SB447,,22An Act to amend 450.11 (1); and to create 118.294 and 448.03 (2) (qm) of the statutes; relating to: ready-to-use glucagon rescue therapies in schools. SB447,,33Analysis 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.
SB447,,44The people of the state of Wisconsin, represented in senate and assembly, do enact as follows: SB447,15Section 1. 118.294 of the statutes is created to read: SB447,,66118.294 Ready-to-use glucagon rescue therapies. (1) Definitions. In this section: SB447,,77(a) “Advanced practice nurse prescriber” means an advanced practice nurse who is certified under s. 441.16. SB447,,88(b) “Diabetes care plan” means a document that specifies the diabetes-related services needed by a pupil at school and at school-sponsored activities and identifies the appropriate staff to provide and supervise these services. SB447,,99(c) “Physician” means a person licensed to practice medicine and surgery under ch. 448. SB447,,1010(d) “Physician assistant” means a person licensed under s. 448.974. SB447,,1111(e) “Ready-to-use undesignated glucagon rescue therapy” means a glucagon rescue therapy approved by the federal food and drug administration that does not require reconstitution for the treatment of severe hypoglycemia in a dosage form that can be rapidly administered to a patient in an emergency, including prefilled injectable or nasally administered glucagon, prescribed in the name of a school or school district. SB447,,1212(f) “School” means a public, private, or tribal school. SB447,,1313(g) “School personnel” means a person who is employed by a school or school district, a person who is employed by a local health department and assigned to a school, or a person who contracts with a school or school district to perform services in connection with a pupil’s diabetes care plan. SB447,,1414(2) Prescriptions for schools. A physician, an advanced practice nurse prescriber, or a physician assistant may prescribe a ready-to-use undesignated glucagon rescue therapy in the name of a school to be maintained by the school for use under sub. (3). Ready-to-use undesignated glucagon rescue therapy prescriptions shall be accompanied by a standing order for the administration of school-supplied, ready-to-use undesignated glucagon rescue therapy for potentially severe hypoglycemic reactions. SB447,,1515(3) Ready-to-use undesignated glucagon rescue therapies in schools. (a) The governing body of a school may obtain a standing order for a ready-to-use undesignated glucagon rescue therapy and maintain a supply of the ready-to-use undesignated glucagon rescue therapy in any secure location that is immediately accessible to school personnel. The governing body of a school shall maintain any supply of ready-to-use undesignated glucagon rescue therapy in accordance with the manufacturer’s instructions. SB447,,1616(b) The governing body of a school may authorize school personnel to administer, on school premises or at a school-sponsored activity, a ready-to-use undesignated glucagon rescue therapy to a pupil in accordance with a standing order from a physician, an advanced practice nurse practitioner, or a physician assistant if the pupil’s prescribed glucagon is not available on-site or has expired. SB447,,1717(c) As soon as practicable after the administration of a ready-to-use undesignated glucagon rescue therapy, school personnel shall report the administration by dialing the telephone number “911” or, in an area in which the telephone number “911” is not available, the telephone number for an emergency medical service provider and notify all of the following of the administration of undesignated glucagon to the pupil: SB447,,18181. The school nurse, if an individual other than the school nurse administered the glucagon. SB447,,19192. The pupil’s parent, guardian, or emergency contact, if known. SB447,,20203. The pupil’s health care provider, if known. SB447,,2121(4) Immunity from civil liability; exemption from practice of medicine. 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 for a ready-to-use undesignated glucagon rescue therapy are not liable for any injury that results from the administration of a ready-to-use undesignated glucagon rescue therapy under this section, regardless of whether authorization was given by the pupil’s parent or guardian or by the pupil’s physician, advanced practice nurse prescriber, or physician assistant, unless the injury is the result of an act or omission that constitutes gross negligence or willful or wanton misconduct. The immunity from liability provided under this subsection is in addition to and not in lieu of that provided under s. 895.48. SB447,,2222(5) Health care professionals. Nothing in this section prohibits a health care professional, as defined in s. 118.29 (1) (c), from acting within the scope of practice of the health care professional’s license, certificate, permit, or registration. SB447,223Section 2. 448.03 (2) (qm) of the statutes is created to read: SB447,,2424448.03 (2) (qm) The administration of a ready-to-use undesignated glucagon rescue therapy in accordance with s. 118.294. SB447,325Section 3. 450.11 (1) of the statutes is amended to read: SB447,,2626450.11 (1) Dispensing. Except as provided in sub. (1i) (b) 2., no person may dispense any prescribed drug or device except upon the prescription order of a practitioner. All prescription orders shall, except as provided in sub. (1a), specify the date of issue, the name and address of the practitioner, the name and quantity of the drug product or device prescribed, directions for the use of the drug product or device, the symptom or purpose for which the drug is being prescribed if required under sub. (4) (a) 8., and, if the order is written by the practitioner, the signature of the practitioner. Except as provided in ss. 118.2925 (3), 118.294 (2), 255.07 (2), 441.18 (2) (a) 1., 448.035 (2), 448.037 (2) (a) 1., 448.9725 (2), and 448.9727 (2) (a) 1. and except for standing orders issued under s. 441.18 (2) (a) 2., 448.037 (2) (a) 2., or 448.9727 (2) (a) 2., all prescription orders shall also specify the name and address of the patient. A prescription order issued under s. 118.2925 (3) or 118.294 (2) shall specify the name and address of the school. A prescription order issued under s. 255.07 (2) shall specify the name and address of the authorized entity or authorized individual. Any oral prescription order shall be immediately reduced to writing by the pharmacist and filed according to sub. (2).
