SB1619

Regular Session

Relating to the use of an epinephrine delivery system by certain entities.

ModeratePlan for compliance

Low Cost

Effective:2025-09-01

Enforcing Agencies

Health and Human Services Commission • Department of State Health Services • Texas Education Agency • Texas State Board of Pharmacy • Texas Commission on Law Enforcement

Compliance Analysis

Key implementation requirements and action items for compliance with this legislation

Implementation Timeline

Effective Date: September 1, 2025.
Compliance Deadline: September 1, 2025. (To maintain statutory immunity, your standing orders and inventory must align by this date).
Agency Rulemaking: Post-September 1, 2025. The Health and Human Services Commission (HHSC) and Department of State Health Services (DSHS) must update rules regarding maintenance and disposal. Expect a "regulatory gray zone" in Q4 2025 where the law permits nasal sprays, but agency rules may still technically reference injector-specific disposal methods.

Immediate Action Plan

Audit Inventory: Determine if your organization will switch to nasal sprays or remain with auto-injectors for the upcoming fiscal year.
Update Standing Orders: Contact your oversight physician immediately to draft a broader standing order effective Sept 1, 2025.
Revise Manuals: Update all policy documents to reflect the new statutory definition ("Delivery System").
Notify Insurers: Inform your liability insurance carrier of the protocol change to ensure coverage extends to the new delivery method.

Operational Changes Required

Contracts

Physician Standing Orders: CRITICAL. You must secure a new standing order from your prescribing physician. If your current order specifies "auto-injector" and a staff member administers a "nasal spray," you are operating outside the order, potentially voiding civil immunity. The new order must authorize "epinephrine delivery systems."
Training Vendors: Amend scopes of work for third-party CPR/First Aid trainers. Contracts must explicitly require instruction on the specific device type (spray vs. injector) you intend to stock.
Waste Disposal: Review contracts with medical waste handlers. Nasal sprays are pressurized canisters, not sharps; verify if they can be commingled in existing sharps containers or require separate segregation.

Hiring/Training

Retraining Required: Staff trained on the "Blue to the Sky, Orange to the Thigh" method for auto-injectors will fail to administer a nasal spray correctly. Immediate retraining is required upon procurement of new devices.
Visual Aids: Replace laminated instructional placards in first-aid kits. Diagrams must match the stocked device.

Reporting & Record-Keeping

Policy Manual Updates: Conduct a global "Find and Replace" in all internal compliance manuals. Change "Epinephrine Auto-Injector" to "Epinephrine Delivery System."
Incident Reporting: Schools, Higher Ed, and Day-Cares must report administration to the Commissioner of State Health Services and the prescribing physician within 10 business days.
Data Granularity: Reporting forms must be updated to capture the *method of delivery* (intramuscular vs. intranasal) to satisfy state data collection requirements.

Fees & Costs

Procurement Savings: No new state fees. Potential operational savings exist if nasal spray units have a lower price point or longer shelf-life than auto-injectors.
Inventory Management: You may utilize existing auto-injector stock until expiration.

Strategic Ambiguities & Considerations

Disposal Protocols: The law allows the use of sprays immediately, but DSHS disposal rules may lag. Until rules are updated, treat used nasal sprays as medical waste, but consult your waste vendor regarding the pressurized nature of the canister.
Training "Equivalency": The statute requires training on "an epinephrine delivery system." It is unclear if generic training covers all device types. Risk Mitigation: Do not rely on generic training. Ensure training is specific to the manufacturer's device in your cabinet.

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Information presented is for general knowledge only and is provided without warranty, express or implied. Consult qualified government affairs professionals and legal counsel before making compliance decisions.

