SB 1374

relating to the administration of epinephrine medication by public
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 medication [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
MEDICATION [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 medication" means an epinephrine
auto-injector, an epinephrine nasal spray, or other medication
designated by the executive commissioner of the Health and Human
Services Commission for treatment of anaphylaxis under Section
(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 medication [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
medication [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
(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
medication [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 medication [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
MEDICATION [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
medication [auto-injectors] at each campus in the district or
(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 medication [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 medication [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 medication
[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 amount [number] of epinephrine medication
[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 medication [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 medication [auto-injector];
(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 medication [auto-injector] present during regular
school [all] hours [the campus is open].
(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
medication [auto-injectors] or medication for respiratory
distress, as applicable, in accordance with a policy adopted under
(e)  The supply of epinephrine medication [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 medication [auto-injector].
SECTION 8.  Section 38.209, Education Code, is amended to
Sec. 38.209.  REPORT ON ADMINISTERING EPINEPHRINE
MEDICATION [AUTO-INJECTOR].  (a)  Not later than the 10th business
day after the date a school personnel member or school volunteer
administers [an] epinephrine medication [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 medication [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 medication [auto-injector];
(2)  whether the person who received the administration
of the epinephrine medication [auto-injector] was a student, a
school personnel member or school volunteer, or a visitor;
(3)  the physical location where the epinephrine
medication [auto-injector] was administered;
(4)  the number of doses of epinephrine medication
(5)  the title of the person who administered the
epinephrine medication [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 medication [auto-injector].
The training must include information on:
(1)  recognizing the signs and symptoms of anaphylaxis;
(2)  administering [an] epinephrine medication
(3)  implementing emergency procedures, if necessary,
after administering [an] epinephrine medication [auto-injector];
(4)  properly disposing of used or expired epinephrine
SECTION 10.  The heading to Section 38.211, Education Code,
Sec. 38.211.  PRESCRIPTION OF EPINEPHRINE MEDICATION
[AUTO-INJECTORS] AND MEDICATION FOR RESPIRATORY DISTRESS.
SECTION 11.  Section 38.211, Education Code, is amended by
amending Subsections (a), (b), (c), (e), and (f) and adding
Subsections (b-1) and (b-2) to read as follows:
(a)  A physician or person who has been delegated
prescriptive authority under Chapter 157, Occupations Code, may
prescribe epinephrine medication [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
medication [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 medication [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.
(b-1)  The commissioner of state health services or, if the
commissioner is not a physician, the chief medical executive of the
Department of State Health Services may issue a statewide standing
order prescribing epinephrine medication to a school district,
open-enrollment charter school, or private school.
(b-2)  If a standing order has not been issued under
Subsection (b-1) to a school district, open-enrollment charter
school, or private school within 30 days of the beginning of a
school year,  a regional director of a public health region
described by Section 121.007, Health and Safety Code, or a health
authority, as defined by Section 121.021, Health and Safety Code,
may issue a standing order prescribing epinephrine medication to a
school district, open-enrollment charter school, or private school
in the director's public health region or health authority's
jurisdiction, as applicable, for that school year.
(c)  The standing order under Subsection (b), (b-1), or (b-2)
is not required to be patient-specific, and the epinephrine
medication [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 medication [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 medication
[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 medication
[auto-injectors] or medication for respiratory distress;
(2)  supervising or delegating the administration of
[an] epinephrine medication [auto-injector] or medication for
(3)  possessing, maintaining, storing, or disposing of
[an] epinephrine medication [auto-injector] or medication for
(4)  prescribing [an] epinephrine medication
[auto-injector] or medication for respiratory distress;
(A)  [an] epinephrine medication [auto-injector];
(B)  medication for respiratory distress;
(6)  administering, or assisting in administering,
[an] epinephrine medication [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.