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January 30, 2020 - Introduced by Representatives Sortwell, Dittrich,
Shankland, Skowronski, Subeck and Tusler, cosponsored by Senators
Jacque and Ringhand. Referred to Committee on Health.
AB839,1,8 1An Act to renumber and amend 255.07 (2); to amend 118.292 (title), 118.292
2(1r) (intro.) and (a) and (2) (a) and (b), 118.2925 (title), 118.2925 (1) (a), 118.2925
3(1) (h), 118.2925 (3), 118.2925 (4) (title), (a), (b) and (c), 118.2925 (4m) (a) and
4(b), 118.2925 (5), 255.07 (title) and (1) (a), 255.07 (3), 255.07 (4), 255.07 (5) (a)
52. and 3., 255.07 (6) (a) (intro.), 1., 2. and 3., (b), (d), (e) and (f), 448.03 (2) (q) and
6450.11 (4) (a) 5. d.; and to create 118.292 (1g) (bm), 118.2925 (1) (fm), 255.07
7(1) (e) and 255.07 (2) (b) of the statutes; relating to: use of epinephrine prefilled
8syringes and standing order for epinephrine.
Analysis by the Legislative Reference Bureau
Current law allows designated school personnel and authorized entities and
individuals who have completed a training program and school nurses to provide or
administer epinephrine auto-injectors to pupils and other individuals. Pupils are
also allowed under current law to possess and use an epinephrine auto-injector in
certain circumstances. Current law allows prescribers to prescribe epinephrine
auto-injectors in the name of the school or the name of the authorized entity or
individual. This bill adds prefilled syringes to the authorities granted for
prescription, possession, and administration of epinephrine auto-injectors in
current law. A “prefilled syringe” is defined in the bill as “a device that is approved

by the federal Food and Drug Administration, that contains a dose of epinephrine,
and that is used for the manual injection of epinephrine into the human body to
prevent or treat a life-threatening allergic reaction.”
The bill allows a health care provider with prescribing authority who is
employed by or under contract with the Department of Health Services to issue a
statewide standing order for the dispensing of epinephrine auto-injectors or
prefilled syringes for use by trained individuals. The bill also allows prescribers to
issue a standing order for the dispensing of epinephrine auto-injectors or prefilled
syringes for use by trained individuals. Under current law, certain prescribers are
allowed to issue standing orders for the dispensing of an opioid antagonist, and DHS
has issued a statewide standing order for the dispensing of naloxone, which is an
opioid antagonist.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB839,1 1Section 1. 118.292 (title) of the statutes is amended to read:
AB839,2,2 2118.292 (title) Possession and use of epinephrine auto-injectors.
AB839,2 3Section 2. 118.292 (1g) (bm) of the statutes is created to read:
AB839,2,74 118.292 (1g) (bm) “Prefilled syringe” means a device that is approved by the
5federal food and drug administration, that contains a dose of epinephrine, and that
6is used for the manual injection of epinephrine into the human body to prevent or
7treat a life-threatening allergic reaction.
AB839,3 8Section 3. 118.292 (1r) (intro.) and (a) and (2) (a) and (b) of the statutes are
9amended to read:
AB839,2,1210 118.292 (1r) (intro.) While in school, at a school-sponsored activity or under
11the supervision of a school authority, a pupil may possess and use an epinephrine
12auto-injector or prefilled syringe if all of the following are true:
AB839,2,1413 (a) The pupil uses the epinephrine auto-injector or prefilled syringe to prevent
14the onset or alleviate the symptoms of an emergency situation.
AB839,3,2
1(2) (a) A pupil as a result of using an epinephrine auto-injector or prefilled
2syringe
under sub. (1r).
AB839,3,43 (b) Any person as a result of a pupil possessing or using an epinephrine
4auto-injector or prefilled syringe under sub. (1r).
AB839,4 5Section 4. 118.2925 (title) of the statutes is amended to read:
AB839,3,7 6118.2925 (title) Life-threatening allergies in schools; use of
7epinephrine
auto-injectors.
AB839,5 8Section 5. 118.2925 (1) (a) of the statutes is amended to read:
AB839,3,109 118.2925 (1) (a) “Administer" means the direct application of an epinephrine
10auto-injector or prefilled syringe to a person's body.
AB839,6 11Section 6. 118.2925 (1) (fm) of the statutes is created to read:
AB839,3,1512 118.2925 (1) (fm) “Prefilled syringe” means a device that is approved by the
13federal food and drug administration, that contains a dose of epinephrine, and that
14is used for the manual injection of epinephrine into the human body to prevent or
15treat a life-threatening allergic reaction.
AB839,7 16Section 7. 118.2925 (1) (h) of the statutes is amended to read:
AB839,3,1817 118.2925 (1) (h) “Self-administer" means to administer an epinephrine
18auto-injector or prefilled syringe to one's own body.
AB839,8 19Section 8. 118.2925 (3) of the statutes is amended to read:
AB839,3,2320 118.2925 (3) Prescriptions for schools. A physician, an advanced practice
21nurse prescriber, or a physician assistant may prescribe epinephrine auto-injectors
22or prefilled syringe in the name of a school that has adopted a plan under sub. (2) (a),
23to be maintained by the school for use under sub. (4).
