Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

Health Care & Wellness Committee

HB 1528

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Background:

Epinephrine is a medication used to treat anaphylactic reactions or sudden, life-threatening allergic reactions. Anaphylactic shock is a serious allergic reaction that is rapid in onset and may cause death. It typically causes a number of symptoms including an itchy rash, throat swelling, breathing problems, and low blood pressure. Common causes of an anaphylactic reaction include insect bites or stings, foods, and medications.

An epinephrine autoinjector is a medical device used most frequently for the treatment of acute allergic reactions to avoid or treat the onset of anaphylactic shock. These medical devises deliver a single, measured dose of epinephrine, also known as adrenaline, using a spring-loaded needle injected into a recipient's muscle.

In 2013, the Legislature authorized epinephrine autoinjectors to be placed on school property and used by the school nurse or a designated trained school employee to respond to an anaphylactic reaction by a student.

Summary of Bill:

Permission to Prescribe, Store, and Use Epinephrine Autoinjectors.

An authorized health care provider (provider) may prescribe epinephrine autoinjectors in the name of an authorized entity (entity), and a pharmacist or physician may dispense such a prescription. Authorized entities are organizations at which allergens capable of causing anaphylaxis may be present, including restaurants, sports arenas, and recreation camps. Pursuant to a valid prescription, an entity may maintain a supply of epinephrine autoinjectors stored in a location accessible in an emergency and consistent with the medication’s instructions for use and rules set by the Department of Health (DOH).

Trained employees or agents of the authorized entity are responsible for storing, maintaining, and overseeing the use of epinephrine autoinjectors. Trained individuals may provide or administer an epinephrine autoinjector to any individual who the employee, agent, or other individual believes in good faith is experiencing anaphylaxis. In addition, an untrained individual may administer an entity’s epinephrine autoinjector if a provider authorizes such a use.

Existing authority for schools to maintain, store, and administer a supply of epinephrine autoinjectors is expanded to allow an untrained individual to use the medical device if authorized to do so by a provider.

Training.

Prior to providing or administering an epinephrine autoinjector prescribed to an entity, an individual must complete an online or in-person training program approved by the DOH or conducted by a nationally recognized organization experienced in training laypersons in emergency medical treatment. The training must cover identification of symptoms of severe allergic reactions including anaphylaxis, best practices and procedures for storage and administration of an epinephrine auto injector, and emergency follow-up procedures. Upon completion of training, individuals must receive a certificate on a form developed or approved by the DOH.

Incident Reports.

Each time an entity uses an epinephrine autoinjector, it must submit an incident report to the DOH on a form that the agency develops. Annually, DOH must publish a report that summarizes and analyzes the incident reports received during the reporting period.

Liability.

Individuals or entities prescribing, providing, or administering an epinephrine autoinjector for an authorized entity are not liable for any injuries or damages that result from administration or failure to administer the medication unless such acts or omissions constitute gross negligence or willful or wonton conduct.