101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
SB2058

 

Introduced 2/15/2019, by Sen. Laura M. Murphy

 

SYNOPSIS AS INTRODUCED:
 
70 ILCS 1205/8-25 new
70 ILCS 1505/26.10-13 new

    Amends the Park District Code. Provides that a park district must permit the self-administration and self-carry of asthma medication by a program participant at an after-school program with asthma or the self-administration and self-carry of an epinephrine injector by a program participant at an after-school program if specified written authorization is provided to the park district. Requires park district employees or volunteers who have undergone training to administer specified asthma medication, epinephrine injectors, and opioid antagonists to after-school program participants unless the program participant indicates they will self-administer the medication. Requires a park district to immediately call local emergency medical services after administration of an epinephrine injector or an opioid antagonist and notify specified individuals after the administration of asthma medication, epinephrine injectors, and opioid antagonists. Limits the liability of park district employees, agents, and medical personnel writing prescriptions for after-school program participants. Provides that each park district shall adopt an asthma episode emergency response protocol. Defines terms. Makes other changes. Amends the Chicago Park District Act making conforming changes.


LRB101 08879 AWJ 53969 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

SB2058LRB101 08879 AWJ 53969 b

1    AN ACT concerning local government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Park District Code is amended by adding
5Section 8-25 as follows:
 
6    (70 ILCS 1205/8-25 new)
7    Sec. 8-25. Administration of asthma medication,
8epinephrine injectors, and opioid antagonist in after-school
9programs; asthma episode emergency response protocol.
10    (a) As used in this Section:
11    "After-school program" means a program sponsored by a park
12district that is organized at the park district during the
13hours after school, during recess from school, or on weekends.
14These activities may include, but are not limited to, academic
15support, arts, music, sports, cultural enrichment, or other
16recreation, health promotion and diseases prevention, life
17skills and work and career development, or youth leadership
18development.
19    "Asthma action plan" means a written plan developed with a
20program participant's medical provider to help control the
21program participant's asthma. The goal of an asthma action plan
22is to reduce or prevent flare-ups and emergency department
23visits through day-to-day management and to serve as a program

 

 

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1participant-specific document to be referenced in the event of
2an asthma episode.
3    "Asthma episode emergency response protocol" means a
4procedure to provide assistance to a program participant
5experiencing symptoms of wheezing, coughing, shortness of
6breath, chest tightness, or breathing difficulty.
7    "Asthma medication" means quick-relief asthma medication,
8including albuterol or other short-acting bronchodilators,
9that is approved by the United States Food and Drug
10Administration for the treatment of respiratory distress.
11"Asthma medication" includes medication delivered through a
12device, including a metered-dose inhaler with a reusable or
13disposable spacer or a nebulizer with a mouthpiece or mask.
14    "Epinephrine injector" means an auto-injector approved by
15the United States Food and Drug Administration for the
16administration of epinephrine and a pre-filled syringe
17approved by the United States Food and Drug Administration and
18used for the administration of epinephrine that contains a
19pre-measured dose of epinephrine that is equivalent to the
20dosages used in an auto-injector.
21    "Opioid antagonist" means a drug that binds to opioid
22receptors and blocks or inhibits the effect of opioids acting
23on those receptors, including, but not limited to, naloxone
24hydrochloride or any other similarly acting drug approved by
25the U.S. Food and Drug Administration.
26    "Program participant" means an individual participating in

 

 

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1an after-school program.
2    "Park district" means park districts organized under this
3Code or the Chicago Park District Act.
4    "Respiratory distress" means the perceived or actual
5presence of wheezing, coughing, shortness of breath, chest
6tightness, breathing difficulty, or any other symptoms
7consistent with asthma. "Respiratory distress" may be
8categorized as "mild-to-moderate" or "severe".
9    "Self-administration" means a program participant's
10discretionary use of his or her prescribed asthma medication or
11epinephrine injector.
12    "Self-carry" means a program participant's ability to
13carry his or her prescribed asthma medication or epinephrine
14injector.
15    "Standing protocol" may be issued by (i) a physician
16licensed to practice medicine in all its branches, (ii) a
17licensed physician assistant with prescriptive authority, or
18(iii) a licensed advanced practice registered nurse with
19prescriptive authority.
20    "Trained personnel" means any park district employee or
21volunteer who has completed training under subsection (p) to
22recognize and respond to anaphylaxis, opioid overdose, and
23respiratory distress.
24    "Undesignated asthma medication" means asthma medication
25prescribed in the name of a park district.
26    "Undesignated epinephrine injector" means an epinephrine

