BILL NUMBER: SB 669	INTRODUCED
	BILL TEXT


INTRODUCED BY   Senator Huff

                        FEBRUARY 22, 2013

   An act to add Section 4119.3 to the Business and Professions Code,
to add Section 1714.23 to the Civil Code, and to add Section
1797.197a to the Health and Safety Code, relating to emergency
medical care.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 669, as introduced, Huff. Emergency medical care: epinephrine
auto-injectors.
   (1) Existing law authorizes a school district or county office of
education to provide emergency epinephrine auto-injectors to trained
personnel, and authorizes that trained personnel to utilize those
epinephrine auto-injectors to provide emergency medical aid to
persons suffering from an anaphylactic reaction. The Pharmacy Law
authorizes a pharmacy to furnish epinephrine auto-injectors to a
school district or county office of education if certain conditions
are met. A violation of the Pharmacy Law is a crime.
   Existing law requires the Emergency Medical Services Authority to
establish training and standards for all prehospital emergency care
personnel regarding the characteristics and method of assessment and
treatment of anaphylactic reactions and the use of epinephrine, and
to promulgate regulations therefor.
   This bill would authorize a prehospital emergency medical care
person, first responder, or lay rescuer to use an epinephrine
auto-injector to render emergency care to another person, as
specified. The bill would require the California Emergency Medical
Services (EMS) Authority to establish or approve authorized training
providers and minimum standards for training and the use and
administration of epinephrine auto-injectors, in consultation with
the local emergency medical system agency, the county health
department, the manufacturer, the State Department of Health Care
Services, and other private organizations. The bill would specify
components to be included in the minimum training and requirements.
The bill would provide that these minimum standards apply to a school
district or county office of education for the emergency
administration of epinephrine auto-injectors, but would permit the
adoption of more stringent standards.
    The bill would authorize a pharmacy to dispense epinephrine
auto-injectors to a prehospital emergency medical care person, first
responder, or lay rescuer for the purpose of rendering emergency care
in accordance with these provisions. Because a violation of this
requirement would be a crime, the bill would impose a state-mandated
local program.
   (2) Under existing law, everyone is generally responsible, not
only for the result of his or her willful acts, but also for an
injury occasioned to another by his or her want of ordinary care or
skill in the management of his or her property or person, except so
far as the latter has, willfully or by want of ordinary care, brought
the injury upon himself or herself.
   This bill would provide that a prehospital emergency care person,
first responder, or lay rescuer who administers an epinephrine
auto-injector to another person who appears to be experiencing
anaphylaxis at the scene of an emergency situation, in good faith and
not for compensation, is not liable for any civil damages resulting
from his or her acts or omissions in administering the epinephrine
auto-injector, if that person has complied with specified
certification and training requirements and standards. The bill also
would provide immunity to a local agency, entity of state or local
government, or other public or private organization that sponsors,
authorizes, supports, finances, or supervises the training of those
persons, or develops standards, for civil damages alleged to result
from those training programs or standards.
   (3) The California Constitution requires the state to reimburse
local agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that no reimbursement is required by this
act for a specified reason.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 4119.3 is added to the Business and Professions
Code, to read:
   4119.3.  (a) Notwithstanding any other law, a pharmacy may
dispense epinephrine auto-injectors to a prehospital emergency care
person, first responder, or lay rescuer for the purpose of rendering
emergency care in accordance with Section 1797.197a of the Health and
Safety Code, if both of the following requirements are met:
   (1) A physician and surgeon provides a written order that
specifies the quantity of epinephrine auto-injectors to be dispensed
to a person described in subdivision (b) of Section 1797.197a. The
physician and surgeon may issue the prescription only upon
presentation of a current certificate demonstrating that the person
is trained and qualified under Section 1797.197a of the Health and
Safety Code to administer an epinephrine auto-injector to another
person in an emergency situation. The prescription shall specify that
the dispensed epinephrine auto-injector is for "EMS Purposes Only"
and that the named recipient is a "Section 1797.197a Responder." A
new prescription shall be written for any additional epinephrine
auto-injectors required.
   (2) (A) The pharmacy shall label each epinephrine auto-injector
dispensed with all of the following:
   (i) The name of the person to whom the prescription was issued.
   (ii) The designations "Section 1797.197a Responder" and "EMS
Purposes Only."
   (iii) The dosage, use, and expiration date.
   (B) Each dispensed prescription shall include the manufacturer's
product information sheet for the epinephrine auto-injector.
   (b) The person described in subdivision (b) of Section 1797.197a
of the Health and Safety Code receiving epinephrine auto-injectors
pursuant to this section shall make and maintain a record for five
years reflecting dates of receipt, use, and destruction of each
auto-injector dispensed, the name of any person to whom epinephrine
was administered using an auto-injector, and the circumstances and
manner of destruction of any auto-injectors.
   (c) The epinephrine auto-injectors dispensed pursuant to this
section may be used only for the purpose, and under the
circumstances, described in Section 1797.197a of the Health and
Safety Code.
  SEC. 2.  Section 1714.23 is added to the Civil Code, to read:
   1714.23.  (a) For purposes of this section, the following
definitions shall apply:
   (1) "Anaphylaxis" means a potentially life-threatening
hypersensitivity or allergic reaction to a substance.
   (A) Symptoms of anaphylaxis may include shortness of breath,
wheezing, difficulty breathing, difficulty talking or swallowing,
hives, itching, swelling, shock, or asthma.
   (B) Causes of anaphylaxis may include, but are not limited to,
insect stings or bites, foods, drugs, and other allergens, as well as
idiopathic or exercise-induced anaphylaxis.
   (2) "Epinephrine auto-injector" means a disposable drug delivery
system with a spring-activated concealed needle that is designed for
emergency administration of epinephrine to provide rapid, convenient
first aid for persons suffering from anaphylaxis.
   (b) Any person described in subdivision (b) of Section 1797.197a
of the Health and Safety Code who administers an epinephrine
auto-injector to another person who appears to be experiencing
anaphylaxis at the scene of an emergency situation, in good faith and
not for compensation, is not liable for any civil damages resulting
from his or her acts or omissions in administering the epinephrine
auto-injector, if that person has complied with the requirements and
standards of Section 1797.197a of the Health and Safety Code.
   (c) This section does not grant immunity from civil damages to any
person whose conduct in rendering emergency care constitutes gross
negligence.
   (d) In order to encourage training of persons described in
subdivision (b) of Section 1797.197a of the Health and Safety Code in
the emergency administration of epinephrine auto-injectors, and to
encourage that emergency care, a local agency, entity of state or
local government, or other public or private organization that
sponsors, authorizes, supports, finances, or supervises the training
of those persons, or develops standards in accordance with Section
1797.197a of the Health and Safety Code, including, but not limited
to, the California Emergency Medical Services (EMS) Authority, the
local Emergency Medical System Agency, the county Department of
Health, the State Department of Health Care Services, the American
Academy of Allergy, Asthma & Immunology, the American Academy of
Pediatrics, the American Heart Association, the American Red Cross,
and the California Medical Association, shall not be liable for civil
damages alleged to result from those training programs or standards.

