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LRB-4156/1
KMS:cdc
2023 - 2024 LEGISLATURE
September 20, 2023 - Introduced by Senators James, Taylor, Cabral-Guevara,
Felzkowski, Quinn and Spreitzer, cosponsored by Representatives Moses,
Rozar, Baldeh, Brandtjen, Cabrera, Conley, Gustafson, Maxey, Murphy,
O'Connor, Ohnstad, Ortiz-Velez, Ratcliff, Spiros, Subeck, Tusler and
Melotik. Referred to Committee on Health.
SB447,1,2 1An Act to amend 450.11 (1); and to create 118.294 and 448.03 (2) (qm) of the
2statutes; relating to: ready-to-use glucagon rescue therapies in schools.
Analysis by the Legislative Reference Bureau
This bill allows physicians, advanced practice nurse prescribers, and physician
assistants to provide prescriptions and standing orders for glucagon rescue
therapies for the treatment of severe hypoglycemia to public, private, and tribal
schools. Under the bill, the governing body of a school may maintain a supply of a
glucagon rescue therapy. The governing body of a school may authorize school
personnel to administer the glucagon rescue therapy to a pupil on school premises
or at a school-sponsored activity if the pupil's prescribed glucagon is not available
on-site or has expired. The bill requires the school personnel to report the
administration of the glucagon rescue therapy as soon as practicable to an
emergency medical service provider, to the school nurse if the school nurse did not
administer the glucagon rescue therapy, to the pupil's parent, guardian, or
emergency contact, if known, and to the pupil's health care provider, if known. Under
the bill, a school and its school personnel, and a physician, an advanced practice
nurse prescriber, or a physician assistant who provides a prescription or standing
order to a school for a glucagon rescue therapy are not liable for any injury that
results from the administration of the glucagon rescue therapy unless the injury is

the result of an act or omission that constitutes gross negligence or willful or wanton
misconduct.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
SB447,1 1Section 1. 118.294 of the statutes is created to read:
SB447,2,3 2118.294 Ready-to-use glucagon rescue therapies. (1) Definitions. In
3this section:
SB447,2,54 (a) “Advanced practice nurse prescriber” means an advanced practice nurse
5who is certified under s. 441.16.
SB447,2,86 (b) “Diabetes care plan" means a document that specifies the diabetes-related
7services needed by a pupil at school and at school-sponsored activities and identifies
8the appropriate staff to provide and supervise these services.
SB447,2,109 (c) “Physician” means a person licensed to practice medicine and surgery under
10ch. 448.
SB447,2,1111 (d) “Physician assistant” means a person licensed under s. 448.974.
SB447,2,1712 (e) “Ready-to-use undesignated glucagon rescue therapy" means a glucagon
13rescue therapy approved by the federal food and drug administration that does not
14require reconstitution for the treatment of severe hypoglycemia in a dosage form that
15can be rapidly administered to a patient in an emergency, including prefilled
16injectable or nasally administered glucagon, prescribed in the name of a school or
17school district.
SB447,2,1818 (f) “School" means a public, private, or tribal school.
SB447,3,219 (g) “School personnel" means a person who is employed by a school or school
20district, a person who is employed by a local health department and assigned to a

