6177365 Education, Office of the State Superintendent of - Notice of Emergency and Proposed Rulemaking - Adding a new Chapter 11 to Title 5-A to implement the Access to Emergency Epinephrine in Schools Amendment Act of 2015.  

  • OFFICE OF THE STATE SUPERINTENDENT OF EDUCATION

     

    NOTICE OF EMERGENCY AND PROPOSED RULEMAKING

    The State Superintendent of Education, in consultation with the Department of Health, pursuant to the authority set forth in Sections 3(b), (15) and (24) of the State Education Office Establishment Act of 2000, effective October 21, 2000 (D.C. Law 13-176; D.C. Official Code §§ 38-2602(b)(15) and (24) (2012 Repl. & 2016 Supp.)), and the Student Access to Treatment Act of 2007, effective February 2, 2008 (D.C. Law 17-107; D.C. Official Code §§ 38-651.01 et seq. (2012 Repl. & 2016 Supp.)), hereby gives notice of the adoption, on an emergency basis, of the following amendments to create a new Chapter 11 (Access to Emergency Epinephrine in Schools) of Subtitle A (Office of the State Superintendent of Education), Title 5 (Education), of the District of Columbia Municipal Regulations (“DCMR”). 

     

    The purpose of the emergency and proposed rulemaking is to establish procedures for schools to acquire and maintain a supply of undesignated epinephrine auto-injectors for administration by a certified employee or agent of the school to a student who the agent or employee believes in good faith is suffering or about to suffer from an anaphylactic reaction.

     

    Emergency rulemaking is necessary to protect the health, safety and welfare of students throughout school in the District of Columbia by ensuring proper implementation of the Act and to provide local education agencies with training and proper guidance on procurement, administration, storage, and disposal of undesignated epinephrine auto-injectors. Without this emergency rulemaking, access to emergency undesignated epinephrine injectors would not be available students suffering or about to suffer from an anaphylactic reaction requiring immediate assistance in District schools.

           

    This emergency rulemaking was adopted on July 28, 2016 and became effective on that date.  The emergency rules will remain in effect for up to one hundred twenty (120) days after the date of adoption, expiring on November 25, 2016, or upon earlier amendment or repeal by the State Superintendent of Education, or publication of a final rulemaking in the D.C. Register, whichever occurs first.

    The State Superintendent of Education also hereby provides notice of her intent to adopt the following amendments as final in not less than thirty (30) days from the date of publication of this notice in the D.C. Register.

     

    Title 5-A DCMR, OFFICE OF THE STATE SUPERINTENDENT OF EDUCATION, is amended by adding a new Chapter 11 to read as follows:

     

    CHAPTER 11           ACCESS TO EMERGENCY EPINEPHRINE IN SCHOOLS

     

    1100                General Provisions and Applicability

    1101                Certified Users of Undesignated Epinephrine Auto-Injectors; Training

    1102                Administration of Undesignated Epinephrine Auto-Injectors

    1103                Access and Acquisition of Undesignated Epinephrine Auto-Injectors

    1104                Storage, and Maintenance of Undesignated Epinephrine Auto-Injectors

    1105                Disposal of Undesignated Epinephrine Auto-Injectors

    1106                Monitoring and Inspections

    1107                Corrective Action and Penalties

    1199                Definitions

     

    1100                                GENERAL PROVISIONS AND APPLICABILITY

     

    1100.1                          The purpose of this chapter is to authorize public schools to possess and administer undesignated epinephrine auto-injectors and to establish the standards and procedures for the use, storage, and oversight of undesignated epinephrine auto-injectors.

     

    1100.2                          The provisions of this chapter shall not apply to a public school that provides education services only to adult students; except, the provisions of this Chapter shall apply to public schools that provide only special education services for adult students.

     

    1100.3                          The Office of the State Superintendent of Education (“OSSE”) shall administer and enforce this chapter.

     

    1101                                CERTIFIED USERS OF UNDESIGNATED EPINEPHRINE AUTO-INJECTORS; TRAINING

     

    1101.1                          Each public school shall have at least two (2) employees or agents of the public school certified in the use of an undesignated epinephrine auto-injector available to administer epinephrine at all times throughout the instructional day. Such employees or agents shall not include a licensed health practitioner assigned to the public school by the Department of Health.

     

    1101.2                          In order to be certified, an employee or agent shall:

     

    (a)        Be trained in the following areas:

     

    (1)               The storage of undesignated epinephrine auto-injectors;

     

    (2)               The proper administration of undesignated epinephrine auto-injectors in emergency circumstances; and

     

    (3)               How to determine whether a public school student is suffering from an anaphylactic reaction; and

     

     (b)       Complete an undesignated epinephrine auto-injector administration training program that is developed and provided by OSSE or an undesignated epinephrine administration training that is approved by OSSE.

