WSR 18-03-039 PERMANENT RULES DEPARTMENT OF HEALTH [Filed January 9, 2018, 1:23 p.m., effective February 9, 2018] Effective Date of Rule: Thirty-one days after filing. Purpose: Chapter 246-570 WAC, the department of health (department) adopted a new chapter of rules to implement 2016 legislation, SSB 6421, which was codified as RCW 70.54.440. The rules provide epinephrine autoinjector and anaphylaxis training and reporting for authorized entities. Citation of Rules Affected by this Order: New WAC 246-570-001, 246-570-010, 246-570-020, 246-570-030, 246-570-040, 246-570-050, 246-570-060, and 246-570-070. Adopted under notice filed as WSR 17-17-143 on August 22, 2017. Changes Other than Editing from Proposed to Adopted Version: WAC 246-570-030, the phrase "… must complete an epinephrine autoinjector training program prior to administering …" was changed to "… must complete an epinephrine autoinjector training by an approved training provider, as defined in WAC 246-570-040 prior to storing, maintaining, providing or administering …" WAC 246-570-070(4) the word "suspend" was added to read "If the department notifies a training program of the department's intent to deny, suspend or revoke approval …" WAC 246-570-070(4) was also changed to note that a training provider seeking to appeal a department action must do so within twenty-eight days of the "training provider's receipt" of the decision instead of when the department mails the adverse notice. All other changes were clarifying edits. A final cost-benefit analysis is available by contacting Brett Lorentson, Washington State Department of Health, P.O. Box 47852, Olympia, WA 98504-7852, phone 360-236-4611, fax 360-236-2901, TTY 360-833-6388 or 711, email Brett.Lorentson@doh.wa.gov. Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 4, Amended 0, Repealed 0. Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0. Number of Sections Adopted on the Agency's own Initiative: New 4, Amended 0, Repealed 0. Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0. Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 8, Amended 0, Repealed 0. Date Adopted: January 8, 2018. John Wiesman, DrPH, MPH Secretary
Chapter 246-570 WAC
EPINEPHRINE AUTOINJECTORS AND ANAPHYLAXIS TRAINING AND REPORTING FOR AUTHORIZED ENTITIES NEW SECTION
WAC 246-570-001 Purpose.
The purpose of this chapter is to establish the requirements for epinephrine autoinjectors and anaphylaxis training for employees and representatives of authorized entities under RCW 70.54.440.
NEW SECTION
WAC 246-570-010 Definitions.
The definitions in this section apply throughout this chapter unless the context clearly indicates otherwise.
(1) "Administer" or "administration" means the direct application of an epinephrine autoinjector to the body of an individual.
(2) "Authorized entity" means any entity or organization at or in connection with which allergens capable of causing anaphylaxis may be present including, but not limited to, restaurants, recreation camps, youth sports leagues, amusement parks, colleges, universities, and sports arenas.
(3) "Department" means the Washington state department of health.
(4) "Dispenser" means a health care provider who may dispense epinephrine autoinjectors pursuant to a prescription issued in the name of an authorized entity.
(5) "Epinephrine autoinjector" means a single-use device used for the automatic injection of a premeasured dose of epinephrine into the human body.
(6) "Prescriber" means an authorized health care provider allowed by law to prescribe an epinephrine autoinjector in the course of professional practice.
(7) "Training provider" means an organization, entity, business, or individual who provides epinephrine autoinjector and anaphylaxis training.
(8) "Self-administration" means a person's discretionary use of an epinephrine autoinjector on themselves.
NEW SECTION
WAC 246-570-020 Proof of epinephrine autoinjector and anaphylaxis training to obtain an epinephrine autoinjector for an authorized entity.
Prior to prescribing or dispensing an epinephrine autoinjector to an authorized entity, a prescriber or dispenser may require proof of epinephrine autoinjector and anaphylaxis training.
NEW SECTION
WAC 246-570-030 Epinephrine autoinjector and anaphylaxis training certification.
An employee or representative of an authorized entity shall complete an epinephrine autoinjector and anaphylaxis training by an approved training provider, as defined in WAC 246-570-040, prior to storing, maintaining, providing or administering an epinephrine autoinjector made available by an authorized entity.
NEW SECTION
WAC 246-570-040 Approved epinephrine autoinjector and anaphylaxis training provider.
(1) Epinephrine autoinjector and anaphylaxis training must be conducted by:
(a) A nationally recognized organization experienced in training laypersons in emergency health treatment. For the purposes of this section, the American Red Cross anaphylaxis and epinephrine autoinjector training course is an approved training provider; or
(b) A training provider approved by the department must meet the following requirements:
(i) Training content must meet the requirements in WAC 246-570-050;
(ii) Each individual providing training shall have:
(A) Knowledge of epinephrine autoinjector and anaphylaxis; and
(B) Experience delivering training in epinephrine autoinjector administration, and anaphylaxis causes and symptoms.
(2) A training provider shall issue a certificate to each person who successfully completes training. The certificate must include:
(a) The training provider's name, address and other contact information;
(b) Name of the training participant;
(c) Date the training was completed;
(d) Expiration date, if any; and
(e) The name of the training or other information indicating that the training was in anaphylaxis and epinephrine autoinjector storage, maintenance, and administration.
NEW SECTION
WAC 246-570-050 Epinephrine autoinjector and anaphylaxis training content.
(1) Epinephrine autoinjector and anaphylaxis training may be conducted online or in person and at a minimum, must include:
(a) Techniques on how to recognize symptoms of severe allergic reactions, including anaphylaxis;
(b) Standards and procedures for the storage and administration of an epinephrine autoinjector;
(c) Emergency follow-up procedures;
(d) The use and administration of an epinephrine autoinjector with adults and children; and
(e) An assessment to ensure the participant gained competency in anaphylaxis and epinephrine autoinjector administration.
(2) Training must be based on current best practices.
NEW SECTION
WAC 246-570-060 Epinephrine autoinjector incident reporting.
(1) Each authorized entity must report to the department each incident when an employee or representative who holds a training certificate under WAC 246-570-030 administers or provides an epinephrine autoinjector to a person believed to be suffering from anaphylaxis.
(2) The incident report must be reported within five days of the incident.
(3) The incident report must be on a form or format provided by the department.
NEW SECTION
WAC 246-570-070 Training approval process.
The secretary will consider for approval any training provider which meets the requirements as outlined in this chapter.
(1) An authorized representative of the training provider shall request approval on a form provided by the department.
(2) The training provider must submit documentation demonstrating that training content meets the requirements of WAC 246-570-050.
(3) Upon the evaluation of a complete application, the secretary will grant or deny approval.
(4) If the department notifies a training provider of the department's intent to deny, suspend or revoke approval, the training provider may request an adjudicative proceeding under chapter 246-10 WAC. A request for an adjudicative proceeding must be in writing, state the basis for contesting the adverse action, include a copy of the adverse notice and be served on and received by the department within twenty-eight days of the training provider's receipt of the adverse notice.
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