Testimony in Support of H.277, An Act Relative to Emergency Stock Epinephrine in Schools Before the Joint Committee on Education

The Massachusetts Medical Society (MMS) wishes to be recorded in support for H.277, An Act Relative to Emergency Stock Epinephrine in Schools. 

This bill would require schools to maintain a stock supply of non-patient specific epinephrine to be administered in the event of an anaphylactic emergency. The Department of Public Health would be charged with promulgating regulations that would require the epinephrine to be stored in an easily accessible unlocked location, specify the number and type of epinephrine auto-injectors required be based on school population, and require the inventory to be checked at regular intervals for expiration and replacement.  Individuals authorized to administer epinephrine must meet certain training requirements which would be defined by regulation.  The bill also exempts a school nurse or other authorized individual who provides, administers, or assists in the administration of epinephrine to a student believed in good faith to be having an anaphylactic reaction from liability for any civil damages for negligence in acts or omissions resulting from the rendering of such treatment.

Schools are currently recommended to have an emergency supply of epinephrine auto-injectors available to protect students with no previous history of life threatening allergies. And, parents of children with known life threatening allergies are also required to supply the school with an epinephrine auto-injector at the start of each school year, for their child’s sole use. Costs for these injectors have soared, adding a financial burden to families. Often, at the end of each school year, the bulk of these auto-injectors remain unused, have expired and must be disposed of. 

The MMS, through a letter to each Massachusetts school district superintendent earlier this month is encouraging schools to use their own emergency supply of epinephrine auto-injectors for all children and require the employees and parents of children with life threatening allergies to continue to provide their school with an individualized health care plan.

Data from the MA Department of Public Health indicates that the frequency of use of administration of epinephrine in schools is quite low. Most school districts in Massachusetts report that either no units or only 1 unit being used throughout the district in a year, and only 6 of nearly 400 school districts reported more than 5 administrations throughout the district in the school year. This indicates that a modest stock of epinephrine would be sufficient to ensure sufficient supply.  

In addition, a centralized supply of epinephrine auto-injectors reduces the burden on school nurses to track expiration dates of each student’s auto-injector. Of note, the policy would still require a physician order to ensure that school nurses are fully informed of the relevant information. 

This policy has already been adopted in the town of Shrewsbury. In a letter to the Worcester Telegram and Gazette, Dale Magee, MD, a past president of the MMS and member of the Shrewsbury school board, stated, “…having just a few doses per school rather than individually labeled doses is less confusing for nursing staff and more than covers the need. [Adoption of this policy] would also save parents hundreds of dollars per year.”  

On behalf of the more than 25,000 members of the MMS, we urge the Committee on Education to support H.277 as a life- and cost-saving initiative in schools.

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