1. (a) A youth facility (facility) shall stock at least one unassigned pediatric epinephrine auto-injector pack (two doses) and one adult epinephrine auto-injector pack (two doses). The number of additional pediatric and adult packs may be determined by a facility assessment led by an authorized health-care provider, based on available resources, in accordance with this subchapter.

2. (b) A facility with greater than 100 youth and staff that voluntarily adopts an unassigned epinephrine auto-injector policy shall conduct an assessment to determine the minimum number of additional unassigned epinephrine auto-injectors and may consider as a part of an assessment:

   1. (1) consultation with administrators, office of risk management, food services management, or any department involved with public well-being;
   2. (2) facility geography, including high risk areas where food exposure or environmental trigger exposure may occur;
   3. (3) enrollment limit and number of personnel; and
   4. (4) the number of youth with an identified allergy.

3. (c) An unassigned epinephrine auto-injector policy shall include:

   1. (1) a designated administrator to coordinate and manage policy implementation;
   2. (2) an assessment, if greater than 100 youth and staff;
   3. (3) a training policy for personnel that is consistent with §40.22 of this subchapter (relating to Training);
   4. (4) a requirement to obtain a prescription from an authorized healthcare provider each year to stock, possess, and maintain the minimum number of unassigned epinephrine auto-injectors, described in §40.20 of this subchapter (relating to Applicability), to be dispensed by an authorized pharmacy, as defined by Texas Occupations Code, Chapter 560, §560.001;
   5. (5) a requirement to obtain a standing order designating how and when to administer an unassigned epinephrine auto-injector;
   6. (6) the number of unassigned epinephrine auto-injectors at the facility;
   7. (7) a process to verify the inventory of unassigned epinephrine auto-injectors at regular intervals for expiration and replacement;
   8. (8) a plan to replace, as soon as reasonably possible, any unassigned epinephrine auto-injector when used or close to expiration;
   9. (9) a requirement that the unassigned epinephrine auto-injectors be stored according to manufacturer's instructions;
   10. (10) designation of one or more secure and easily-accessible locations to store unassigned epinephrine auto-injectors; and
   11. (11) procedures for notifying local emergency medical services when a person is suspected of experiencing anaphylaxis and when an epinephrine auto-injector is administered.
4. (d) If a facility implements an unassigned epinephrine auto-injector policy under this subchapter, the facility must provide written or electronic notice to a parent or guardian of each youth enrolled within 15 calendar days.
5. (e) If a facility changes or discontinues the policy adopted under this subchapter, the facility must provide a written or electronic notice detailing the change or discontinuation to a parent or guardian of each youth within 15 calendar days of the change or discontinuation.

Source Note:The provisions of this §40.25 adopted to be effective February 9, 2021, 46 TexReg 917.