HBA-MPM H.B. 2648 77(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 2648 By: Capelo Public Health 7/26/2001 Enrolled BACKGROUND AND PURPOSE Individuals with allergies and asthma can experience a severe allergic reaction that results in anaphylactic shock, which is life-threatening. Nationally, an estimated 50 people die each year as a result of insect sting reactions, according to the American College of Allergy, Asthma, and Immunology. As well, the Journal of Allergy and Clinical Immunology documented 32 cases of fatal food allergy-induced anaphylaxis between 1994 and 1999. The preferred treatment for severe allergic reactions is the subcutaneous administration of epinephrine, also known as adrenalin. Texas has four levels of emergency medical technicians (EMTs). However, prior to the 77th Legislature, only EMT paramedics were permitted to carry and administer epinephrine, while basic and intermediate EMTs could only assist an individual in administering the individual's own auto-injector of epinephrine. Fatal outcomes are most often associated with either not using epinephrine or a delay in its use. Equipping all levels of EMTs with the knowledge and authority to carry and administer epinephrine could save lives. House Bill 2648 provides for the training and use of epinephrine auto-injector devices by all EMTs and first response providers in Texas. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Texas Department of Health in SECTION 1 (Section 773.014, Health and Safety Code) of this bill. ANALYSIS House Bill 2648 amends the Health and Safety Code to authorize emergency medical service (EMS) provider and first responder organizations to acquire and possess epinephrine auto-injector devices. The bill authorizes EMS personnel certified as or at a higher level than emergency medical technicians (EMS personnel) to carry and administer epinephrine auto-injector devices. The use of epinephrine auto-injector devices under these provisions is authorized only in accordance with Texas Department of Health (TDH) rules and a delegated practice agreement that provides for medical supervision by a licensed physician. The bill requires EMS personnel who administer epinephrine auto-injector devices to others to immediately report the use to the supervising physician. H.B. 2648 requires TDH to adopt rules to administer these provisions, including a rule that EMS personnel are authorized to administer an epinephrine auto-injector device only if the person has successfully completed a training course approved by TDH on the use of the device. The bill provides that the administration of an epinephrine auto-injector device is considered to be the administration of emergency care for legal purposes relating to liability for the provision of emergency care and does not constitute the unlawful practice of any health care profession. The provisions of this bill do not impose a standard of care not otherwise required by law. EFFECTIVE DATE This Act takes effect September 1, 2001 for the limited purpose of allowing the Texas Department of Health to adopt rules under this Act. The Act takes effect January 1, 2002.