Legislative Timeline

This bill's path through the Texas Legislature

TopicsDay Care Education Education--higher Education--higher--general Education--primary & Secondary Education--primary & Secondary--charter Schools Education--primary & Secondary--general Health Health--emergency Services & Personnel Health--other Diseases & Medical Conditions Law Enforcement Minors Minors--health & Safety Medicine & Prescription Drugs Pharmacies & Pharmacists Health & Human Services Commission

Official Analysis

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BILL ANALYSIS

Senate Research Center	S.B. 1619
89R5992 RAL-F	By: Zaffirini
	Education K-16
	3/17/2025
	As Filed

AUTHOR'S / SPONSOR'S STATEMENT OF INTENT

The administration of epinephrine, the first-line treatment for anaphylaxis�a severe, potentially life-threatening allergic reaction that can cause difficulty breathing, swelling, and a dangerous drop in blood pressure�has traditionally relied on auto-injectors, such as EpiPens. New technologies, however, including nasal sprays and other emerging delivery methods, offer additional treatment options. Some of these alternatives may be more affordable and accessible, yet current Texas law exclusively references "auto-injectors," which may create confusion and limit the adoption of newer, medically approved devices. Updating statutory language is necessary to ensure Texans can access all available epinephrine treatments without requiring frequent legislative updates.

S.B. 1619 is a cleanup bill that would replace the term "auto-injector" with "delivery device" across relevant statutes. This update would ensure the law includes all FDA-approved epinephrine delivery methods, including current and future technologies, while helping to remove unnecessary cost barriers for patients.

By modernizing terminology, improving statutory consistency, and allowing for more affordable treatment options, S.B. 1619 would help ensure Texans experiencing anaphylaxis have access to the most effective and cost-efficient epinephrine treatments available.

As proposed, S.B. 1619 amends current law relating to the use of an epinephrine delivery device by certain entities.

RULEMAKING AUTHORITY

Rulemaking authority previously granted to the commissioner of state health services is transferred to the executive commissioner of the Health and Human Services Commission and modified in SECTION 16 (Section 51.882, Education Code) of this bill.

Rulemaking authority previously granted to the executive commissioner of the Health and Human Services Commission is modified in SECTION 7 (Section 38.208, Education Code), SECTION 23 (Section 773.014, Health and Safety Code), and SECTION 25 (Section 773.050, Health and Safety Code) of this bill.

Rulemaking authority previously granted to the Texas State Board of Pharmacy is modified in SECTION 29 (Section 562.057, Occupations Code) of this bill.

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Section 38.0151(f), Education Code, to provide that a school district or open-enrollment charter school that provides for the maintenance, administration, and disposal of epinephrine delivery devices, rather than epinephrine auto-injectors, under Subchapter E is not required to comply with Section 38.0151 (Policies for Care of Certain Students at Risk of Anaphylaxis).

SECTION 2. Amends the heading to Subchapter E, Chapter 38, Education Code, to read as follows:

SUBCHAPTER E. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE DELIVERY DEVICES AND MEDICATION FOR RESPIRATORY DISTRESS

SECTION 3. Amends Section 38.201, Education Code, by amending Subdivision (3-a) and adding Subdivision (3-b) to define "epinephrine delivery device."

SECTION 4. Amends Section 38.202(a), Education Code, to make conforming changes.

SECTION 5. Amends Section 38.207, Education Code, to make conforming changes.

SECTION 6. Amends the heading to Section 38.208, Education Code, to read as follows:

Sec. 38.208. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE DELIVERY DEVICES AND MEDICATION FOR RESPIRATORY DISTRESS.

SECTION 7. Amends Sections 38.208(a), (b), (c), (d), (d-2), and (e), Education Code, as follows:

(a)-(b) Makes conforming changes to these subsections.

(c) Requires the executive commissioner of the Health and Human Services Commission (executive commissioner), in consultation with the commissioner of education, and with advice from the advisory committee established under Section 38.202 (Advisory Committee: Establishment and Composition) as appropriate, to adopt rules regarding the maintenance, administration, and disposal of an epinephrine deliver device, rather than an epinephrine auto-injector, at a school campus. Makes conforming changes.

(d), (d-2), and (e) Makes conforming changes to these subsections.

SECTION 8. Amends Section 38.209, Education Code, as follows:

Sec. 38.209. New heading: REPORT ON ADMINISTERING EPINEPHRINE DELIVERY DEVICE. (a)-(b) Makes conforming changes to these subsections.