 

 

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1injector prescribed in the name of a park district.
2    (b) A park district must permit the self-administration and
3self-carry of asthma medication by a program participant with
4asthma or the self-administration and self-carry of an
5epinephrine injector by a program participant at an
6after-school program, provided that:
7        (1) the parents or guardians of the program participant
8    provide to the park district: (i) written authorization
9    from the parents or guardians for (A) the
10    self-administration and self-carry of asthma medication or
11    (B) the self-carry of asthma medication; or (ii) for (A)
12    the self-administration and self-carry of an epinephrine
13    injector or (B) the self-carry of an epinephrine injector,
14    written authorization from the program participant's
15    physician, physician assistant, or advanced practice
16    registered nurse; and
17        (2) the parents or guardians of the program participant
18    provide to the park district: (i) the prescription label,
19    which must contain the name of the asthma medication, the
20    prescribed dosage, and the time at which or circumstances
21    under which the asthma medication is to be administered; or
22    (ii) for the self-administration or self-carry of an
23    epinephrine injector, a written statement from the program
24    participant's physician, physician assistant, or advanced
25    practice registered nurse containing the following
26    information:

 

 

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1            (A) the name and purpose of the epinephrine
2        injector;
3            (B) the prescribed dosage; and
4            (C) the time or times at which or the special
5        circumstances under which the epinephrine injector is
6        to be administered.
7    The parents or guardians may provide to the park district
8an Individual Health Care Action Plan, asthma action plan,
9Illinois Food Allergy Emergency Action Plan and Treatment
10Authorization Form, plan pursuant to Section 504 of the federal
11Rehabilitation Act of 1973, or individualized education
12program plan to satisfy all or a portion of the requirements of
13this subsection. To the extent that the submitted plan
14authorizes school personnel or other persons to administer
15asthma medication or an epinephrine injector, submission of the
16plan by the parents or guardians authorizes trained personnel
17of the park district to administer asthma medication or an
18epinephrine injector in the same manner as school personnel or
19other persons are allowed to under a plan or as otherwise
20authorized by this Section.
21    The information provided shall be kept on file in the
22records of the park district.
23    (c) A park district may authorize the provision of a
24program participant-specific or undesignated epinephrine
25injector to a program participant or any personnel authorized
26under a program participant's Individual Health Care Action

 

 

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1Plan, Illinois Food Allergy Emergency Action Plan and Treatment
2Authorization Form, or plan pursuant to Section 504 of the
3federal Rehabilitation Act of 1973 to administer an epinephrine
4injector to the program participant, that meets the program
5participant's prescription on file.
6    (d) The park district must train all personnel working at
7after-school programs as provided in subsections (q), (r), and
8(s) and, after training, trained personnel must: (i) provide an
9undesignated epinephrine injector to a program participant for
10self-administration only that meets the program participant's
11prescription on file; (ii) administer an undesignated
12epinephrine injector that meets the prescription on file to any
13program participant who has an Individual Health Care Action
14Plan, Illinois Food Allergy Emergency Action Plan and Treatment
15Authorization Form, plan pursuant to Section 504 of the federal
16Rehabilitation Act of 1973, or individualized education
17program plan that authorizes the use of an epinephrine
18injector; (iii) administer an undesignated epinephrine
19injector to a program participant that the trained personnel in
20good faith believes is having an anaphylactic reaction; (iv)
21administer an opioid antagonist to a program participant that
22the trained personnel in good faith believes is having an
23opioid overdose; (v) provide undesignated asthma medication to
24a program participant for self-administration only that meets
25the program participant's prescription on file; (vi)
26administer undesignated asthma medication that meets the

 

 

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1prescription on file to any program participant who has an
2Individual Health Care Action Plan, asthma action plan, plan
3pursuant to Section 504 of the federal Rehabilitation Act of
41973, or individualized education program plan that authorizes
5the use of asthma medication; and (vii) administer undesignated
6asthma medication to a program participant that the trained
7personnel believes in good faith is having respiratory
8distress.
9    Trained personnel is not required to administer an
10undesignated epinephrine injector, an opioid antagonist, or an
11undesignated asthma medication to a program participant if the
12program participant indicates that they will self-administer.
13Trained personnel may administer an undesignated epinephrine
14injector, an opioid antagonist, or an undesignated asthma
15medication to any person that is not a program participant on
16park district property or at a park district activity if the
17trained personnel in good faith believes the person is in need
18of the undesignated epinephrine injector, an opioid
19antagonist, or an undesignated asthma medication.
20    (e) The park district must inform the parents or guardians
21of the program participant, in writing, that the park district
22and its employees and agents, including a physician, physician
23assistant, or advanced practice registered nurse providing a
24standing protocol and a prescription for park district
25undesignated epinephrine injectors, an opioid antagonist, or
26undesignated asthma medication, are to incur no liability or

