Administration of Epinephrine Auto-Injectors in the Schools PSEA Legal Advisory July 17, 2015 School employees often have questions when employers direct staff to administer medication to students. One medication frequently prescribed for students who may have an anaphylactic allergic reaction in school is epinephrine, which is administered through an epinephrine autoinjector1 to treat anaphylactic allergic reactions. There have been some recent developments in Pennsylvania which provide guidance to school employees with regard to administration of epinephrine auto-injectors. Pennsylvania’s Legislature has enacted legislation which requires that educational entities develop policies to authorize students to possess and self-administer epinephrine auto-injectors in school. 24 P.S. § 14-1414.1, effective November 30, 2004. Under such policies: (1) students must be able to demonstrate to the certified school nurse the capability for self-administration and for responsible behavior in the use of the epinephrine auto-injector; (2) students must notify the school nurse immediately following each use of the medication; and (3) schools must establish procedures for ensuring that students have permission to carry and self-administer epinephrine auto-injectors and must ensure that other students do not have access to the device or medication. The Legislature has also enacted a law which among other things, allows school officials to authorize trained school employees to: (1) provide an epinephrine auto-injector to a student who is allowed to self-administer the medication; or (2) administer an epinephrine auto-injector to a student pursuant to a prescription from that student’s health care professional; or (3) administer an epinephrine auto-injector according to the standing protocol from a physician or certified registered nurse practitioner, to any student who the school employee in good faith believes is experiencing an anaphylactic reaction. 24 P.S. § 14-1414.2, effective December 30, 2014. In addition, the law allows physicians or certified registered nurse practitioners to prescribe epinephrine auto-injectors in the name of the school and permits schools to maintain a supply of epinephrine auto-injectors. Finally, the law requires that school employees designated to administer epinephrine auto-injectors must complete a training program authorized by the Department of Health. In terms of liability for administration of epinephrine auto-injectors, another Pennsylvania statute, The Good Samaritan Act, provides that school employees who in good faith believe a student needs emergency medical care, first aid, or rescue and render such care, first aid, or rescue to the student are immune from civil liability for any acts or omissions except for those intentionally designed to seriously harm or those which are grossly negligent and which result in 1 Often referred to by the brand name “Epi-Pen.” PSEA Legal Advisory Copyright © 2015 PSEA serious harm to the student. 42 P.S. § 8337.1. The new epinephrine auto-injector law explicitly provides that trained school employees who provide students with medication under the law have immunity under this statute. Although the new law clarifies that employees who administer an epinephrine auto-injector under the statute will be protected under the Good Samaritan Act, PSEA recommends that when a school entity assigns this duty to an employee, the school entity should: (1) provide a written designation to that effect; (2) indicate in writing that the employee will receive the training required under the epinephrine auto-injector statute; and (3) except in cases involving a student’s initial anaphylactic reaction, ensure that there is written parental or guardian permission for school employees to administer an epinephrine auto-injector. The employee should keep a record of the training and should check to ensure that there is in fact parental or guardian permission on file. The statutes discussed above provide answers to some of the questions which arise when school entities direct employees to administer or assist in the administration of epinephrine autoinjectors. Because complex issues may still develop when officials assign responsibilities to school employees in this area, members may continue to need help in addressing matters pertaining to administration of epinephrine auto-injectors and should contact their locals and UniServs for assistance. PSEA Legal Advisory Copyright © 2015 PSEA