     

    1101.3                          Certification to administer an undesignated epinephrine auto-injector shall expire one (1) year after the date the certification is issued.

     

    1102                                ADMINISTRATION OF UNDESIGNATED EPINEPHRINE AUTO-INJECTORS

     

    1102.1                          A certified employee or agent of a public school may administer epinephrine via an undesignated epinephrine auto-injector in emergency circumstances to a public school student if:

     

    (a)        The student does not have a known allergy diagnosis or allergy action plan on file;

     

    (b)        The certified employee or agent believes, in good faith, that the student is suffering from or about to suffer from an anaphylactic reaction; and

     

    (c)        The student is on the public school premises, on a school bus, or on a field trip or other sanctioned excursion away from the public school premises.

     

    1102.2                          After the administration of epinephrine via an undesignated epinephrine auto-injector to a public school student pursuant to this chapter, the public school shall comply with the following requirements:

     

    (1)               The student shall be immediately transported by emergency medical services to a hospital emergency department for medical evaluation;

     

    (2)               The principal, or designee, of the public school shall, as soon as practicable, notify the student’s emergency contact;

     

    (3)               The certified employee or agent of the public school who administered the epinephrine auto-injector shall document the details of the incident; and

     

    (4)               The principal of the public school, or the principal’s designee, shall, within twenty-four (24) hours after the administration of the undesignated epinephrine auto-injector, notify OSSE and the physician, physician assistant, or advanced practice nurse who provided the standing order permitting the use of the undesignated epinephrine auto-injector of its use.

     

    1103                                ACCESS AND ACQUISITION OF UNDESIGNATED EPINEPHRINE AUTO-INJECTORS

     

    1103.1                          A public school shall stock, at all times, a minimum of two (2) pediatric dose and two (2) adult dose undesignated epinephrine auto-injectors on the public school premise.

     

    1103.2                          A public school shall obtain undesignated epinephrine auto-injectors for use in emergency circumstances from OSSE or OSSE’s authorized designee.

     

    1103.3                          A public school shall request additional undesignated epinephrine auto-injectors from OSSE in the following circumstances:

     

    (1)               An undesignated epinephrine auto-injector has been used;

     

    (2)               An undesignated epinephrine auto-injector is within two (2) months of expiration;

     

    (3)               An undesignated epinephrine auto-injector is discolored;

     

    (4)               An undesignated epinephrine auto-injector has visible particles; or

    (5)               The school is on notice that an undesignated epinephrine auto-injector is stolen or missing.

     

    1103.4                          The public school shall be responsible for the cost of replacing a stolen or missing undesignated epinephrine auto-injector.

     

    1104                                STORAGE, AND MAINTENANCE OF UNDESIGNATED EPINEPHRINE AUTO-INJECTORS

     

    1104.1                          A public school shall store undesignated epinephrine auto-injectors in a secure, but easily accessible location(s) on the public school premises that is dark and maintained at room temperature or in accordance with the manufacturer label of the stock epinephrine auto-injector, which may include administrative offices, clinical space, or instructional space.

     

    1104.2                          A certified employee or agent of a public school may carry an appropriate supply of the public school’s undesignated epinephrine auto-injectors during a field trip or sanctioned excursion away from public school property.

     

    1104.3                          A public school shall designate at least one (1) certified employee or agent of the public school as responsible for properly storing, destroying, and maintaining the undesignated epinephrine auto-injectors.

     

    1104.4                          A designated certified employee or agent of a public school shall routinely check the stock of undesignated epinephrine auto-injectors throughout the school year and maintain in a monthly log, in a format and manner as determined by OSSE, the following information:

     

    (1)               The date the undesignated epinephrine auto-injector was received from OSSE or OSSE’s authorized designee;

     

    (2)               The expiration date of the undesignated epinephrine auto-injector;

     

    (3)               Where the undesignated epinephrine auto-injector is stored on the public school premises;

     

    (4)               Any visualized particles or color change in the solution;

     

    (5)               The date and manner of disposition of each undesignated epinephrine auto-injector, if applicable;

     

    (6)               The date an undesignated epinephrine auto-injector was used, if applicable; and

     

    (7)               The date a replacement undesignated epinephrine auto-injector was requested of OSSE or OSSE’s authorized designee.

     

    1104.5                          A public school shall retain each monthly log record for each undesignated epinephrine auto-injector acquired pursuant to this chapter for three (3) years.

     

    1105                                DISPOSAL OF UNDESIGNATED EPINEPHRINE AUTO-INJECTORS

     

    1105.1                          A public school shall dispose of a discharged undesignated epinephrine auto-injector by placing the discharged undesignated epinephrine auto-injector into its carrying case and giving it to the emergency responder or medical provider upon their arrival.  

