HB 2801

relating to the definition of an epinephrine delivery device and
the use of those devices in public and private schools.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1.  Section 38.0151(f), Education Code, is amended
(f)  A school district or open-enrollment charter school
that provides for the maintenance, administration, and disposal of
epinephrine delivery devices [auto-injectors] under Subchapter E
is not required to comply with this section.
SECTION 2.  The heading to Subchapter E, Chapter 38,
Education Code, is amended to read as follows:
SUBCHAPTER E.  MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE
DELIVERY DEVICES [AUTO-INJECTORS] AND MEDICATION FOR RESPIRATORY
SECTION 3.  Section 38.201, Education Code, is amended by
amending Subdivision (3-a) and adding Subdivision (3-b) to read as
(3-a)  "Epinephrine delivery device" means a medical
delivery device approved by the United States Food and Drug
Administration that delivers a dose of epinephrine intended for use
to treat anaphylaxis, including:
(A)  an epinephrine auto-injector; and
(B)  an epinephrine nasal spray.
(3-b)  "Medication for respiratory distress" means
albuterol, levalbuterol, or another medication designated by the
executive commissioner of the Health and Human Services Commission
for treatment of respiratory distress under Section 38.208(c).
SECTION 4.  Section 38.202(a), Education Code, is amended to
(a)  The commissioner of state health services shall
establish an advisory committee to examine and review the
administration, on a campus of a school district, an
open-enrollment charter school, a private school, or an institution
(1)  epinephrine delivery devices [auto-injectors] to
a person experiencing an anaphylactic reaction; and
(2)  medication for respiratory distress to a person
experiencing respiratory distress.
SECTION 5.  Section 38.207, Education Code, is amended to
Sec. 38.207.  ADVISORY COMMITTEE: DUTIES.  The advisory
committee shall advise the commissioner of state health services
(1)  the storage and maintenance of epinephrine
delivery devices [auto-injectors] and medication for respiratory
distress on school campuses and campuses of institutions of higher
(2)  the training of school personnel and school
volunteers, and of personnel and volunteers at institutions of
higher education, in the administration of an epinephrine delivery
(3)  the training of school personnel and school
volunteers, and of personnel and volunteers at institutions of
higher education, in the administration of a medication for
(A)  one or more school personnel members or
school volunteers trained in the administration of an epinephrine
delivery device [auto-injector] to be on each school campus;
(B)  one or more school personnel members or
school volunteers trained in the administration of medication for
respiratory distress to be on each school campus;
(C)  one or more personnel members or volunteers
of an institution of higher education trained in the administration
of an epinephrine delivery device [auto-injector] to be on each
campus of an institution of higher education; and
(D)  one or more personnel members or volunteers
of an institution of higher education trained in the administration
of medication for respiratory distress to be on each campus of an
institution of higher education.
SECTION 6.  The heading to Section 38.208, Education Code,
Sec. 38.208.  MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE
DELIVERY DEVICES [AUTO-INJECTORS] AND MEDICATION FOR RESPIRATORY
SECTION 7.  Sections 38.208(a), (b), (c), (d), (d-2), and
(e), Education Code, are amended to read as follows:
(a)  Each school district, open-enrollment charter school,
and private school may adopt and implement a policy regarding the
maintenance, administration, and disposal of epinephrine delivery
devices [auto-injectors] at each campus in the district or school.
(b)  If a policy is adopted under Subsection (a), the policy:
(1)  must provide that school personnel and school
volunteers who are authorized and trained may administer an
epinephrine delivery device [auto-injector] to a person who is
reasonably believed to be experiencing anaphylaxis on a school
(2)  may provide that school personnel and school
volunteers who are authorized and trained may administer an
epinephrine delivery device [auto-injector] to a person who is
reasonably believed to be experiencing anaphylaxis at an off-campus
school event or while in transit to or from a school event.
(c)  The executive commissioner of the Health and Human
Services Commission, in consultation with the commissioner of
education, and with advice from the advisory committee as
appropriate, shall adopt rules regarding the maintenance,
administration, and disposal of an epinephrine delivery device
[auto-injector] at a school campus subject to a policy adopted
under Subsection (a) and the maintenance, administration, and
disposal of medication for respiratory distress at a school campus
subject to a policy adopted under Subsection (a-1).  The rules must
(1)  the number of epinephrine delivery devices
[auto-injectors] available at each campus;
(2)  the amount of medication for respiratory distress
(3)  the process for each school district,
open-enrollment charter school, and private school to check the
inventory of epinephrine delivery devices [auto-injectors] and
medication for respiratory distress at regular intervals for
(4)  the amount of training required for school
personnel and school volunteers to administer:
(A)  an epinephrine delivery device
(B)  medication for respiratory distress; and
(5)  the types of medication that may be administered
under Subsection (b-1) to persons experiencing respiratory
distress, based on a review of the best available medical evidence.