 

 

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1professional discipline, except for willful and wanton
2conduct, as a result of any injury arising from the
3administration of asthma medication, an epinephrine injector,
4or an opioid antagonist regardless of whether authorization was
5given by the program participant's parents or guardians or by
6the program participant's physician, physician assistant, or
7advanced practice registered nurse. The parents or guardians of
8the program participant must sign a statement acknowledging
9that the park district and its employees and agents are to
10incur no liability, except for willful and wanton conduct, as a
11result of any injury arising from the administration of asthma
12medication, an epinephrine injector, or an opioid antagonist
13regardless of whether authorization was given by the program
14participant's parents or guardians or by the program
15participant's physician, physician assistant, or advanced
16practice registered nurse and that the parents or guardians
17must indemnify and hold harmless the park district and its
18employees and agents against any claims, except a claim based
19on willful and wanton conduct, arising out of the
20administration of asthma medication, an epinephrine injector,
21or an opioid antagonist regardless of whether authorization was
22given by the program participant's parents or guardians or by
23the program participant's physician, physician assistant, or
24advanced practice registered nurse.
25    (f) When trained personnel administers an undesignated
26epinephrine injector to a person whom the trained personnel in

 

 

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1good faith believes is having an anaphylactic reaction,
2administers an opioid antagonist to a person whom the trained
3personnel in good faith believes is having an opioid overdose,
4or administers undesignated asthma medication to a person whom
5the trained personnel in good faith believes is having
6respiratory distress, notwithstanding the lack of notice to the
7parents or guardians of the program participant or the absence
8of the parents or guardians signed statement acknowledging no
9liability, except for willful and wanton conduct, the park
10district and its employees and agents, including a physician, a
11physician assistant, or an advanced practice registered nurse
12providing standing protocol and a prescription for
13undesignated epinephrine injectors, an opioid antagonist, or
14undesignated asthma medication, are to incur no liability or
15professional discipline, except for willful and wanton
16conduct, as a result of any injury arising from the use of an
17undesignated epinephrine injector, the use of an opioid
18antagonist, or the use of undesignated asthma medication,
19regardless of whether authorization was given by the program
20participant's parents or guardians or by the program
21participant's physician, physician assistant, or advanced
22practice registered nurse.
23    (g) The permission for self-administration and self-carry
24of asthma medication or the self-administration and self-carry
25of an epinephrine injector is effective for the school year for
26which it is granted and shall be renewed each subsequent school

 

 

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1year upon fulfillment of the requirements of this Section.
2    (h) Provided that the requirements of this Section are
3fulfilled, a program participant with asthma may
4self-administer and self-carry his or her asthma medication or
5a program participant may self-administer and self-carry an
6epinephrine injector (i) while at an after-school program, (ii)
7while at a park district-sponsored activity related to an
8after-school program, (iii) while under the supervision of
9after-school program personnel, or (iv) before or after
10after-school programs, such as while being transported in park
11district vehicles to or from an after-school program.
12    (i) Provided that the requirements of this Section are
13fulfilled, trained personnel must administer an undesignated
14epinephrine injector to a program participant whom the trained
15personnel in good faith believes to be having an anaphylactic
16reaction (i) while at an after-school program, (ii) while at a
17park district-sponsored activity related to an after-school
18program, (iii) while under the supervision of after-school
19program personnel, or (iv) before or after after-school
20programs, such as while being transported in park district
21vehicles to or from an after-school program. Trained personnel
22may carry undesignated epinephrine injectors on his or her
23person while in a park district or at a park district-sponsored
24activity.
25    (j) Provided that the requirements of this Section are
26fulfilled, trained personnel must administer an opioid

 

 

