Emergency Epinephrine Auto-Injectors for Schools - S.L. 2014-100 (S 744), Sec. 8.23
Single-use epinephrine auto-injectors (often called EpiPens[1]) are a medical device used to counteract anaphylaxis, a severe allergic reaction. Several instances in which students have died from anaphylaxis while at school have prompted a national movement to ensure the availability of these devices in schools. North Carolina has had a law permitting students to carry and self-administer EpiPens if certain conditions are met since 2005 (G.S. 115C-375.2, enacted by S.L. 2005-22, summarized here). In addition, students who did not meet the criteria for self-administration could provide an EpiPen to school personnel to administer in an emergency. However, there was no requirement for schools to stock epinephrine devices for students who did not provide their own.
Single-use epinephrine auto-injectors (often called EpiPens[1]) are a medical device used to counteract anaphylaxis, a severe allergic reaction. Several instances in which students have died from anaphylaxis while at school have prompted a national movement to ensure the availability of these devices in schools. North Carolina has had a law permitting students to carry and self-administer EpiPens if certain conditions are met since 2005 (G.S. 115C-375.2, enacted by S.L. 2005-22, summarized here). In addition, students who did not meet the criteria for self-administration could provide an EpiPen to school personnel to administer in an emergency. However, there was no requirement for schools to stock epinephrine devices for students who did not provide their own.
The federal School Access to Emergency Epinephrine Act (P.L. 113-48) authorized the US Department of Health and Human Services to give preference in awarding asthma treatment grants to states that require schools to maintain stocks of epinephrine auto-injectors, permit trained personnel to administer the medicine, and develop plans by which such personnel are available during all hours of the school day. Section 8.23 of S.L. 2014-100 (S 744) enacted new G.S. 115C-375.2A to meet these criteria in North Carolina. The new statute requires local boards of education to provide for a supply of epinephrine auto-injectors on school property. Each school must have at least two auto-injectors stored in a secure but unlocked and easily accessible location for use by trained school personnel in an emergency. Each principal must designate one or more school personnel to be trained in the emergency use of the devices. The training must be conducted by a school nurse or a qualified representative of the local health department. The school nurse or other trained person for each school must obtain a non-patient-specific prescription for epinephrine auto-injectors from the local health department. To assist in implementing this provision, the NC Division of Public Health has requested that the Board of Pharmacy place epinephrine auto-injectors on the formulary of drugs that may be dispensed by trained public health nurse dispensers. The Board of Pharmacy has proposed rules to do this. A separate provision in S.L. 2014-100 directs the North Carolina Board of Pharmacy to adopt additional rules to authorize schools to obtain non-patient-specific prescriptions in accordance with the new law.
The new statute also requires each principal to collaborate with other appropriate school personnel to develop an action plan for use of EpiPens in an emergency. Minimum components of the plan are specified in the new law and include calling emergency services and notifying affected students’ parents and physicians when the devices are used.
An amendment to G.S. 115C-238.29F requires the Department of Public Instruction to ensure that charter schools comply with all of the new requirements, and to direct the boards of directors of charter schools to provide the necessary supply of epinephrine auto-injectors.
Finally, the law provides qualified immunity from civil liability for local health department health care providers, school officials, school employees, and school volunteers for acts or omissions relating to the new requirements. All of the new provisions are effective November 1, 2014.
[1] The term “EpiPen” is used colloquially as if it were a generic term and that is how I am using it here, but it is actually the brand name for a epinephrine auto-injector manufactured by Mylan Pharmaceuticals. Other products include Auvi-Q (a product of Sanofi US), Twinject and Adrenaclick (both manufactured by Sciele Pharma).