1     
SCHOOL PRESCRIPTION AMENDMENTS

2     
2024 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Mark A. Strong

5     
Senate Sponsor: ____________

6     

7     LONG TITLE
8     General Description:
9          This bill modifies provisions related to certain prescription drugs and schools.
10     Highlighted Provisions:
11          This bill:
12          ▸     defines terms;
13          ▸     requires certain health care providers to provide a prescription upon request to
14     certain school employees or a school nurse for epinephrine, albuterol, and glucagon
15     for use in an emergency situation subject to restrictions;
16          ▸     waives liability for certain persons; and
17          ▸     makes technical and conforming changes.
18     Money Appropriated in this Bill:
19          None
20     Other Special Clauses:
21          None
22     Utah Code Sections Affected:
23     AMENDS:
24          26B-4-401, as renumbered and amended by Laws of Utah 2023, Chapter 307
25          26B-4-409, as renumbered and amended by Laws of Utah 2023, Chapter 307
26          26B-4-410, as renumbered and amended by Laws of Utah 2023, Chapter 307
27          53G-9-501, as enacted by Laws of Utah 2018, Chapter 3
28          53G-9-504, as last amended by Laws of Utah 2019, Chapters 293, 349
29     

30     Be it enacted by the Legislature of the state of Utah:
31          Section 1. Section 26B-4-401 is amended to read:
32          26B-4-401. Definitions.
33          As used in this part:
34          (1) "Agent" means a coach, teacher, employee, representative, or volunteer.
35          (2) (a) "Amateur sports organization" means, except as provided in Subsection (2)(b):
36          (i) a sports team;
37          (ii) a public or private school;
38          (iii) a public or private sports league;
39          (iv) a public or private sports camp; or
40          (v) any other public or private organization that organizes, manages, or sponsors a
41     sporting event for its members, enrollees, or attendees.
42          (b) "Amateur sports organization" does not include a professional:
43          (i) team;
44          (ii) league; or
45          (iii) sporting event.
46          (3) "Anaphylaxis" means a potentially life-threatening hypersensitivity to a substance.
47          (a) Symptoms of anaphylaxis may include shortness of breath, wheezing, difficulty
48     breathing, difficulty talking or swallowing, hives, itching, swelling, shock, or asthma.
49          (b) Causes of anaphylaxis may include insect sting, food allergy, drug reaction, and
50     exercise.
51          (4) "Asthma action plan" means a written plan:
52          (a) developed with a school nurse, a student's parent or guardian, and the student's
53     health care provider to help control the student's asthma; and
54          (b) signed by the student's:
55          (i) parent or guardian; and
56          (ii) health care provider.
57          (5) "Asthma emergency" means an episode of respiratory distress that may include
58     symptoms such as wheezing, shortness of breath, coughing, chest tightness, or breathing
59     difficulty.
60          (6) "Child" means an individual who is under the age of 18.
61          (7) "Department health care provider" means a health care provider who is acting in the
62     capacity of a health care provider during employment for the department.
63          [(7)] (8) "Epinephrine auto-injector" means a portable, disposable drug delivery device
64     that contains a measured, single dose of epinephrine that is used to treat a person suffering a
65     potentially fatal anaphylactic reaction.
66          [(8)] (9) "Health care provider" means an individual who is licensed as:
67          (a) a physician under Title 58, Chapter 67, Utah Medical Practice Act;
68          (b) a physician under Title 58, Chapter 68, Utah Osteopathic Medical Practice Act;
69          (c) an advanced practice registered nurse under Section 58-31b-302; or
70          (d) a physician assistant under Title 58, Chapter 70a, Utah Physician Assistant Act.
71          [(9)] (10) "Pharmacist" means the same as that term is defined in Section 58-17b-102.
72          [(10)] (11) "Pharmacy intern" means the same as that term is defined in Section
73     58-17b-102.
74          [(11)] (12) "Physician" means the same as that term is defined in Section 58-67-102.
75          (13) "Public school" means a district school or a charter school.
76          [(12)] (14) "Qualified adult" means a person who:
77          (a) is [18 years of age or older] at least 18 years old; and
78          (b) (i) for purposes of administering an epinephrine auto-injector, has successfully
79     completed the training program established in Section 26B-4-407; and
80          (ii) for purposes of administering stock albuterol, has successfully completed the
81     training program established in Section 26B-4-408.