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1antagonist to a program participant whom the trained personnel
2in good faith believes to be having an opioid overdose (i)
3while at an after-school program, (ii) while at a park
4district-sponsored activity related to an after-school
5program, (iii) while under the supervision of after-school
6program personnel, or (iv) before or after after-school
7programs, such as while being transported in park district
8vehicles to or from an after-school program. Trained personnel
9may carry an opioid antagonist on his or her person while in a
10park district or at a park district-sponsored activity.
11    (k) If the requirements of this Section are met, trained
12personnel must administer undesignated asthma medication to a
13program participant whom the trained personnel in good faith
14believes to be experiencing respiratory distress (i) while at
15an after-school program, (ii) while at a park
16district-sponsored activity related to an after-school
17program, (iii) while under the supervision of after-school
18program personnel, or (iv) before or after after-school
19programs, such as while being transported in park district
20vehicles to or from an after-school program. Trained personnel
21may carry undesignated asthma medication on his or her person
22while in a park district or at a park district-sponsored
23activity.
24    (l) The park district must maintain a supply of
25undesignated epinephrine injectors in secure locations that
26are accessible before, during, and after an after-school

 

 

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1program where an allergic person is most at risk. A physician,
2a physician assistant who has prescriptive authority in
3accordance with Section 7.5 of the Physician Assistant Practice
4Act of 1987, or an advanced practice registered nurse who has
5prescriptive authority in accordance with Section 65-40 of the
6Nurse Practice Act may prescribe undesignated epinephrine
7injectors in the name of the park district to be maintained for
8use when necessary. The supply of undesignated epinephrine
9injectors shall be maintained in accordance with the
10manufacturer's instructions.
11    The park district shall maintain a supply of an opioid
12antagonist in secure locations where an individual may have an
13opioid overdose. A health care professional who has been
14delegated prescriptive authority for opioid antagonists in
15accordance with Section 5-23 of the Substance Use Disorder Act
16may prescribe opioid antagonists in the name of the park
17district, to be maintained for use when necessary. The supply
18of opioid antagonists shall be maintained in accordance with
19the manufacturer's instructions.
20    The park district must maintain a supply of undesignated
21asthma medication in secure locations that are accessible
22before, during, or after an after-school program where a person
23is most at risk. A physician, a physician assistant who has
24prescriptive authority under Section 7.5 of the Physician
25Assistant Practice Act of 1987, or an advanced practice
26registered nurse who has prescriptive authority under Section

 

 

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165-40 of the Nurse Practice Act may prescribe undesignated
2asthma medication in the name of the park district to be
3maintained for use when necessary. The supply of undesignated
4asthma medication must be maintained in accordance with the
5manufacturer's instructions.
6    (m) The park district shall pay for the costs of the
7undesignated epinephrine injectors, opioid antagonists, and
8undesignated asthma medication.
9    (n) Upon any administration of an epinephrine injector or
10an opioid antagonist, a park district must immediately call
119-1-1 or, if 9-1-1 is not available, other local emergency
12medical services and notify the program participant's parent,
13guardian, or emergency contact, if known.
14    (o) Within 24 hours of the administration of an
15undesignated epinephrine injector, a park district must notify
16the physician, physician assistant, or advanced practice
17registered nurse who provided the standing protocol and a
18prescription for the undesignated epinephrine injector of its
19use.
20    Within 24 hours after the administration of an opioid
21antagonist, a park district must notify the health care
22professional who provided the prescription for the opioid
23antagonist of its use.
24    Within 24 hours after the administration of undesignated
25asthma medication, a park district must notify the program
26participant's parent or guardian or emergency contact, if

 

 

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1known, and the physician, physician assistant, or advanced
2practice registered nurse who provided the standing protocol
3and a prescription for the undesignated asthma medication of
4its use. The park district must follow up with the trained
5personnel, if available, and may, with the consent of the
6child's parent or guardian, notify the child's health care
7provider of record, as determined under this Section, of its
8use.
9    (p) Prior to the administration of an undesignated
10epinephrine injector, trained personnel must submit to the park
11district's administration proof of completion of a training
12curriculum to recognize and respond to anaphylaxis that meets
13the requirements of subsection (q). Training must be completed
14annually. The park district must maintain records related to
15the training curriculum and trained personnel.
16    Prior to the administration of an opioid antagonist,
17trained personnel must submit to the park district's
18administration proof of completion of a training curriculum to
19recognize and respond to an opioid overdose, which curriculum
20must meet the requirements of subsection (r). Training must be
21completed annually. Trained personnel must also submit to the
22park district's administration proof of cardiopulmonary
23resuscitation and automated external defibrillator
24certification. The park district must maintain records
25relating to the training curriculum and the trained personnel.
26    Prior to the administration of undesignated asthma

