San Antonio Express-News & Houston Chronicle
AUSTIN – San Antonio’s largest school districts, Northside and North East ISD, are a step ahead of lawmakers filing bills that would require public and charter schools to stock medicine that can counteract allergic reactions.
Despite a federal law that provides financial incentives to stock the drug, many Texas schools do not because of liability concerns.
But the two San Antonio school districts keep epinephrine stocked for students and staff who may not know that they have an allergic reaction and face the risk of anaphylaxis shock at school.
Epinephrine is injected into the thigh, often by a device known by the brand name EpiPen, to open up the airway in a severe alleric reaction. Currently, the state does not require schools to keep extra EpiPens stocked.
Shirley Schreiber, director of health services for Northside ISD, said the district has stocked extra epinephrine for approximately 35 years. Like other schools in Texas, the district has always allowed students who have a prescription from their doctor to keep a kit at school.
“We’re always happy when it’s needed that we have one,” Schreiber said.
Before a student is given the epinephrine auto-injection in Northside ISD, Schreiber said the registered nurse must call a medical consultant to OK the shot. Immediately following the shot, the nurse calls EMS to take the student to the hospital.
Northside ISD Superintendent Brian Woods said an EpiPen can never be administered without a doctor’s order. Although a nurse must spend time calling a doctor before giving the shot, it has not been a problem at Northside’s schools.
“If there was a serious situation we could react to it in a short amount of time,” Woods said.
In 2013, President Barack Obama signed the School Access to Emergency Epinephrine Act, which offers financial incentives to schools that choose to stock unassigned EpiPens. Despite this, many schools in Texas do not keep the shots stocked because the state does not provide liability protection.
One lawmaker hopes to protect schools who choose to stock EpiPens.
Rep. Myra Crownover, R-Denton, filed House Bill 2847, which would not make it mandatory for schools to stock EpiPens, but would give schools immunity from liability if they chose to do so.
Although there may be a risk, Theodore Freeman, medical director of the health advisory committee in North East ISD, has been writing the standing order for NEISD to give epinephrine to students that do not have it prescribed for them.
“From a medical perspective we’d like to get unassigned epinephrine in all schools and get the liability issue cleared up,” Freeman said.
The benefits of keeping the drug stocked seem to far outweigh the liability risks for the two San Antonio school districts.
“It is a risk, but it is a bigger risk if a child dies from not getting epinephrine,” Freeman said.
North East ISD spokeswoman Aubrey Chancellor said the district began stocking unassigned epinephrine in 2005. The district keeps two unassigned EpiPens at every school—one pediatric dose and one adult dosed. Chancellor said two doses have been administered this school year.
“When someone has an allergic reaction, it can become very serious very quickly,” Chancellor said. “In some cases, EpiPens can be the difference between life and death.”
Other lawmakers want to force schools to keep EpiPens stocked for students and staff.
Sen. Juan “Chuy” Hinojosa, D-McAllen, filed Senate Bill 66 this session, which would require public and charter schools to stock the lifesaving epinephrine injectors. Rep. Abel Herrero, D-Robstown, filed its companion bill, House Bill 566. The Senate bill was left pending in the Committee on Education earlier this month.
Hinojosa’s bill represents the football jersey number of Cameron Espinosa, a student from Haas Middle School in Corpus Christi, who died after suffering a severe allergic reaction to an ant bite while playing football. The school did not have epinephrine available for the boy and used a defibrillator before EMS responded.
“The safety and well-being of our students is of the utmost importance, and it is unfortunate that health issues exist in our public school system where it takes a tragedy to make something happen,” Hinojosa said in a statement.
The Legislative Budget Board estimates that there would be no fiscal implication to the state, but local governments could see an impact.
Schools would have to pay for two EpiPens every year, which could cost each campus up to $900 per year. The total cost for all 8,800 campuses could cost up to $8 million annually. In addition, at least one employee would be required to undergo annual training, which costs around $20.
A spokesperson for Hinojosa said schools would be able to accept gifts, donations, grants and federal funding to alleviate the costs.