SECTION 9. Amends Section 38.210(a), Education Code, to make conforming changes.

SECTION 10. Amends the heading to Section 38.211, Education Code, to read as follows:

Sec. 38.211. PRESCRIPTION OF EPINEPHRINE DELIVERY DEVICES AND MEDICATION FOR RESPIRATORY DISTRESS.

SECTION 11. Amends Sections 38.211(a), (b), (c), (e), and (f), Education Code, as follows:

(a)-(c) Makes conforming changes to these subsections.

(e) Requires that an order issued under Section 38.211 contain certain information, including, as applicable, the quantity and types of epinephrine delivery devices, rather than epinephrine auto-injectors, or the quantity and types of medications for respiratory distress to be obtained and maintained under the order.

(f) Makes a conforming change to this subsection.

SECTION 12. Amends Section 38.215(a), Education Code, to make conforming changes.

SECTION 13. Amends the heading to Subchapter Y-1, Chapter 51, Education Code, to read as follows:

SUBCHAPTER Y-1. MAINTENANCE, STORAGE, ADMINISTRATION, AND DISPOSAL OF EPINEPHRINE DELIVERY DEVICES

SECTION 14. Amends Section 51.881, Education Code, by adding Subdivision (4-a) to define "epinephrine delivery device."

SECTION 15. Amends the heading to Section 51.882, Education Code, to read as follows:

Sec. 51.882. MAINTENANCE, STORAGE, ADMINISTRATION, AND DISPOSAL OF EPINEPHRINE DELIVERY DEVICES.

SECTION 16. Amends Sections 51.882(a), (b), (c), (d), and (e), Education Code, as follows:

(a)-(b) Makes conforming changes to these subsections.

(c) Requires the executive commissioner, rather than the commissioner of state health services, with advice from the advisory committee to adopt rules regarding the maintenance, storage, administration, and disposal of an epinephrine delivery device, rather than an epinephrine auto-injector, on the campus of an institution of higher education subject to a policy adopted under Subsection (a) (relating to authorizing each institution of higher education to adopt and implement a policy regarding epinephrine delivery devices on the institution's campus). Makes conforming changes.

(d)-(e) Makes conforming changes to these subsections.

SECTION 17. Amends Section 51.883, Education Code, as follows:

Sec. 51.883. New heading: REPORT ON ADMINISTERING EPINEPHRINE DELIVERY DEVICE. (a)-(b) Makes conforming changes to these subsections.

SECTION 18. Amends Sections 51.884(a) and (b), Education Code, to make conforming changes.

SECTION 19. Amends the heading to Section 51.885, Education Code, to read as follows:

Sec. 51.885. PRESCRIPTION OF EPINEPHRINE DELIVERY DEVICES.

SECTION 20. Amends Sections 51.885(a), (b), (d), and (e), Education Code, to make conforming changes.

SECTION 21. Amends Section 51.888(a), Education Code, to make conforming changes.

SECTION 22. Amends Section 773.003, Health and Safety Code, by amending Subdivision (15-a) and adding Subdivisions (15-b) and (15-c) to define "epinephrine auto-injector" and "epinephrine delivery device."

SECTION 23. Amends Sections 773.014(a), (b), (c), (c-1), (d), (e), (f), and (g), Health and Safety Code, as follows:

(a) Makes conforming changes to this subsection.

(b) Requires that the rules adopted by the executive commissioner designed to protect the public health and safety to implement Section 773.014 (Administration of Epinephrine by Emergency Medical Services Personnel) authorize emergency services personnel to administer an epinephrine delivery device, rather than an epinephrine auto-injector device, to another only if the person has successfully completed a certain training course.

(c)-(g) Makes conforming changes to these subsections.

SECTION 24. Amends Sections 773.0145(a), (c), (d), (e), (f), (g), (h), (i), (k), (l), (m), (o), (p), (q), and (r), Health and Safety Code, to make conforming changes.