     

    1105.2                          A public school shall dispose of a unused, and expired undesignated epinephrine auto-injector as infectious waste in accordance with 22-B DCMR § 502 (Disposal of Unused Pharmaceuticals).

     

    1106                                MONITORING AND INSPECTIONS

     

    1106.1                          OSSE, and any other duly authorized official of OSSE or another agency of the District of Columbia having jurisdiction over or responsibilities pertaining to undesignated epinephrine auto-injectors, shall have the right, with prior notice, to enter upon and into the public school premises to determine compliance with this chapter and the Act.

     

    1106.2                          The public school shall fully cooperate with authorized representatives of the Government of the District of Columbia, including OSSE, and shall provide them access to facilities, staff, and records related to the administration of undesignated epinephrine auto-injectors.

     

    1106.3                          The supply of undesignated epinephrine auto-injectors and the monthly log shall available for review during these announced inspections.

     

    1107                                CORRECTIVE ACTION AND PENALTIES

     

    1107.1                          If a public school fails to comply with this chapter or the Act, OSSE may issue an order (referred to hereinafter as a “corrective action order”) requiring the public school to take such action as is necessary to ensure compliance with this chapter or the Act or, after providing the public school with written notice of intent and a reasonable opportunity to respond, may issue an order revoking or limit the eligibility of the public school to compete for funding distributed by OSSE for the following school year pursuant to the Healthy Schools Act (“HSA”). In the absence of extenuating circumstances, a reasonable opportunity to respond shall be no less than thirty (30) calendar days.

     

    1107.2                          OSSE shall provide to each public school written notice of the decision to prohibit eligibility to receive HSA funding distributed by OSSE for the following school year,  and, if applicable, required remedial action.  The notice shall state with specificity the reasons, the specific remedial action required of the public school, the effective date of the enforcement action, and an opportunity to respond within thirty (30) calendar days from the date of the notice.

     

    1107.3                          The public school’s written response shall include the following:

     

    (a)                Each basis for the school’s contesting the decision and, for each such basis, a complete statement of facts and associated legal support;

     

    (b)               The specific relief requested; and

     

    (c)                Two (2) copies of all documentary evidence supporting the recipient’s positions.

     

    1107.4                          An OSSE employee designated by the State Superintendent of Education shall review the public school’s request. The OSSE employee shall not have participated in the monitoring or inspection of the public school for compliance with the Act or this chapter, or the decision to revoke or prohibit eligibility to receive funding distributed by OSSE pursuant to the HSA.  The decision of the OSSE employee shall be final.

     

    1199                DEFINITIONS

     

    1199.1             When used in this chapter, the following terms and phrases shall have the meanings ascribed:  

     

    Act -- Access to Emergency Epinephrine in Schools Amendment Act of 2015 (Act), effective March 9, 2016 (D.C. Law 21-77; D.C. Official Code § 38-651.04a (2012 Repl. & 2016 Supp.))

     

    Certified – having obtained a certificate of completion of epinephrine administration training that is developed and implemented by OSSE and approved by OSSE.

     

    Emergency circumstances – circumstances that indicate that a delay in treatment would endanger the health or life of a student.

     

    Instructional day – the period of the day when instruction begins and ends. operating during traditional daytime hours, before 9:00 a.m. and after 4:00 p.m.

     

    OSSE – the Office of the State Superintendent of Education established by Section 2 of the State Education Office Establishment Act of 2000, effective October 21, 2000 (D.C. Law 13-176; D.C. Official Code § 38-2601).

     

    Public school -- a District of Columbia Public Schools school or a public charter school. The term ”public school” does not include a parochial school or a private school.

     

    Public school premises -- A building, structure,  field house, gymnasium, parking lot, greenhouse, playground, stadium, open space, or other property owned or used for school purposes.

     

    Undesignated epinephrine auto-injector -- a disposable drug delivery system with a spring-activated needle, which is obtained without a prescription for a particular person, that is designed for the emergency administration of epinephrine to a person suffering an anaphylactic reaction.

     

     

    All persons desiring to comment on the subject matter of this proposed rulemaking should file comments in writing not later than thirty (30) days after the date of publication of this notice in the D.C. Register via email addressed to: ossecomments.proposedregulations@dc.gov; or by mail or hand delivery to the Office of the State Superintendent of Education, Attn: Jamai Deuberry re: Access to Emergency Epinephrine in Schools, 810 First Street, N.E., 9th Floor, Washington, D.C. 20002. Additional copies of this rule are available from the above address and on the Office of the State Superintendent of Education website at www.osse.dc.gov.