Broadens epinephrine administration mechanisms permitted in schools, institutions of higher education, and youth camps.

S3869

SENATE, No. 3869

STATE OF NEW JERSEY

222nd LEGISLATURE

�

INTRODUCED MARCH 10, 2026

Sponsored by:

Senator� VIN GOPAL

District 11 (Monmouth)

SYNOPSIS

���� Broadens epinephrine administration mechanisms
permitted in schools, institutions of higher education, and youth camps.

CURRENT VERSION OF TEXT

���� As introduced.

��

An Act
concerning the emergency administration of epinephrine
in schools, institutions of higher education, and youth camps, and amending
various parts of statutory law.

����
Be It
Enacted
by the Senate and General Assembly of
the State of New Jersey:

���� 1.�� Section 1 of P.L.1997,
c.368 (C.18A:40-12.5) is amended to read as follows:

���� 1.� Each board of education or
chief school administrator of a nonpublic school shall develop a policy in
accordance with the guidelines established by the Department of Education
pursuant to section 4 of P.L.2007, c.57 (C.18A:40-12.6a) for the emergency administration
of
one unit dose
epinephrine
[
via a pre-filled
auto-injector mechanism
]

to a pupil for anaphylaxis provided that:

���� a.� the parents or guardians
of the pupil provide to the board of education or chief school administrator of
a nonpublic school written authorization for the administration of the
epinephrine;

���� b.� the parents or guardians
of the pupil provide to the board of education or chief school administrator of
a nonpublic school written orders from the physician or advanced practice nurse
that the pupil requires the administration of epinephrine for anaphylaxis;

���� c.� the board or chief school
administrator of a nonpublic school informs the parents or guardians of the
pupil in writing that the district and its employees or agents or the nonpublic
school and its employees or agents shall have no liability as a result of any
injury arising from the administration of the
one unit dose
epinephrine
[
via a
pre-filled auto-injector mechanism
]
;

���� d.� the parents or guardians
of the pupil sign a statement acknowledging their understanding that the
district or the nonpublic school shall have no liability as a result of any
injury arising from the administration of the
one unit dose
epinephrine
[
via a
pre-filled auto-injector mechanism
]

to the pupil and that the parents or guardians shall indemnify and hold
harmless the district and its employees or agents or the nonpublic school and
its employees or agents against any claims arising out of the administration of
the
one unit dose
epinephrine
[
via
a pre-filled auto injector mechanism
]
;
and

���� e.� the permission is
effective for the school year for which it is granted and is renewed for each
subsequent school year upon fulfillment of the requirements in subsections a.
through d. of this section.

���� The policy developed by a
board of education or chief school administrator of a nonpublic school shall
require:

���� (1) the placement of a pupil's
prescribed epinephrine in a secure but unlocked location easily accessible by
the school nurse and designees to ensure prompt availability in the event of an
allergic emergency at school or at a school-sponsored function.� The location
of the epinephrine shall be indicated on the pupil's emergency care plan.�
Back-up
one unit dose
epinephrine
[
via
a pre-filled auto-injector mechanism
]

shall also be available at the school if needed;

���� (2) the school nurse or
designee to be promptly available on site at the school and school-sponsored
functions in the event of an allergic reaction; and

���� (3) the transportation of the
pupil to a hospital emergency room by emergency services personnel after the
administration of epinephrine, even if the pupil's symptoms appear to have
resolved.

���� f.� The policy developed by a
board of education or chief school administrator of a nonpublic school shall
also:

���� (1) permit the school nurse or
trained designee to administer
one unit dose
epinephrine
[
via a
pre-filled auto-injector mechanism
]

to any pupil without a known history of anaphylaxis or any pupil whose parent
or guardian has not met the requirements of subsections a., b., and d. of this
section and has not received the notice required pursuant to subsection c. of
this section when the nurse or designee in good faith believes that the pupil
is having an anaphylactic reaction; and

���� (2) require each public and
nonpublic school to maintain in a secure but unlocked and easily accessible
location a supply of
[
epinephrine
auto-injectors
]

one unit dose epinephrine

administration devices
that is
prescribed under a standing protocol from a licensed physician or an advanced
practice nurse, and is accessible to the school nurse and trained designees for
administration to a pupil having an anaphylactic reaction.