82          [(13)] (15) "Qualified epinephrine auto-injector entity":
83          (a) means a facility or organization that employs, contracts with, or has a similar
84     relationship with a qualified adult who is likely to have contact with another person who may
85     experience anaphylaxis; and
86          (b) includes:
87          (i) recreation camps;
88          (ii) an education facility, school, or university;
89          (iii) a day care facility;
90          (iv) youth sports leagues;
91          (v) amusement parks;
92          (vi) food establishments;
93          (vii) places of employment; and
94          (viii) recreation areas.
95          [(14)] (16) "Qualified health care provider" means a health care provider who:
96          (a) is licensed under Title 58, Occupations and Professions; and
97          (b) may evaluate and manage a concussion within the health care provider's scope of
98     practice.
99          [(15)] (17) "Qualified stock albuterol entity" means a public or private school that
100     employs, contracts with, or has a similar relationship with a qualified adult who is likely to
101     have contact with another person who may experience an asthma emergency.
102          [(16)] (18) (a) "Sporting event" means any of the following athletic activities that is
103     organized, managed, or sponsored by an organization:
104          (i) a game;
105          (ii) a practice;
106          (iii) a sports camp;
107          (iv) a physical education class;
108          (v) a competition; or
109          (vi) a tryout.
110          (b) "Sporting event" does not include:
111          (i) the issuance of a lift ticket or pass by a ski resort, the use of the ticket or pass, or a
112     ski or snowboarding class or school at a ski resort, unless the skiing or snowboarding is part of
113     a camp, team, or competition that is organized, managed, or sponsored by the ski resort;
114          (ii) as applied to a government entity, merely making available a field, facility, or other
115     location owned, leased, or controlled by the government entity to an amateur sports
116     organization or a child, regardless of whether the government entity charges a fee for the use;
117     or
118          (iii) free play or recess taking place during school hours.
119          [(17)] (19) "Stock albuterol" means a prescription inhaled medication:
120          (a) used to treat asthma; and
121          (b) that may be delivered through a device, including:
122          (i) an inhaler; or
123          (ii) a nebulizer with a mouthpiece or mask.
124          [(18)] (20) "Traumatic head injury" means an injury to the head arising from blunt
125     trauma, an acceleration force, or a deceleration force, with one of the following observed or
126     self-reported conditions attributable to the injury:
127          (a) transient confusion, disorientation, or impaired consciousness;
128          (b) dysfunction of memory;
129          (c) loss of consciousness; or
130          (d) signs of other neurological or neuropsychological dysfunction, including:
131          (i) seizures;
132          (ii) irritability;
133          (iii) lethargy;
134          (iv) vomiting;
135          (v) headache;
136          (vi) dizziness; or
137          (vii) fatigue.
138          Section 2. Section 26B-4-409 is amended to read:
139          26B-4-409. Authority to obtain and use an epinephrine auto-injector or stock
140     albuterol.
141          [(1) A qualified adult who is a teacher or other school employee at a public or private
142     primary or secondary school in the state, or a school nurse, may obtain from the school district
143     physician, the medical director of the local health department, or the local emergency medical
144     services director a prescription for:]
145          [(a) epinephrine auto-injectors for use in accordance with this part; or]
146          [(b) stock albuterol for use in accordance with this part.]
147          (1) The school district physician, a department health care provider, the medical
148     director of the local health department, or the local emergency medical services director shall
149     provide a prescription for the following if requested by a qualified adult, who is a teacher or
150     other school employee at a public or private primary or secondary school in the state, or a
151     school nurse:
152          (a) epinephrine auto-injectors for use in accordance with this part; or
153          (b) stock albuterol for use in accordance with this part.
154          (2) (a) A qualified adult may obtain an epinephrine auto-injector for use in accordance
155     with this part that is dispensed by:
156          (i) a pharmacist as provided under Section 58-17b-1004; or
157          (ii) a pharmacy intern as provided under Section 58-17b-1004.
158          (b) A qualified adult may obtain stock albuterol for use in accordance with this part
159     that is dispensed by:
160          (i) a pharmacist as provided under Section 58-17b-1004; or
161          (ii) a pharmacy intern as provided under Section 58-17b-1004.