SECTION 25. Amends Section 773.050(g), Health and Safety Code, to require that rules by the executive commissioner adopting minimum standards under Section 773.050 (Minimum Standards) require an emergency services vehicle to be equipped with an epinephrine delivery device, rather than with an epinephrine auto-injector device or similar device, to treat anaphylaxis.

SECTION 26. Amends the heading to Section 42.067, Human Resources Code, to read as follows:

Sec. 42.067. EPINEPHRINE DELIVERY DEVICES; IMMUNITY FROM LIABILITY.

SECTION 27. Amends Section 42.067(a), Human Resources Code, by adding Subdivision (2-a) to define "epinephrine delivery device."

SECTION 28. Amends Sections 42.067(b), (c), (d), (f), (g), (h), (i), (k), (l), (n), and (q), Human Resources Code, to make conforming changes.

SECTION 29. Amends Section 562.057, Occupations Code, as follows:

(a) Makes conforming changes to this subsection.

(b) Requires that the rules adopted by the Texas State Board of Pharmacy designed to protect the public health and safety to implement Section 562.057 (Administration of Epinephrine) provide that a pharmacist is authorized to administer epinephrine through an epinephrine delivery device, rather than through an epinephrine auto-injector device, to a patient in an emergency situation.

(c)-(f) Makes conforming changes to these subsections.

(g) Defines "epinephrine auto-injector" and "epinephrine delivery device."

SECTION 30. Amends Section 1701.701, Occupations Code, by adding Subdivision (2-a) to define "epinephrine delivery device."

SECTION 31. Amends Section 1701.702, Occupations Code, to make conforming changes.

SECTION 32. Amends Sections 1701.703(a), (b), (c), (e), and (f), Occupations Code, to make conforming changes.

SECTION 33. Amends Section 1701.704, Occupations Code, as follows:

Sec. 1701.704. New heading: MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE DELIVERY DEVICES. Makes conforming changes to this section.

SECTION 34. Amends Section 1701.705, Occupations Code, as follows:

Sec. 1701.705. New heading: NOTIFICATION OF ADMINISTRATION OF EPINEPHRINE DELIVERY DEVICE. Makes conforming changes to this section.

SECTION 35. Amends Section 1701.707, Occupations Code, to make a conforming change.

SECTION 36. Amends Section 1701.708(a), Occupations Code, to make conforming changes.

SECTION 37. Effective date: upon passage or September 1, 2025.

Senate Authors

Sen. Judith ZaffiriniDemocrat · Primary Author

Coauthors (1)

Juan Hinojosa (D)

House Sponsors

Rep. Philip CortezDemocrat · Primary Sponsor

Joint Sponsors

Terri Leo-Wilson (R)

Bill Text(with markup)

