Current through Register Vol. 49, No. 9, September, 2024
SECTION I
- Authority
The following regulations have been hereby promulgated pursuant
to Act 1108 of 2015, codified at Arkansas Code §§
20-13-403 and
20-13-408.
SECTION II
- Purpose
The purpose of these regulations is to expand public access to
auto-injectable epinephrine and to expand immunity to include an authorized
entity that provides prescribed auto-injectable epinephrine.
SECTION III
- Definitions
As used in this section:
(1) "Authorized entity" means an entity or
organization at which or in connection with which allergens capable of causing
an anaphylactic reaction may be present, including without limitation:
(A) A restaurant;
(B) An amusement park;
(C) A sports arena;
(D) Day Care;
(E) Colleges and Universities;
(F) Before and After School programs;
and
(G) Summer and recreational
camps
(2)
"Auto-injectable epinephrine" means a single-use device used for the automatic
injection of a premeasured dose of epinephrine into the human body;
(3) "Certificate" means a certificate issued
under this subchapter to authorize the receipt, possession, and administration
of prescribed auto-injectable epinephrine;
(4) "Expected user" means an authorized
entity's employee or agent who is responsible for the storage, maintenance, and
general supervision of auto-injectable epinephrine acquired by the authorized
entity;
(5) "Healthcare
professional" means a licensed physician, chiropractor, dentist, optometrist,
podiatrist, or other licensed healthcare professional;
(6) "Physician" means an individual licensed
to practice medicine in the State of Arkansas under the Arkansas Medical
Practices Act, §
17-95-201 et seq., §
17-95-301 et seq., and §
17-95-401 et seq.; and
(7) "Self-administration" means a person's
discretionary use of auto-injectable epinephrine pursuant to a prescription or
written direction from a healthcare professional.
SECTION IV - Eligibility for
Certificate
A person may receive a certificate under this subchapter only
if the person:
(1) Is eighteen (18)
years of age or older;
(2) Has, or
reasonably expects to have, regular contact with at least one (1) other person
as a result of the person's relationship or occupational or volunteer status,
including without limitation:
(A) A
parent;
(B) A camp
counselor;
(C) A scout
leader;
(D) A school nurse, school
teacher, or other school employee;
(E) A forest ranger;
(F) A tour guide;
(G) A chaperone; or
(H) An authorized entity; and
(3) Has been properly instructed
by a physician or has completed an anaphylaxis training program conducted by a
nationally recognized organization experienced in training laypersons in
emergency health treatment or other person approved by the Department of
Health. The instruction shall minimally include recognition of the symptoms of
systemic reactions to insect stings and other allergic reactions and the proper
administration of an injection of epinephrine.
(4) A certificate issued pursuant to these
Rules and Regulations expires two (2) years after the date of issuance. A new
certificate may be issued to the individual upon proof of completion of the
knowledge and skills course described in Section VIII of these Rules.
SECTION V
- Authority of
Certificate Holder
The certificate also shall authorize the certificate holder to
possess, provide, and administer in an emergency situation when a physician is
not immediately available - the prescribed epinephrine to a person who:
(1) Has contact with the certificate holder
as a result of the certificate holder's relationship or occupational or
volunteer status under §
20-13-404(2);
and
(2) Appears to be suffering a
severe adverse reaction to an insect sting or other allergic
reaction.
SECTION VI
- Immunity
(A) A person or
entity that in good faith renders emergency care or treatment by the use of
auto-injectable epinephrine is immune from civil liability resulting from:
(1) The emergency care or treatment;
and
(2) Any good faith act or
omission to provide or arrange for further medical treatment.
(B) A person or entity granted
immunity under subsection (a) of this section includes without limitation:
(1) A physician or medical facility that
distributes auto- injectable epinephrine or issues a certificate under this
subchapter;
(2) A person or entity
that provides auto-injectable epinephrine training to an expected user or
authorized entity;
(3) A person or
entity responsible for the location where the auto-injectable epinephrine is
located or used; and
(4) A
certificate holder.
(C)
The immunity under subsection (a) of this section does not apply if the cause
of action results from gross negligence or willful or wanton
misconduct.
(D) Immunity under this
section is in addition to the immunity provided to an individual acting as a
"Good Samaritan" under the provisions of §
17-95-101.
SECTION VII
- Administration of
Act
(A) The Department of Health shall
prepare a certificate form for use by a physician as authorized under this
subchapter.
(1) A copy of a certificate
issued under this subchapter shall be forwarded by the issuing physician to the
department.
(2) The department
shall maintain the copy on file and make it available for public
inspection.
(B)
Certificates of training issued pursuant to Section IV (3) will be accepted and
kept on file by the Arkansas Department of Health.
SECTION VIII
- Auto-injectable
epinephrine use by an authorized entity
(A) In order to ensure the public health and
safety, an authorized entity that acquires auto-injectable epinephrine shall
ensure that:
(1) An expected user:
(a) Completes appropriate knowledge and
skills courses at least one (1) time every two (2) years in anaphylaxis and
auto-injectable epinephrine use; and
(b) Obtains a certificate under this
subchapter;
(2) The
auto-injectable epinephrine is maintained according to the manufacturer's
operational guidelines and instructions in a locked, secure location;
and
(3) A person who renders
emergency care or treatment to a person having an anaphylactic reaction by
using auto-injectable epinephrine activates the emergency medical services
system as soon as possible and immediately reports the use of auto-injectable
epinephrine to the medical provider responding to the emergency.
(B) An authorized entity and its
expected users may:
(1) Obtain a prescription
in the name of the authorized entity for epinephrine auto-injectors and acquire
epinephrine auto-injectors under the prescription;
(2) Provide auto-injectable epinephrine for
immediate self-administration to an individual who the authorized entity or
expected user believes in good faith is experiencing anaphylaxis, regardless of
whether the individual has a prescription for auto-injectable epinephrine or
has previously been diagnosed with an allergy;
(3) Administer auto-injectable epinephrine
directly to an individual who the authorized entity or expected user believes
in good faith is experiencing anaphylaxis, regardless of whether the individual
has a prescription for auto-injectable epinephrine or has been previously
diagnosed with an allergy.
(C) An authorized entity that possesses and
makes available auto- injectable epinephrine shall:
(1) Submit to the Department of Health a
report of each incident on the authorized entity's premises in which the
authorized entity provides or administers auto-injectable epinephrine. The
report shall include the following:
(a) the
name and address of the authorized entity;
(b) the name and certificate number of the
person administering auto-injectable epinephrine;
(c) the age of the person receiving the
injection; and
(d) the name of the
emergency medical service contacted after the injection was administered.
The department shall annually publish a report that summarizes
and analyzes the reports submitted under this subdivision; and
(2) Notify an agent of
emergency communications, 911, or vehicle dispatch center of the existence,
location, and type of auto-injectable epinephrine.