AB839,9 24Section 9. 118.2925 (4) (title), (a), (b) and (c) of the statutes are amended to
25read:
AB839,4,1
1118.2925 (4) (title) Use of epinephrine auto-injectors.
AB839,4,42 (a) Provide an epinephrine auto-injector or prefilled syringe to a pupil to
3self-administer the epinephrine auto-injector or prefilled syringe in accordance
4with a prescription specific to the pupil that is on file with the school.
AB839,4,65 (b) Administer an epinephrine auto-injector or prefilled syringe to a pupil in
6accordance with a prescription specific to the pupil that is on file with the school.
AB839,4,197 (c) Administer an epinephrine auto-injector or prefilled syringe to a pupil or
8other person who the school nurse or designated school personnel in good faith
9believes is experiencing anaphylaxis in accordance with a standing protocol from a
10physician, an advanced practice nurse prescriber, or a physician assistant,
11regardless of whether the pupil or other person has a prescription for an epinephrine
12auto-injector or prefilled syringe. If the pupil or other person does not have a
13prescription for an epinephrine auto-injector or prefilled syringe, or the person who
14administers the epinephrine auto-injector or prefilled syringe does not know
15whether the pupil or other person has a prescription for an epinephrine auto-injector
16or prefilled syringe, the person who administers the epinephrine auto-injector or
17prefilled syringe
shall, as soon as practicable, report the administration by dialing
18the telephone number “911" or, in an area in which the telephone number “911" is not
19available, the telephone number for an emergency medical service provider.
AB839,10 20Section 10. 118.2925 (4m) (a) and (b) of the statutes are amended to read:
AB839,4,2421 118.2925 (4m) (a) The authority to self-administer an epinephrine
22auto-injector or prefilled syringe under sub. (4) (a) is independent of the authorized
23possession and use of an epinephrine auto-injector or prefilled syringe under s.
24118.292 (1r).
AB839,5,3
1(b) The authority to administer an epinephrine auto-injector or prefilled
2syringe
under sub. (4) (b) and (c) is independent of the authority to administer an
3epinephrine auto-injector under s. 118.29 (2) (a) 2. and 2m.
AB839,11 4Section 11. 118.2925 (5) of the statutes is amended to read:
AB839,5,155 118.2925 (5) Immunity from civil liability; exemption from practice of
6medicine.
A school and its designated school personnel, and a physician, advanced
7practice nurse prescriber, or physician assistant who provides a prescription or
8standing protocol for school epinephrine auto-injectors or prefilled syringes, are not
9liable for any injury that results from the administration or self-administration of
10an epinephrine auto-injector or prefilled syringe under this section, regardless of
11whether authorization was given by the pupil's parent or guardian or by the pupil's
12physician, physician assistant, or advanced practice nurse prescriber, unless the
13injury is the result of an act or omission that constitutes gross negligence or willful
14or wanton misconduct. The immunity from liability provided under this subsection
15is in addition to and not in lieu of that provided under s. 895.48.
AB839,12 16Section 12. 255.07 (title) and (1) (a) of the statutes are amended to read:
AB839,5,18 17255.07 (title) Life-saving allergy medication; use of epinephrine
18auto-injectors.
AB839,5,20 19(1) (a) “Administer" means the direct application of an epinephrine
20auto-injector or prefilled syringe to the body of an individual.
AB839,13 21Section 13. 255.07 (1) (e) of the statutes is created to read:
AB839,5,2522 255.07 (1) (e) “Prefilled syringe” means a device that is approved by the federal
23food and drug administration, that contains a dose of epinephrine, and that is used
24for the manual injection of epinephrine into the human body to prevent or treat a
25life-threatening allergic reaction.
AB839,14
1Section 14. 255.07 (2) of the statutes is renumbered 255.07 (2) (a) and
2amended to read:
AB839,6,93 255.07 (2) (a) A health care practitioner may prescribe an epinephrine
4auto-injector or prefilled syringe in the name of an authorized entity or an
5authorized individual for use in accordance with this section. A health care
6practitioner may issue a standing order to one or more persons authorizing the
7dispensing of epinephrine auto-injectors or prefilled syringes for use under sub. (4)
8by an authorized individual or by an employee or agent of an authorized entity who
9has completed the training required by sub. (5).
AB839,15 10Section 15. 255.07 (2) (b) of the statutes is created to read:
AB839,6,1511 255.07 (2) (b) A health care provider with prescribing authority who is
12employed by or under contract with the department may issue a statewide standing
13order for the dispensing of epinephrine auto-injectors or prefilled syringes for use
14under sub. (4) by authorized individuals or by employees or agents of authorized
15entities who have completed the training required by sub. (5).
AB839,16 16Section 16. 255.07 (3) of the statutes is amended to read:
AB839,7,217 255.07 (3) Authorized entities or individuals permitted to maintain supply.
