an epinephrine auto-injector. The department of health shall annually

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publish a report that summarizes and analyzes all reports submitted to it under this section.

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY - EPINEPHRINE

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     This act would significantly regulate the use and acquisition of epinephrine auto-injectors

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to treat allergic reactions.

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     This act would take effect upon passage.

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