   (e) Nothing in this section relieves a manufacturer, designer,
developer, distributor, or supplier of an epinephrine auto-injector
of liability under any other applicable law.
  SEC. 3.  Section 1797.197a is added to the Health and Safety Code,
to read:
   1797.197a.  (a) For purposes of this section, the following
definitions shall apply:
   (1) "Anaphylaxis" means a potentially life-threatening
hypersensitivity or allergic reaction to a substance.
   (A) Symptoms of anaphylaxis may include shortness of breath,
wheezing, difficulty breathing, difficulty talking or swallowing,
hives, itching, swelling, shock, or asthma.
   (B) Causes of anaphylaxis may include, but are not limited to,
insect stings or bites, foods, drugs, and other allergens, as well as
idiopathic or exercise-induced anaphylaxis.
   (2) "Epinephrine auto-injector" means a disposable drug delivery
system with a spring-activated concealed needle that is designed for
emergency administration of epinephrine to provide rapid, convenient
first aid for persons suffering from anaphylaxis.
   (3) "First responder" means a police officer, firefighter, rescue
worker, or any other person who provides emergency response, first
aid care, or other medically related assistance either in the course
of the person's occupational duties or as a volunteer.
   (4) "Lay rescuer" means any person not otherwise licensed or
certified to use an epinephrine auto-injector on another who has met
the training standards and other requirements of this section.
   (5) "Prehospital emergency medical care person" has the same
meaning as defined in paragraph (2) of subdivision (a) of Section
1797.189.
   (b) A prehospital emergency medical care person, first responder,
or a lay rescuer may use an epinephrine auto-injector to render
emergency care to another person if all of the following requirements
are met:
   (1) The epinephrine auto-injector is legally obtained by
prescription from an authorized health care provider. An authorized
health care provider may issue a prescription for an epinephrine
auto-injector to a person described in this subdivision for the
purpose of rendering emergency care to another person, upon
presentation of current certification demonstrating that person is
trained and qualified pursuant to this section to administer an
epinephrine auto-injector as a prehospital emergency medical care
person, first responder, or lay rescuer.
   (2) The epinephrine auto-injector is used on another, with the
expressed or implied consent of that person, for the indicated
purpose described in paragraphs (1) and (2) of subdivision (a).
   (3) The epinephrine auto-injector is stored and maintained as
directed by the manufacturer's instructions for that product.
   (4) The person using the auto-injector has successfully completed
a course of training with an authorized training provider, as
described in subdivision (c), and has current certification of
training issued by the provider.
   (c) (1) The authorized training providers and minimum standards
for training and the use and administration of epinephrine
auto-injectors pursuant to this section shall be established and
approved by the California Emergency Medical Services (EMS) Authority
in consultation with the local emergency medical system agency, the
county health department, manufacturers, the State Department of
Health Care Services, the American Academy of Allergy, Asthma &
Immunology, the American Academy of Pediatrics, the American Heart
Association, the American Red Cross, and the California Medical
Association.
   (2) The minimum training and requirements shall include all of the
following components:
   (A) Techniques for recognizing circumstances, signs, and symptoms
of anaphylaxis.
   (B) Standards and procedures for proper storage and emergency use
of epinephrine auto-injectors.
   (C) Emergency follow-up procedures, including activation of the
Emergency Medical System, by calling the emergency 911 telephone
number or otherwise alerting and summoning more advanced medical
personnel and services.
   (D) Compliance with all regulations governing the training,
indications, use, and precautions concerning epinephrine
auto-injectors.
   (E) Written material covering the information required under this
provision, including the manufacturer product information sheets on
commonly available models of epinephrine auto-injectors.
   (F) Completion of a training course in cardiopulmonary
resuscitation and the use of an automatic external defibrillator
(AED) for infants, children, and adults that complies with
regulations adopted by the EMS Authority and the standards of the
American Heart Association or the American Red Cross, and a current
certification for that training.
   (G) Training certification for no more than two years, after which
recertification with an authorized training provider is required.
   (3) The minimum standards established and approved pursuant to
this subdivision apply to a school district or county office of
education, which may adopt more stringent standards for training and
the use and emergency administration of epinephrine auto-injectors
pursuant to Section 49414 of the Education Code.
  SEC. 4.  No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.