18An authorized entity or an authorized individual may acquire and maintain a supply
19of epinephrine auto-injectors and prefilled syringes pursuant to a prescription
20issued in accordance with this section. The authorized entity or authorized
21individual shall store an epinephrine auto-injector or prefilled syringe in a location
22readily accessible in an emergency and in accordance with the epinephrine
23auto-injector's or prefilled syringe's instructions for use. An authorized entity shall
24designate an employee or agent who has completed the training required in sub. (5)

1to be responsible for the storage, maintenance, control, and general oversight of
2epinephrine auto-injectors or prefilled syringes acquired by the authorized entity.
AB839,17 3Section 17. 255.07 (4) of the statutes is amended to read:
AB839,7,74 255.07 (4) Use of epinephrine auto-injectors. An employee or agent of an
5authorized entity who has completed the training required by sub. (5) or an
6authorized individual may use an epinephrine auto-injector or prefilled syringe
7prescribed under sub. (2) to do any of the following:
AB839,7,138 (a) Provide one or more epinephrine auto-injectors or prefilled syringes to any
9individual who the employee, agent, or authorized individual believes in good faith
10is experiencing anaphylaxis, or to the parent, guardian, or caregiver of that
11individual for immediate administration, regardless of whether the individual has
12a prescription for an epinephrine auto-injector or prefilled syringe or has previously
13been diagnosed with an allergy.
AB839,7,1814 (b) Administer an epinephrine auto-injector or prefilled syringe to any
15individual who the employee, agent, or authorized individual believes in good faith
16is experiencing anaphylaxis, regardless of whether the individual has a prescription
17for an epinephrine auto-injector or prefilled syringe or has previously been
18diagnosed with an allergy.
AB839,18 19Section 18. 255.07 (5) (a) 2. and 3. of the statutes are amended to read:
AB839,7,2120 255.07 (5) (a) 2. Standards and procedures for the storage and administration
21of an epinephrine auto-injector and, if applicable, a prefilled syringe.
AB839,7,2522 3. Emergency follow-up procedures after an epinephrine auto-injector or
23prefilled syringe
is administered, including the necessity of calling the telephone
24number “911" or another telephone number for an emergency medical service
25provider.
AB839,19
1Section 19. 255.07 (6) (a) (intro.), 1., 2. and 3., (b), (d), (e) and (f) of the statutes
2are amended to read:
AB839,8,73 255.07 (6) (a) (intro.) All of the following are not liable for any injury that
4results from the administration or failure to administer an epinephrine
5auto-injector or prefilled syringe under this section, unless the injury is the result
6of an act or omission that constitutes gross negligence or willful or wanton
7misconduct:
AB839,8,118 1. An authorized entity or authorized individual that possesses and makes
9available an epinephrine auto-injector or prefilled syringe and employees, agents,
10and authorized individuals that store, maintain, control, oversee, provide, or use an
11epinephrine auto-injector or prefilled syringe.
AB839,8,1312 2. A health care practitioner who prescribes or dispenses an epinephrine
13auto-injector or prefilled syringe to an authorized entity or authorized individual.
AB839,8,1514 3. A pharmacist or other person who dispenses an epinephrine auto-injector
15or prefilled syringe to an authorized entity or authorized individual.
AB839,8,1816 (b) The use of an epinephrine auto-injector or prefilled syringe under this
17section does not constitute the practice of medicine or of any other health care
18profession that requires a credential to practice.
AB839,8,2119 (d) A person is not liable for any injuries or related damages that result from
20providing or administering an epinephrine auto-injector or prefilled syringe outside
21of this state if the person satisfies any of the following criteria:
AB839,8,2422 1. The person would not have been liable for injuries or damages if the
23epinephrine auto-injector or prefilled syringe was provided or administered in this
24state.
AB839,9,3
12. The person is not liable for injuries or damages under the law of the state
2in which the epinephrine auto-injector or prefilled syringe was provided or
3administered.
AB839,9,64 (e) Nothing in this section creates or imposes any duty, obligation, or basis for
5liability on any authorized entity, or employees, agents, or authorized individuals,
6to acquire or make available an epinephrine auto-injector or prefilled syringe.
AB839,9,117 (f) Nothing in this section creates or imposes any duty, obligation, or basis for
8liability on any employer or any other person to supervise or exercise control over an
9individual's provision or administration of an epinephrine auto-injector or prefilled
10syringe
, if the employer or other person reasonably believes the individual is acting
11as an authorized individual under this section.
AB839,20 12Section 20 . 448.03 (2) (q) of the statutes is amended to read:
AB839,9,1413 448.03 (2) (q) The administration of an epinephrine auto-injector or prefilled
14syringe
in accordance with s. 118.2925 or 255.07.
AB839,21 15Section 21 . 450.11 (4) (a) 5. d. of the statutes is amended to read:
AB839,9,1816 450.11 (4) (a) 5. d. For an epinephrine auto-injector or prefilled syringe
17prescribed under s. 118.2925 (3) or 255.07 (2), the name of the school, authorized
18entity, authorized individual, or other person specified under s. 255.07 (3).
AB839,9,1919 (End)
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