(cf: P.L.2015, c.13, s.1)

���� 2.� Section 2 of P.L.1997,
c.368 (C.18A:40-12.6) is amended to read as follows:

���� 2.� The policy for the
administration of medication to a pupil shall provide that the school nurse
shall have the primary responsibility for the administration of the
epinephrine.� The school nurse shall designate, in consultation with the board
of education, or chief school administrator of a nonpublic school additional
employees of the school district or nonpublic school who volunteer to
administer
one

unit dose
epinephrine
[
via a pre-filled auto-injector
mechanism
]

to a pupil for anaphylaxis when the nurse is not physically present at the
scene.� In the event that a licensed athletic trainer volunteers to administer
epinephrine, it shall not constitute a violation of the "Athletic Training
Licensure Act," P.L.1984, c.203 (C.45:9-37.35 et seq.).

���� Except as otherwise provided
pursuant to subsection f. of section 1 of P.L.1997, c.368 (C.18A:40-12.5), the
school nurse shall determine that:

���� a.� the designees have been
properly trained in the administration of the
one unit dose
epinephrine
[
via a
pre-filled auto-injector mechanism
]

using standardized training protocols established by the Department of
Education in consultation with the Department of Health;

���� b.� the parents or guardians
of the pupil consent in writing to the administration of the
one unit dose

epinephrine
[
via
a pre-filled auto-injector mechanism
]

by the designees;

���� c.� the board or chief school
administrator of a nonpublic school informs the parents or guardians of the
pupil in writing that the district and its employees or agents or the nonpublic
school and its employees and agents shall have no liability as a result of any
injury arising from the administration of the epinephrine to the pupil;

���� d.� the parents or guardians
of the pupil sign a statement acknowledging their understanding that the
district or nonpublic school shall have no liability as a result of any injury
arising from the administration of the
one unit dose
epinephrine
[
via a
pre-filled auto-injector mechanism
]

to the pupil and that the parents or guardians shall indemnify and hold
harmless the district and its employees or agents against any claims arising
out of the administration of the
one unit dose
epinephrine
[
via a pre-filled
auto-injector mechanism
]

to the pupil; and

���� e.� the permission is
effective for the school year for which it is granted and is renewed for each
subsequent school year upon fulfillment of the requirements in subsections a.
through d. of this section.

���� The Department of Education,
in consultation with the Department of Health, shall require trained designees
for students enrolled in a school who may require the emergency administration
of epinephrine for anaphylaxis when the school nurse is not available.

���� Nothing in this section shall
be construed to prohibit the emergency administration of
one unit dose

epinephrine
[
via
a pre-filled auto-injector mechanism
]

to a pupil for anaphylaxis by the school nurse or other employees designated
pursuant to this section when the pupil is authorized to self-administer
epinephrine pursuant to section 1 of P.L.1993, c.308 (C.18A:40-12.3), or when
there is a coexisting diagnosis of asthma, or when a prescription is received
from a licensed health care professional for epinephrine coupled with another
form of medication, or when the epinephrine is administered pursuant to
subsection f. of section 1 of P.L.1997, c.368 (C.18A:40-12.5).

(cf: P.L.2015, c.13, s.2)

���� 3.� Section 1 of P.L.1993,
c.308 (C.18A:40-12.3) is amended to read as follows:

���� 1.� a.� A board of education
or the governing board or chief school administrator of a nonpublic school
shall permit the self-administration of medication by a pupil for asthma or
other potentially life-threatening illnesses, a life-threatening allergic reaction,
or adrenal insufficiency provided that:

���� (1) the parents or guardians
of the pupil provide to the board of education or the governing board or chief
school administrator of a nonpublic school written authorization for the
self-administration of medication;

