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What You Need to Know about Unassigned EpiPens

Epipens on a table

Incidents of childhood allergic disease are increasing. Visits to pediatric emergency departments for severe allergic reactions, also known as anaphylaxis, have doubled,

Statistically, the numbers are still low — rising from 5.7 to 11.7 per 10,000 visits between 2009 and 2013 — but the stakes can be high. Anaphylaxis can be fatal in up to two percent of cases, according to the Academy of Emergency Medicine. Epinephrine autoinjectors are the mainstay of treatment for these dangerous immune reactions. You might be more familiar with epinephrine auto-injectors by some of their brand names, like EpiPen®, Auvi-Q®, or Adrenaclick®. State law allows students with known allergies to carry prescribed auto-injectors with them for quick treatment after exposure to an allergen.

School districts have been allowed to stock and administer unassigned epinephrine auto-injectors on campuses since the Texas Legislature passed a law in 2015 that permits — but doesn’t require — school districts to do so. The Department of State Health Services (DSHS) developed rules in August 2018 for districts that choose to provide unassigned epinephrine auto-injectors. Districts should examine the DSHS rules and think through this decision carefully.

What Is an Unassigned Epinephrine Auto-Injector?

An unassigned epinephrine auto-injector is prescribed by an authorized health-care provider in the name of a school district. These epinephrine auto-injectors can be administered in an emergency to someone who experiences anaphylaxis without a prior diagnosis or who does not have a prescribed auto-injector at hand when they experience anaphylaxis.

What Board Action Is Required if a District Wants To Provide Unassigned Epinephrine Auto Injectors?

Your board is required by law to adopt a policy regarding unassigned epinephrine auto-injectors — but only if the district chooses to obtain and administer them. We recommend that district administrators review TASB Legal Services’ article on what school districts need to know about unassigned epinephrine auto-injectors (member login required) before making a policy recommendation to the board. Districts should understand DSHS’s requirements before they choose to purchase or accept donations of unassigned epinephrine auto-injectors.

If your district believes it can meet these regulatory requirements, be sure your board has adopted unassigned epinephrine auto-injector provisions at FFAC(LOCAL). If your policy does not contain these provisions or was last updated before 2018, contact your policy consultant for sample language to present to your board for consideration.

Districts may choose whether to:

  • Adopt a policy authorizing unassigned auto-injectors at all.
  • Authorize and train school personnel, volunteers, or both.
  • Authorize administration of an auto-injector at off-campus school events and during transportation to and from such events.

What About Unassigned Asthma Medication or Opioid Antagonists?

State law also authorizes districts to provide unassigned prescription asthma medication and/or opioid antagonists, such as Naloxone®. 

How Can TASB Policy Service Help?

Your policy consultant can discuss your options regarding unassigned auto-injectors with you and has policy language you can present to your board for consideration. Consultation and drafting are at no additional charge beyond your Policy Service subscription. Log into your dashboard to for your Policy Consultant's contact information.

The Regulations Resource Manual (RRM) has sample regulations and forms related to unassigned epinephrine auto-injectors. In your district, the superintendent, superintendent’s administrative assistant, and the policy contact (who may be the superintendent) have access to the RRM. You’ll find sample forms regarding training documentation, employee or volunteer agreement to administer unassigned epinephrine auto-injectors, and inventory tracking.

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