162          (3) A qualified adult:
163          (a) may immediately administer an epinephrine auto-injector to a person exhibiting
164     potentially life-threatening symptoms of anaphylaxis when a physician is not immediately
165     available; and
166          (b) shall initiate emergency medical services or other appropriate medical follow-up in
167     accordance with the training materials retained under Section 26B-4-407 after administering an
168     epinephrine auto-injector.
169          (4) If a school nurse is not immediately available, a qualified adult:
170          (a) may immediately administer stock albuterol to an individual who:
171          (i) has a diagnosis of asthma by a health care provider;
172          (ii) has a current asthma action plan on file with the school; and
173          (iii) is showing symptoms of an asthma emergency as described in the student's asthma
174     action plan; and
175          (b) shall initiate appropriate medical follow-up in accordance with the training
176     materials retained under Section 26B-4-408 after administering stock albuterol.
177          (5) (a) A qualified entity that complies with Subsection (5)(b) or (c), may obtain a
178     supply of epinephrine auto-injectors or stock albuterol, respectively, from a pharmacist under
179     Section 58-17b-1004, or a pharmacy intern under Section 58-17b-1004 for:
180          (i) storing:
181          (A) the epinephrine auto-injectors on the qualified epinephrine auto-injector entity's
182     premises; and
183          (B) stock albuterol on the qualified stock albuterol entity's premises; and
184          (ii) use by a qualified adult in accordance with Subsection (3) or (4).
185          (b) A qualified epinephrine auto-injector entity shall:
186          (i) designate an individual to complete an initial and annual refresher training program
187     regarding the proper storage and emergency use of an epinephrine auto-injector available to a
188     qualified adult; and
189          (ii) store epinephrine auto-injectors in accordance with the standards established by the
190     department in Section 26B-4-411.
191          (c) A qualified stock albuterol entity shall:
192          (i) designate an individual to complete an initial and annual refresher training program
193     regarding the proper storage and emergency use of stock albuterol available to a qualified
194     adult; and
195          (ii) store stock albuterol in accordance with the standards established by the department
196     in Section 26B-4-411.
197          Section 3. Section 26B-4-410 is amended to read:
198          26B-4-410. Immunity from liability.
199          (1) The following, if acting in good faith, are not liable in any civil or criminal action
200     for any act taken or not taken under the authority of Sections 26B-4-406 through 26B-4-411
201     with respect to an anaphylactic reaction, or asthma emergency:
202          (a) a qualified adult;
203          (b) a physician, pharmacist, or any other person or entity authorized to prescribe or
204     dispense prescription drugs;
205          (c) a person who conducts training described in Section 26B-4-407 or 26B-4-408;
206          (d) a qualified epinephrine auto-injector entity; [and]
207          (e) a qualified stock albuterol entity[.];
208          (f) the department;
209          (g) a local health department;
210          (h) a local education agency; and
211          (i) a local emergency medical services entity.
212          (2) Section 53G-9-502 does not apply to the administration of an epinephrine
213     auto-injector or stock albuterol in accordance with this part.
214          (3) This section does not eliminate, limit, or reduce any other immunity from liability
215     or defense against liability that may be available under state law.
216          Section 4. Section 53G-9-501 is amended to read:
217          53G-9-501. Definitions.
218          [Reserved] As used in this part:
219          (1) "Department health care provider" means a health care provider acting in the
220     capacity of a health care provider during employment for the Department of Health and Human
221     Services.
222          (2) "Glucagon authorization" means a signed statement from a parent of a student with
223     diabetes:
224          (a) certifying that glucagon has been prescribed for the student;
225          (b) requesting that the student's public school identify and train school personnel who
226     volunteer to be trained in the administration of glucagon in accordance with this section; and
227          (c) authorizing the administration of glucagon in an emergency to the student in
228     accordance with this section.
229          (3) "Health care provider" means an individual who is licensed as:
230          (a) a physician under Title 58, Chapter 67, Utah Medical Practice Act, or Title 58,
231     Chapter 68, Utah Osteopathic Medical Practice Act;
232          (b) an advanced practice registered nurse under Section 58-31b-302; or
233          (c) a physician assistant under Title 58, Chapter 70a, Utah Physician Assistant Act.