���� (2) the parents or guardians
of the pupil provide to the board of education or the governing board or chief
school administrator of a nonpublic school written certification from the
physician of the pupil that the pupil has asthma or another potentially life-threatening
illness, is subject to a life-threatening allergic reaction, or has adrenal
insufficiency and is capable of, and has been instructed in, the proper method
of self-administration of medication;

���� (3) the board of education or
the governing board or chief school administrator of a nonpublic school informs
the parents or guardians of the pupil in writing that the district and its
employees or agents or the nonpublic school and its employees or agents shall
incur no liability as a result of any injury arising from the
self-administration of medication by the pupil;

���� (4) the parents or guardians
of the pupil sign a statement acknowledging that the district or the nonpublic
school shall incur no liability as a result of any injury arising from the
self-administration of medication by the pupil and that the parents or guardians
shall indemnify and hold harmless the district and its employees or agents or
the nonpublic school and its employees or agents against any claims arising out
of the self-administration of medication by the pupil; and

���� (5) the permission is
effective for the school year for which it is granted and is renewed for each
subsequent school year upon fulfillment of the requirements in paragraphs (1)
through (4) of this subsection.

���� b.� Notwithstanding any other
law or regulation to the contrary, a pupil who is permitted to self-administer
medication under the provisions of this section shall be permitted to carry an
inhaler or prescribed medication for allergic reactions, including a
[
pre-filled
auto-injector mechanism
]

one unit dose epinephrine
, or prescribed medication for adrenal
insufficiency at all times, provided that the pupil does not endanger himself
or other persons through misuse.

���� c. �Any person who acts in
good faith in accordance with the requirements of this act shall be immune from
any civil or criminal

liability arising from actions
performed pursuant to this act.

(cf: P.L.2019, c.118, s.1)

���� 4.� Section 3 of P.L.2013,
c.211 (C.18A:61D-13) is amended to read as follows:

���� 3.� As used in this act:

���� "Institution of higher
education" means a public or independent institution of higher education.

���� "Licensed campus medical
professional" means a physician, physician assistant, advanced practice
nurse, or registered nurse who is appropriately licensed by the State of New
Jersey and is designated by an institution of higher education to oversee the
institution's epinephrine administration and training program.

���� "Member of the campus
community" means an individual who is a student, faculty, or staff member
of an institution of higher education.

���� "Secretary" means
the Secretary of Higher Education.

���� "Trained designee"
means a member of the campus community trained by a licensed campus medical
professional in the emergency administration of
one unit dose

epinephrine
[
via
a pre-filled auto-injector mechanism
]
.

(cf: P.L.2013, c.211, s.3)

���� 5.� Section 4 of P.L.2013,
c.211 (C.18A:61D-14) is amended to read as follows:

���� 4.� a.� An institution of
higher education may develop a policy, in accordance with the guidelines
established by the secretary pursuant to section 6 of P.L.2013, c.211
(C.18A:61D-16), for the emergency administration of
one unit dose

epinephrine
[
via
a pre-filled auto-injector mechanism
]

to a member of the campus community for anaphylaxis when a medical professional
is not available.� The policy shall:

���� (1) permit a trained designee,
under the guidance of a licensed campus medical professional, to administer
one
unit dose
epinephrine
[
via
a pre-filled auto-injector mechanism
]

to a member of the campus community for whom the designee is responsible, when
the designee in good faith believes that the member of the campus community is
having an anaphylactic reaction;

���� (2) permit a trained designee,
when responsible for the safety of one or more members of the campus community,
to carry in a secure but easily accessible location a supply of
[
pre-filled
]

one unit
dose
epinephrine
[
auto-injectors
]
that is
prescribed under a standing protocol from a licensed physician; and

���� (3) provide that the licensed
campus medical professional shall have responsibility for : training designees
on how to identify an anaphylactic reaction, how to identify the indications
for when to use epinephrine, and how to administer
one unit dose

epinephrine
[
via
a pre-filled auto-injector mechanism
]
;
and distributing prescribed
[
pre-filled
]

one unit
dose
epinephrine
[
auto-injectors
]
to trained
designees.