 

 

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1medication, trained personnel must submit to the park
2district's administration proof of completion of a training
3curriculum to recognize and respond to respiratory distress,
4which must meet the requirements of subsection (s). Training
5must be completed annually, and the park district must maintain
6records relating to the training curriculum and the trained
7personnel.
8    (q) A training curriculum to recognize and respond to
9anaphylaxis, including the administration of an undesignated
10epinephrine injector, may be conducted online or in person.
11    Training must include, but is not limited to:
12        (1) how to recognize signs and symptoms of an allergic
13    reaction, including anaphylaxis;
14        (2) how to administer an epinephrine injector; and
15        (3) a test demonstrating competency of the knowledge
16    required to recognize anaphylaxis and administer an
17    epinephrine injector.
18        Training may also include, but is not limited to:
19            (A) a review of high-risk areas within a park
20        district and its related facilities;
21            (B) steps to take to prevent exposure to allergens;
22            (C) emergency follow-up procedures, including the
23        importance of calling 9-1-1 or, if 9-1-1 is not
24        available, other local emergency medical services;
25            (D) how to respond to a program participant with a
26        known allergy, as well as a program participant with a

 

 

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1        previously unknown allergy; and
2            (E) other criteria as determined by the park
3        district.
4    (r) A training curriculum to recognize and respond to an
5opioid overdose, including the administration of an opioid
6antagonist, may be conducted online or in person. The training
7must comply with any training requirements under Section 5-23
8of the Substance Use Disorder Act and the corresponding rules.
9It must include, but is not limited to:
10        (1) how to recognize symptoms of an opioid overdose;
11        (2) information on drug overdose prevention and
12    recognition;
13        (3) how to perform rescue breathing and resuscitation;
14        (4) how to respond to an emergency involving an opioid
15    overdose;
16        (5) opioid antagonist dosage and administration;
17        (6) the importance of calling 9-1-1 or, if 9-1-1 is not
18    available, other local emergency medical services;
19        (7) care for the overdose victim after administration
20    of the overdose antagonist;
21        (8) a test demonstrating competency of the knowledge
22    required to recognize an opioid overdose and administer a
23    dose of an opioid antagonist; and
24        (9) other criteria as determined by the park district.
25    (s) A training curriculum to recognize and respond to
26respiratory distress, including the administration of

 

 

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1undesignated asthma medication, may be conducted online or in
2person. The training must include, but is not limited to:
3        (1) how to recognize symptoms of respiratory distress
4    and how to distinguish respiratory distress from
5    anaphylaxis;
6        (2) how to respond to an emergency involving
7    respiratory distress;
8        (3) asthma medication dosage and administration;
9        (4) the importance of calling 9-1-1 or, if 9-1-1 is not
10    available, other local emergency medical services;
11        (5) a test demonstrating competency of the knowledge
12    required to recognize respiratory distress and administer
13    asthma medication; and
14        (6) other criteria as determined by the park district.
15    (t) Annually, each park district shall request an asthma
16action plan from the parents or guardians of a program
17participant with asthma. If provided, the asthma action plan
18must be kept on file in the records of the park district.
19Copies of the asthma action plan may be distributed to
20appropriate park district staff who interact with the program
21participant on a regular basis.
22    (u) Each park district shall adopt, before January 1, 2021,
23an asthma episode emergency response protocol similar to the
24model asthma episode emergency response protocol adopted by the
25State Board of Education under subsection (j-10) of Section
2622-30 of the School Code.

 

 

SB2058- 18 -LRB101 08879 AWJ 53969 b

1    (v) Every 2 years, trained personnel shall complete an
2in-person or online training program on the management of
3asthma, the prevention of asthma symptoms, and emergency
4response in the park district setting.
5    (w) Nothing in this Section shall limit the amount of or
6supply of epinephrine injectors that a park district or program
7participant may carry or maintain.
 
8    Section 10. The Chicago Park District Act is amended by
9adding Section 26.10-13 as follows:
 
10    (70 ILCS 1505/26.10-13 new)
11    Sec. 26.10-13. Administration of asthma medication,
12epinephrine injectors, and opioid antagonist in after-school
13programs; asthma episode emergency response protocol. The
14Chicago Park District is subject to Section 8-25 of the Park
15District Code.