Date: 02/12/2013

Final
BILL SUMMARY for HB13-1171

HOUSE COMMITTEE ON PUBLIC HEALTH CARE & HUMAN SERVICES

Votes: View--> Action Taken:
Adopt amendment L.002 (Attachment C). The motion p
Refer House Bill 13-1171, as amended, to the Commi		Pass Without Objection
PASS



02:01 PM -- House Bill 13-1171

Representative Primavera introduced House Bill 13-1171. The bill requires the State Board of Education, in consultation with the Department of Public Health and Environment, to adopt rules by December 31, 2013, for treatment plans for the management of students with life-threatening allergies. The plans must include education and training for personnel designated to manage students with life-threatening allergies, including school nurses; standards for training programs that must be completed by designated personnel in order to administer an epinephrine auto-injector (epi-pen); procedures for responding to students' life-threatening allergic reactions; a process for developing individualized health care and allergy action plans for students known to have life-threatening allergies; protocols to prevent students' exposure to allergens; and incident reporting protocols. The bill also allows, but does not require, public and nonpublic schools to adopt policies that authorize designated personnel, in accordance with standard protocol, to administer an epi-pen to a student who is believed to be experiencing anaphylaxis. School governing bodies are authorized to enter into agreements with manufacturers of epinephrine auto-injectors or third-party suppliers in order to obtain the injectors at fair market or reduced prices.

Representative Primavera discussed anaphylaxis and how an epi-pen works. She stated that the bill doesn't require that schools have epi-pens, but allows public and nonpublic schools to adopt policies that authorize designated personnel to administer an epi-pen to a student who is believed to be experiencing anaphylaxis. She discussed the bill's fiscal note. Representative Primavera responded to questions from the committee regarding the training required by bill, the cost of the epi-pens to schools, the shelf life of the epi-pens, and the bill's fiscal note.

02:17 PM -- Kirk Mlinek, Legislative Council Staff, responded to committee questions regarding the bill's fiscal note.

02:19 PM -- Teresa Ross, Colorado Association of School Nurses, testified in opposition to the bill. She discussed the portions of the bill the association does support, stating that the bill provides an opportunity for schools to have a stock of epi-pens and allows the school nurse to administer an epi-pen to students having an anaphylaxis incident. She stated that the association is troubled by the fact that, under the bill, nonmedical personnel could make a determination that a student is suffering anaphylaxis. The committee discussed whether a nurse should make the determination of whether an epi-pen should be administered. Ms. Ross stated that school personnel should call 911 rather than allowing unlicensed personnel to administer the epi-pen, and she described the negative outcomes that can occur if an epi-pen is administered to a student who is not actually in an anaphylactic state. Ms. Ross discussed the burden that would be placed on school nurses to train other school personnel to administer epi-pens.

02:41 PM -- Dr. Haidi Demain, representing herself, described her daughter's food allergies. She discussed the prevalence of food allergies in children and that one in four students who may need epinephrine do not have an existing prescription for the drug. She stated that there are no known reasons to withhold epinephrin in cases of anaphylaxis and that the training requirements of the bill will provide confidence to school employees to administer epinephrine in emergency situations. She responded to questions from the committee regarding the side effects of administering epinephrine to a person who is not in an anaphylactic state.

02:54 PM -- Bruce Lott, Mylan Inc., discussed the number of children with food allergies and legislation in other states regarding epinephrine auto injectors. He responded to questions from the committee regarding the epi-pen.

03:03 PM -- Christianna Fogler, representing herself as a school principal, testified regarding an allergy incident in her school. She spoke in support of permitting school personnel to respond in such situations.

03:09 PM -- Katie Pritchard, representing herself, discussed students who have died from anaphylaxis. She described her daughter's food allergies, and noted that her daughter's school personnel are trained to address anaphylaxis.

03:13 PM -- McKinzie Ham, representing herself, discussed her food allergies and stated that it is difficult for her to self-administer her epi-pen, so she supports allowing others to do so if necessary.

03:15 PM -- Katie Martin, representing herself, introduced her children and discussed her daughter's allergies. She noted that a number of children have food allergies that they do not know about.

03:20 PM -- Alessandro Chiastra, representing himself, testified regarding his food allergies. He stated the slightest exposure to his allergens could cause anaphylactic shock. He described the incidents of allergic reactions he has experienced and responded to questions from the committee.

03:28 PM -- Julie Rugg, representing herself, discussed her experiences as an allergy and asthma nurse. She stated that the prevalence of food allergies is on the rise. She stated that from the onset of a reaction to an allergen, anaphylaxis can occur within seconds and that delayed administration of epinephrine causes more problems than unnecessary dosing. She stated that a diagnosis is not required to administer epinephrine and compared the administration of epi-pens by lay people to the administration of CPR, the use of automatic external defibrillators, and the use of the Heimlich Maneuver.

03:36 PM -- Lorrie Ham, representing herself, testified regarding her daughter's food allergies and asthma. She stated that having epi-pens available in schools would provide peace of mind for parents.

03:38 PM -- Dr. David Fleischer, representing himself, testified regarding his research regarding food allergies at National Jewish. He stated that epinephrine is safe and the side effects are minimal. He reiterated that it is better to give the epi-pen than to not give it, and early administration of epinephrine leads to better outcomes. He stated that all school personnel should be trained to administer an epi-pen. He responded to questions from the committee regarding whether National Jewish can be involved in providing the training required by the bill and the bill's fiscal note.

03:49 PM -- Kathy Rienert, representing herself as a school nurse, testified in support of having a supply of epinephrine in schools and the administration of the epinephrine by nurses. She stated that the bill is unrealistic in its training requirements.

03:53 PM

Representative Primavera described amendment L.002 (Attachment C).

130212 AttachC.pdf130212 AttachC.pdf
BILL:HB13-1171
TIME: 03:53:33 PM
MOVED:Primavera
MOTION:Adopt amendment L.002 (Attachment C). The motion passed without objection.
SECONDED:Schafer
VOTE
Conti
Everett
Joshi
Landgraf
May
McCann
Excused
Schafer
Singer
Stephens
Tyler
Wilson
Young
Primavera
YES: 0 NO: 0 EXC: 1 ABS: 0 FINAL ACTION: Pass Without Objection

03:55 PM

The committee recessed.

04:02 PM

The committee reconvened.

BILL:HB13-1171
TIME: 04:04:35 PM
MOVED:Primavera
MOTION:Refer House Bill 13-1171, as amended, to the Committee on Appropriations. The motion passed on a vote of 11-2.
SECONDED:Singer
VOTE
Conti
Yes
Everett
No
Joshi
No
Landgraf
Yes
May
Yes
McCann
Yes
Schafer
Yes
Singer
Yes
Stephens
Yes
Tyler
Yes
Wilson
Yes
Young
Yes
Primavera
Yes
Final YES: 11 NO: 2 EXC: 0 ABS: 0 FINAL ACTION: PASS



04:07 PM

The committee adjourned.