���� b.� Each institution of higher
education that develops a policy pursuant to subsection a. of this section
shall designate a physician, physician assistant, advanced practice nurse, or
registered nurse who is appropriately licensed by the State of New Jersey to
serve as the licensed campus medical professional.

���� c.� A licensed campus medical
professional is authorized to:

���� (1) establish and administer a
standardized training protocol for the emergency administration of epinephrine
by trained designees;

���� (2) ensure that trained
designees have satisfactorily completed the training protocol;

���� (3) obtain a supply of
[
pre-filled
]

one unit
dose
epinephrine
[
auto-injectors
]
under a
standing protocol from a licensed physician; and

���� (4) control distribution to
trained designees of
[
pre-filled
]

one

unit
dose
epinephrine
[
auto-injectors
]
.

(cf: P.L.2013, c.211, s.4)

���� 6.� Section 8 of P.L.2013,
c.211 (C.18A:61D-18) is amended to read as follows:

���� 8.� Nothing in this act shall
be construed to:

���� a.� permit a trained designee
to perform the duties or fill the position of a licensed medical professional;

���� b.� prohibit the
administration of
[
a
pre-filled
]

one unit dose
epinephrine
[
auto-injector
mechanism
]

by a person acting pursuant to a lawful prescription;

���� c.� prevent a licensed and
qualified member of a health care profession from administering a
[
pre-filled
]

one unit
dose
epinephrine
[
auto-injector
mechanism
]

if the duties are consistent with the accepted standards of the member's
profession; or

���� d.� violate the "Athletic
Training Licensure Act," P.L.1984, c.203 (C.45:9-37.35 et seq.) in the
event that a licensed athletic trainer administers epinephrine to a member of
the campus community as a trained designee pursuant to this act.

(cf: P.L.2013, c.211, s.8)

���� 7.� Section 3 of P.L.2015,
c.231 (C.26:12-19) is amended to read as follows:

���� 3.� As used in this act:

���� "Commissioner" means
the Commissioner of Health.

���� "Member of the youth camp
community" means a person who is a camper at, or a staff member of, a
youth camp.

���� "Professionally qualified
health care provider" means a licensed health care professional whose
authorized scope of practice includes the administration of medication, whether
independently, or through a joint protocol or standing order from a physician.

���� "Trained designee"
means a youth camp staff member who has been trained by the youth camp health
director or, if the youth camp health director is not professionally qualified
to administer epinephrine, by a professionally qualified health care provider,
in the detection of anaphylaxis and the emergency administration of
one

unit
dose
epinephrine
[
using
a pre-filled auto-injector mechanism
]
.

���� "Youth camp" means
the same as that term is defined by section 3 of P.L.1973, c.375 (C.26:12-3).

���� "Youth camp health
director" means and includes a person, 18 years of age or older, who meets
the qualifications required by N.J.A.C.8:25-5.2 and who is responsible for the
proper medical recordkeeping, care, and treatment of campers at a youth camp.�
Youth camps that do not have a health director who is a medical professional
may use one of the following options: a youth camp health director trained in
the emergency administration of
one unit dose
epinephrine
[
via a
pre-filled auto-injector mechanism
]

by the professionally qualified health care provider responsible for writing
the prescription with documentation; an emergency medical technician certified
in emergency epinephrine
[
auto-injector
]

administration; or an individual trained in the detection of anaphylaxis and
the emergency administration of
one unit dose
epinephrine
[
using a
pre-filled auto-injector device
]
.

���� "Youth camp
operator" means the same as that term is defined by section 3 of P.L.1973,
c.375 (C.26:12-3).