1school, or a person who contracts with a school or school district to perform services
2in connection with a pupil's diabetes care plan.
SB447,3,9 3(2) Prescriptions for schools. A physician, an advanced practice nurse
4prescriber, or a physician assistant may prescribe a ready-to-use undesignated
5glucagon rescue therapy in the name of a school to be maintained by the school for
6use under sub. (3). Ready-to-use undesignated glucagon rescue therapy
7prescriptions shall be accompanied by a standing order for the administration of
8school-supplied, ready-to-use undesignated glucagon rescue therapy for
9potentially severe hypoglycemic reactions.
SB447,3,16 10(3) Ready-to-use undesignated glucagon rescue therapies in schools. (a)
11The governing body of a school may obtain a standing order for a ready-to-use
12undesignated glucagon rescue therapy and maintain a supply of the ready-to-use
13undesignated glucagon rescue therapy in any secure location that is immediately
14accessible to school personnel. The governing body of a school shall maintain any
15supply of ready-to-use undesignated glucagon rescue therapy in accordance with
16the manufacturer's instructions.
SB447,3,2117 (b) The governing body of a school may authorize school personnel to
18administer, on school premises or at a school-sponsored activity, a ready-to-use
19undesignated glucagon rescue therapy to a pupil in accordance with a standing order
20from a physician, an advanced practice nurse practitioner, or a physician assistant
21if the pupil's prescribed glucagon is not available on-site or has expired.
SB447,4,222 (c) As soon as practicable after the administration of a ready-to-use
23undesignated glucagon rescue therapy, school personnel shall report the
24administration by dialing the telephone number “911” or, in an area in which the
25telephone number “911” is not available, the telephone number for an emergency

1medical service provider and notify all of the following of the administration of
2undesignated glucagon to the pupil:
SB447,4,43 1. The school nurse, if an individual other than the school nurse administered
4the glucagon.
SB447,4,55 2. The pupil's parent, guardian, or emergency contact, if known.
SB447,4,66 3. The pupil's health care provider, if known.
SB447,4,17 7(4) Immunity from civil liability; exemption from practice of medicine. A
8school and its school personnel, and a physician, an advanced practice nurse
9prescriber, or a physician assistant who provides a prescription or standing order for
10a ready-to-use undesignated glucagon rescue therapy are not liable for any injury
11that results from the administration of a ready-to-use undesignated glucagon
12rescue therapy under this section, regardless of whether authorization was given by
13the pupil's parent or guardian or by the pupil's physician, advanced practice nurse
14prescriber, or physician assistant, unless the injury is the result of an act or omission
15that constitutes gross negligence or willful or wanton misconduct. The immunity
16from liability provided under this subsection is in addition to and not in lieu of that
17provided under s. 895.48.
SB447,4,20 18(5) Health care professionals. Nothing in this section prohibits a health care
19professional, as defined in s. 118.29 (1) (c), from acting within the scope of practice
20of the health care professional's license, certificate, permit, or registration.
SB447,2 21Section 2. 448.03 (2) (qm) of the statutes is created to read:
SB447,4,2322 448.03 (2) (qm) The administration of a ready-to-use undesignated glucagon
23rescue therapy in accordance with s. 118.294.
SB447,3 24Section 3. 450.11 (1) of the statutes is amended to read:
SB447,5,16
1450.11 (1) Dispensing. Except as provided in sub. (1i) (b) 2., no person may
2dispense any prescribed drug or device except upon the prescription order of a
3practitioner. All prescription orders shall, except as provided in sub. (1a), specify the
4date of issue, the name and address of the practitioner, the name and quantity of the
5drug product or device prescribed, directions for the use of the drug product or device,
6the symptom or purpose for which the drug is being prescribed if required under sub.
7(4) (a) 8., and, if the order is written by the practitioner, the signature of the
8practitioner. Except as provided in ss. 118.2925 (3), 118.294 (2), 255.07 (2), 441.18
9(2) (a) 1., 448.035 (2), 448.037 (2) (a) 1., 448.9725 (2), and 448.9727 (2) (a) 1. and
10except for standing orders issued under s. 441.18 (2) (a) 2., 448.037 (2) (a) 2., or
11448.9727 (2) (a) 2., all prescription orders shall also specify the name and address of
12the patient. A prescription order issued under s. 118.2925 (3) or 118.294 (2) shall
13specify the name and address of the school. A prescription order issued under s.
14255.07 (2) shall specify the name and address of the authorized entity or authorized
15individual. Any oral prescription order shall be immediately reduced to writing by
16the pharmacist and filed according to sub. (2).
SB447,5,1717 (End)
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