234          (4) "Public school" means a district school or a charter school.
235          Section 5. Section 53G-9-504 is amended to read:
236          53G-9-504. Administration of glucagon -- Training of volunteer school personnel
237     -- Authority to use glucagon -- Immunity from liability.
238          [(1) As used in this section, "glucagon authorization" means a signed statement from a
239     parent of a student with diabetes:]
240          [(a) certifying that glucagon has been prescribed for the student;]
241          [(b) requesting that the student's public school identify and train school personnel who
242     volunteer to be trained in the administration of glucagon in accordance with this section; and]
243          [(c) authorizing the administration of glucagon in an emergency to the student in
244     accordance with this section.]
245          [(2)] (1) (a) A public school shall, within a reasonable time after receiving a glucagon
246     authorization, train two or more school personnel who volunteer to be trained in the
247     administration of glucagon, with training provided by the school nurse or another qualified,
248     licensed medical professional.
249          (b) A public school shall allow all willing school personnel to receive training in the
250     administration of glucagon, and the school shall assist and may not obstruct the identification
251     or training of volunteers under this Subsection [(2)] (1).
252          (c) The Utah Department of Health and Human Services, in cooperation with the state
253     superintendent, shall design a glucagon authorization form to be used by public schools in
254     accordance with this section.
255          [(3)] (2) (a) Training in the administration of glucagon shall include:
256          (i) techniques for recognizing the symptoms that warrant the administration of
257     glucagon;
258          (ii) standards and procedures for the storage and use of glucagon;
259          (iii) other emergency procedures, including calling the emergency 911 number and
260     contacting, if possible, the student's parent; and
261          (iv) written materials covering the information required under this Subsection [(3)] (2).
262          (b) A school shall retain for reference the written materials prepared in accordance with
263     Subsection [(3)(a)(iv)] (2)(a)(iv).
264          [(4)] (3) A public school shall permit a student or school personnel to possess or store
265     prescribed glucagon so that it will be available for administration in an emergency in
266     accordance with this section.
267          [(5)] (4) (a) A person who has received training in accordance with this section may
268     administer glucagon at a school or school activity to a student with a glucagon authorization if:
269          (i) the student is exhibiting the symptoms that warrant the administration of glucagon;
270     and
271          (ii) a licensed health care professional is not immediately available.
272          (b) A person who administers glucagon in accordance with Subsection [(5)(a)] (4)(a)
273     shall direct a responsible person to call 911 and take other appropriate actions in accordance
274     with the training materials retained under Subsection [(3)(b)] (2)(b).
275          (5) (a) The school district physician, a department health care provider, the medical
276     director of the local health department, or the local emergency medical services director shall
277     provide a prescription for glucagon to be administered in accordance with this section if
278     requested by school personnel, who are trained to administer glucagon, or the school nurse.
279          (b) School personnel or a school nurse that obtains glucagon in accordance with this
280     section may only use the glucagon in accordance with this section.
281          (6) [School personnel who provide or receive training under this section and] The
282     following who act in good faith are not liable in any civil or criminal action for any act taken or
283     not taken under the authority of this section with respect to the administration of glucagon[.]:
284          (a) school personnel who provide or receive training under this section;
285          (b) a physician, pharmacist, or any other person or entity authorized to prescribe or
286     dispense prescription drugs;
287          (c) the Department of Health and Human Services;
288          (d) a local health department;
289          (e) a local education agency; and
290          (f) a local emergency medical services entity.
291          (7) Section 53G-9-502 does not apply to the administration of glucagon in accordance
292     with this section.
293          (8) Section 53G-8-205 does not apply to the possession and administration of glucagon
294     in accordance with this section.
295          (9) The unlawful or unprofessional conduct provisions of Title 58, Occupations and
296     Professions, do not apply to a person licensed as a health professional under Title 58,
297     Occupations and Professions, including a nurse, physician, physician assistant, or pharmacist
298     who, in good faith[,]:
299          (a) trains nonlicensed volunteers to administer glucagon in accordance with this
300     section[.]; or
301          (b) provides glucagon or a glucagon prescription in accordance with Subsection (5)(a).
302          Section 6. Effective date.
303          This bill takes effect on May 1, 2024.