(cf: P.L.2015, c.231, s.3)

���� 8.� Section 4 of P.L.2015,
c.231 (C.26:12-20) is amended to read as follows:

���� 4.� a. A youth camp operator,
as part of a youth camp medical program, and in accordance with the provisions
of the "New Jersey Youth Camp Safety Act," P.L.1973, c.375 (C.26:12-1
et seq.) and rules and regulations adopted by the Department of Health pursuant
thereto, may develop a policy for the emergency administration of a
one unit
dose
epinephrine
[
via
a pre-filled auto-injector mechanism
]

to a member of the youth camp community for anaphylaxis when a professionally
qualified health care provider is not immediately available.� The policy shall:

���� (1) permit the youth camp
health director and trained designees to administer a
one unit dose

epinephrine
[
via
a pre-filled auto-injector mechanism
]

to a member of the youth camp community for whom the youth camp health director
or trained designee is responsible, when the youth camp health director or
trained designee believes, in good faith, that the member of the youth camp
community is having an anaphylactic reaction; and

���� (2) permit the youth camp
health director and trained designees, when responsible for the safety of one
or more members of the youth camp community, to carry, in a secure but easily
accessible location, a supply of
[
pre-filled
]

one unit
dose
epinephrine
[
auto-injectors
]
that is
prescribed under a standing protocol from a licensed physician or other
authorized prescriber.

���� b.� If a youth camp develops a
policy for the emergency administration of
one unit dose
epinephrine
[
via a
pre-filled auto-injector mechanism
]
,
the youth camp operator, in cooperation with the youth camp health director,
shall:

���� (1) maintain and adhere to a
standardized training protocol for the emergency administration of epinephrine
by trained designees under the youth camp medical program, which training
protocol shall be established and administered by a professionally qualified
health care provider;

���� (2) ensure that trained
designees have satisfactorily completed the training protocol;

���� (3) obtain and maintain a
supply of
[
pre-filled
]

one unit
dose
epinephrine
[
auto-injectors
]
, pursuant to
a standing protocol from a licensed physician or other authorized prescriber,
for use by the youth camp health director and trained designees in emergency
anaphylaxis situations; and

���� (4) establish protocols and
one or more secure locations for the safe and accessible storage of the youth
camp's supply of
[
pre-filled
]

one unit
dose
epinephrine
[
auto-injectors
]
.

(cf: P.L.2015, c.231, s.4)

���� 9.� Section 6 of P.L.2015,
c.231 (C.26:12-22) is amended to read as follows:

���� 6.� Nothing in this act shall
be construed to:

���� a.� permit a trained designee
to perform the duties or fill the position of a licensed medical professional;

���� b.� prohibit the
administration of a
[
pre-filled
]

one unit
dose
epinephrine
[
auto-injector
mechanism
]

by a person acting pursuant to a lawful prescription;

���� c.� prevent a licensed and
qualified member of a health care profession from administering a
[
pre-filled
]

one unit
dose
epinephrine
[
auto-injector
mechanism
]

if the duties are consistent with the accepted standards of practice applicable
to the member's profession;

���� d.� violate the "Athletic
Training Licensure Act," P.L.1984, c.203 (C.45:9-37.35 et seq.) in the
event that a licensed athletic trainer administers epinephrine to a member of
the youth camp community as a trained designee pursuant to this act; or

���� e.� require written
authorization from a camper's parent or guardian, or from any youth camp staff
member, prior to the emergency administration of epinephrine when:

���� (1) there is no identified
medical diagnosis involving risk of anaphylaxis on record with the youth camp
health director; or

���� (2) there is a medical
diagnosis involving risk of anaphylaxis recorded with the youth camp health
director, but the
[
pre-filled
]

one

unit
dose
epinephrine
[
auto-injector
mechanism
]

was not provided to the youth camp by the camper or by the camper's parent or
authorized guardian.

(cf: P.L.2015, c.231, s.6)

���� 10.� This act shall take
effect immediately.

STATEMENT

���� This bill modifies current law
regulating the method in which epinephrine is administered in schools,
institutions of higher education, and youth camps during emergency
circumstances where an individual is experiencing anaphylaxis.� Specifically,
the bill removes references in current law requiring the use of a pre-filled
auto-injector mechanism to administer epinephrine and replaces it with the term
�one use dose epinephrine.�� In doing so, this bill expands the emergency use
of epinephrine in these settings to include epinephrine nasal spray, as well as
future advances in this area of medicine.