GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2015
SESSION LAW 2015-274
HOUSE BILL 647
AN ACT authorizing health care providers to prescribe, and pharmacists to dispense, epinephrine auto‑injectors to authorized child‑serving entities other than schools for the emergency treatment of anaphylaxis.
The General Assembly of North Carolina enacts:
SECTION 1. Article 1B of Chapter 90 of the General Statutes is amended by adding a new section to read:
"§ 90‑21.15A. Emergency treatment using epinephrine auto‑injector; immunity.
(a) Definitions. – The following definitions apply in this section:
(1) Administer. – The direct application of an epinephrine auto‑injector to the body of an individual.
(2) Authorized entity. – Any entity or organization, other than a school described in G.S. 115C‑375.2A, at which allergens capable of causing anaphylaxis may be present, including, but not limited to, recreation camps, colleges, universities, day care facilities, youth sports leagues, amusement parks, restaurants, places of employment, and sports arenas. An authorized entity shall also include any person, corporation, or other entity that owns or operates any entity or organization listed.
(3) Epinephrine auto‑injector. – A single‑use device used for the automatic injection of a premeasured dose of epinephrine into the human body.
(4) Health care provider. – A health care provider licensed to prescribe drugs under the laws of this State.
(5) Provide. – To supply one or more epinephrine auto‑injectors to an individual.
(b) Prescribing to Authorized Entities Permitted. – A health care provider may prescribe epinephrine auto‑injectors in the name of an authorized entity for use in accordance with this section, and pharmacists and health care providers may dispense epinephrine auto‑injectors pursuant to a prescription issued in the name of an authorized entity. A prescription issued pursuant to this section shall be valid for no more than two years.
(d) Use of Epinephrine Auto‑Injectors by Authorized Entities. – An employee or agent of an authorized entity or other individual who has completed the training required by subsection (e) of this section may use epinephrine auto‑injectors prescribed pursuant to G.S. 90‑726.1 to do any of the following:
(1) Provide an epinephrine auto‑injector to any individual who the employee, agent, or other individual believes in good faith is experiencing anaphylaxis, or a person believed in good faith to be the parent, guardian, or caregiver of such individual, for immediate administration, regardless of whether the individual has a prescription for an epinephrine auto‑injector or has previously been diagnosed with an allergy.
(2) Administer an epinephrine auto‑injector to any individual who the employee, agent, or other individual believes in good faith is experiencing anaphylaxis, regardless of whether the individual has a prescription for an epinephrine auto‑injector or has previously been diagnosed with an allergy.
(e) Mandatory Training Program. – An authorized entity that elects to acquire and stock a supply of epinephrine auto‑injectors as described in subsection (c) of this section shall designate employees or agents to complete an anaphylaxis training program. The training may be conducted online or in person and shall, at a minimum, include all of the following components:
(1) How to recognize signs and symptoms of severe allergic reactions, including anaphylaxis.
(2) Standards and procedures for the storage and administration of an epinephrine auto‑injector.
(3) Emergency follow‑up procedures.
In‑person training shall cover the three components listed in this subsection and be conducted by (i) a physician, physician assistant, or registered nurse licensed to practice in this State; (ii) a nationally recognized organization experienced in training laypersons in emergency health treatment; or (iii) an entity or individual approved by the Department of Health and Human Services.
Online training shall cover the three components listed in this subsection and be offered (i) by a nationally recognized organization experienced in training laypersons in emergency health treatment; (ii) by an entity or individual approved by the Department of Health and Human Services; or (iii) by means of an online training course that has been approved by another state.
(f) Immunity. –
(1) The following persons are immune from criminal liability and from suit in any civil action brought by any person for injuries or related damages that result from any act or omission taken pursuant to this section:
a. Any authorized entity that voluntarily and without expectation of payment possesses and makes available epinephrine auto‑injectors.
b. Any employee or agent of an authorized entity, or any other individual, who provides or administers an epinephrine auto‑injector to an individual whom the employee, agent, or other individual believes in good faith is experiencing symptoms of anaphylaxis and has completed the required training set forth in subsection (e) of this section.
c. A health care provider that prescribes epinephrine auto‑injectors to an authorized entity.
d. A pharmacist or health care provider that dispenses epinephrine auto‑injectors to an authorized entity.
e. Any individual or entity that conducts the training mandated by subsection (e) of this section.
(2) The immunity conferred by this section does not apply to acts or omissions constituting willful or wanton conduct as defined in G.S. 1D‑5(7) or intentional wrongdoing.
(3) Nothing in this section creates or imposes any duty, obligation, or basis for liability on any authorized entity, any employee or agent of an authorized entity, or any other individual to acquire, possess, store, make available, or administer an epinephrine auto‑injector.
(4) This section does not eliminate, limit, or reduce any other immunity or defense that may be available under State law, including the protections set forth in G.S. 90‑21.14.
(g) Liability for Acts Outside of This State. – An authorized entity located in this State shall not be liable under the laws of this State for any injuries or related damages resulting from the provision or administration of an epinephrine auto‑injector outside of this State under either of the following circumstances:
(1) If the authorized entity would not have been liable for such injuries or related damages if the epinephrine auto‑injector had been provided or administered within this State.
(2) If the authorized entity is not liable for such injuries or related damages under the laws of the state in which the epinephrine auto‑injector was provided or administered.
(h) Does Not Constitute Practice of Medicine. – The administration of an epinephrine auto‑injector in accordance with this section is not the practice of medicine or any other profession that otherwise requires licensure."
SECTION 2. The North Carolina Board of Pharmacy may adopt temporary and permanent rules addressing the authorization for authorized entities under Section 1 of this act to obtain a prescription for epinephrine for emergency health circumstances.
SECTION 3. This act becomes effective December 31, 2015.
In the General Assembly read three times and ratified this the 29th day of September, 2015.
s/ Philip E. Berger
President of the Senate
s/ Tim Moore
Speaker of the House of Representatives
s/ Pat McCrory
Governor
Approved 10:31 a.m. this 20th day of October, 2015