(d)  Each school district, open-enrollment charter school,
and private school that adopts a policy under Subsection (a) must
require that each campus have one or more school personnel members
or school volunteers authorized and trained to administer an
epinephrine delivery device [auto-injector] present during all
(d-2)  A school personnel member or school volunteer may not
be subject to any penalty or disciplinary action for refusing to
administer or receive training to administer epinephrine delivery
devices [auto-injectors] or medication for respiratory distress,
as applicable, in accordance with a policy adopted under Subsection
(e)  The supply of epinephrine delivery devices
[auto-injectors] at each campus must be stored in a secure location
and be easily accessible to school personnel and school volunteers
authorized and trained to administer an epinephrine delivery device
SECTION 8.  Section 38.209, Education Code, is amended to
Sec. 38.209.  REPORT ON ADMINISTERING EPINEPHRINE DELIVERY
DEVICE [AUTO-INJECTOR].  (a)  Not later than the 10th business day
after the date a school personnel member or school volunteer
administers an epinephrine delivery device [auto-injector] in
accordance with a policy adopted under Section 38.208(a), the
school shall report the information required under Subsection (b)
(1)  the school district, the charter holder if the
school is an open-enrollment charter school, or the governing body
of the school if the school is a private school;
(2)  the physician or other person who prescribed the
epinephrine delivery device [auto-injector]; and
(3)  the commissioner of state health services.
(b)  The report required under this section must include the
(1)  the age of the person who received the
administration of the epinephrine delivery device [auto-injector];
(2)  whether the person who received the administration
of the epinephrine delivery device [auto-injector] was a student, a
school personnel member or school volunteer, or a visitor;
(3)  the physical location where the epinephrine
delivery device [auto-injector] was administered;
(4)  the number of doses of epinephrine [auto-injector]
(5)  the title of the person who administered the
epinephrine delivery device [auto-injector]; and
(6)  any other information required by the commissioner
SECTION 9.  Section 38.210(a), Education Code, is amended to
(a)  Each school district, open-enrollment charter school,
and private school that adopts a policy under Section 38.208(a) is
responsible for training school personnel and school volunteers in
the administration of an epinephrine delivery device
[auto-injector].  The training must include information on:
(1)  recognizing the signs and symptoms of anaphylaxis;
(2)  administering an epinephrine delivery device
(3)  implementing emergency procedures, if necessary,
after administering an epinephrine delivery device
(4)  properly disposing of used or expired epinephrine
delivery devices [auto-injectors].
SECTION 10.  The heading to Section 38.211, Education Code,
Sec. 38.211.  PRESCRIPTION OF EPINEPHRINE DELIVERY DEVICES
[AUTO-INJECTORS] AND MEDICATION FOR RESPIRATORY DISTRESS.
SECTION 11.  Sections 38.211(a), (b), (c), (e), and (f),
Education Code, are amended to read as follows:
(a)  A physician or person who has been delegated
prescriptive authority under Chapter 157, Occupations Code, may
prescribe epinephrine delivery devices [auto-injectors] or
medication for respiratory distress in the name of a school
district, open-enrollment charter school, or private school.
(b)  A physician or other person who prescribes epinephrine
delivery devices [auto-injectors] or medication for respiratory
distress under Subsection (a) shall provide the school district,
open-enrollment charter school, or private school with a standing
order for the administration of, as applicable:
(1)  an epinephrine delivery device [auto-injector] to
a person reasonably believed to be experiencing anaphylaxis; or
(2)  medication for respiratory distress to a person
reasonably believed to be experiencing respiratory distress.
(c)  The standing order under Subsection (b) is not required
to be patient-specific, and the epinephrine delivery device
[auto-injector] or medication for respiratory distress may be
administered to a person without a previously established
physician-patient relationship.
(e)  An order issued under this section must contain:
(1)  the name and signature of the prescribing
(2)  the name of the school district, open-enrollment
charter school, or private school to which the order is issued;
(3)  as applicable, the quantity and types of
epinephrine delivery devices [auto-injectors] or the quantity and
types of medications for respiratory distress to be obtained and
maintained under the order; and
(f)  A pharmacist may dispense an epinephrine delivery
device [auto-injector] or medication for respiratory distress to a
school district, open-enrollment charter school, or private school
without requiring the name or any other identifying information
SECTION 12.  Section 38.215(a), Education Code, is amended
(a)  A person who in good faith takes, or fails to take, any
action under this subchapter is immune from civil or criminal
liability or disciplinary action resulting from that action or
(1)  issuing an order for epinephrine delivery devices
[auto-injectors] or medication for respiratory distress;
(2)  supervising or delegating the administration of an
epinephrine delivery device [auto-injector] or medication for
(3)  possessing, maintaining, storing, or disposing of
an epinephrine delivery device [auto-injector] or medication for
(4)  prescribing an epinephrine delivery device
[auto-injector] or medication for respiratory distress;
(A)  an epinephrine delivery device
(B)  medication for respiratory distress;
(6)  administering, or assisting in administering, an
epinephrine delivery device [auto-injector] or medication for
(7)  providing, or assisting in providing, training,
consultation, or advice in the development, adoption, or
implementation of policies, guidelines, rules, or plans; or
(8)  undertaking any other act permitted or required
SECTION 13.  This Act takes effect immediately if it
receives a vote of two-thirds of all the members elected to each
house, as provided by Section 39, Article III, Texas Constitution.
If this Act does not receive the vote necessary for immediate
effect, this Act takes effect September 1, 2025.