S.B. No. 1619

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Fiscal NoteView Original

	AN ACT
	relating to the use of an epinephrine delivery system by certain
	entities.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1. Section 38.0151(f), Education Code, is amended
	to read as follows:
	(f) A school district or open-enrollment charter school
	that provides for the maintenance, administration, and disposal of
	epinephrine delivery systems [~~auto-injectors~~] under Subchapter E
	is not required to comply with this section.
	SECTION 2. The heading to Subchapter E, Chapter 38,
	Education Code, is amended to read as follows:
	SUBCHAPTER E. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE
	DELIVERY SYSTEMS [~~AUTO-INJECTORS~~] AND MEDICATION FOR RESPIRATORY
	DISTRESS
	SECTION 3. Section 38.201, Education Code, is amended by
	amending Subdivision (3-a) and adding Subdivision (3-b) to read as
	follows:
	(3-a) "Epinephrine delivery system" means a medical
	delivery device approved by the United States Food and Drug
	Administration that delivers a dose of epinephrine intended for use
	to treat anaphylaxis, including:
	(A) an epinephrine auto-injector; and
	(B) an epinephrine nasal spray.
	(3-b) "Medication for respiratory distress" means
	albuterol, levalbuterol, or another medication designated by the
	executive commissioner of the Health and Human Services Commission
	for treatment of respiratory distress under Section 38.208(c).
	SECTION 4. Section 38.202(a), Education Code, is amended to
	read as follows:
	(a) The commissioner of state health services shall
	establish an advisory committee to examine and review the
	administration, on a campus of a school district, an
	open-enrollment charter school, a private school, or an institution
	of higher education, of:
	(1) epinephrine delivery systems [~~auto-injectors~~] to
	a person experiencing an anaphylactic reaction; and
	(2) medication for respiratory distress to a person
	experiencing respiratory distress.
	SECTION 5. Section 38.207, Education Code, is amended to
	read as follows:
	Sec. 38.207. ADVISORY COMMITTEE: DUTIES. The advisory
	committee shall advise the commissioner of state health services
	on:
	(1) the storage and maintenance of epinephrine
	delivery systems [~~auto-injectors~~] and medication for respiratory
	distress on school campuses and campuses of institutions of higher
	education;
	(2) the training of school personnel and school
	volunteers, and of personnel and volunteers at institutions of
	higher education, in the administration of an epinephrine delivery
	system [~~auto-injector~~];
	(3) the training of school personnel and school
	volunteers, and of personnel and volunteers at institutions of
	higher education, in the administration of a medication for
	respiratory distress; and
	(4) a plan for:
	(A) one or more school personnel members or
	school volunteers trained in the administration of an epinephrine
	delivery system [~~auto-injector~~] to be on each school campus;
	(B) one or more school personnel members or
	school volunteers trained in the administration of medication for
	respiratory distress to be on each school campus;
	(C) one or more personnel members or volunteers
	of an institution of higher education trained in the administration
	of an epinephrine delivery system [~~auto-injector~~] to be on each
	campus of an institution of higher education; and
	(D) one or more personnel members or volunteers
	of an institution of higher education trained in the administration
	of medication for respiratory distress to be on each campus of an
	institution of higher education.
	SECTION 6. The heading to Section 38.208, Education Code,
	is amended to read as follows:
	Sec. 38.208. MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE
	DELIVERY SYSTEMS [~~AUTO-INJECTORS~~] AND MEDICATION FOR RESPIRATORY
	DISTRESS.
	SECTION 7. Sections 38.208(a), (b), (c), (d), (d-2), and
	(e), Education Code, are amended to read as follows:
	(a) Each school district, open-enrollment charter school,
	and private school may adopt and implement a policy regarding the
	maintenance, administration, and disposal of epinephrine delivery
	systems [~~auto-injectors~~] at each campus in the district or school.
	(b) If a policy is adopted under Subsection (a), the policy:
	(1) must provide that school personnel and school
	volunteers who are authorized and trained may administer an
	epinephrine delivery system [~~auto-injector~~] to a person who is
	reasonably believed to be experiencing anaphylaxis on a school
	campus; and
	(2) may provide that school personnel and school
	volunteers who are authorized and trained may administer an
	epinephrine delivery system [~~auto-injector~~] to a person who is
	reasonably believed to be experiencing anaphylaxis at an off-campus
	school event or while in transit to or from a school event.
	(c) The executive commissioner of the Health and Human
	Services Commission, in consultation with the commissioner of
	education, and with advice from the advisory committee as
	appropriate, shall adopt rules regarding the maintenance,
	administration, and disposal of an epinephrine delivery system
	[~~auto-injector~~] at a school campus subject to a policy adopted
	under Subsection (a) and the maintenance, administration, and
	disposal of medication for respiratory distress at a school campus
	subject to a policy adopted under Subsection (a-1). The rules must
	establish:
	(1) the number of epinephrine delivery systems
	[~~auto-injectors~~] available at each campus;
	(2) the amount of medication for respiratory distress
	available at each campus;
	(3) the process for each school district,
	open-enrollment charter school, and private school to check the
	inventory of epinephrine delivery systems [~~auto-injectors~~] and
	medication for respiratory distress at regular intervals for
	expiration and replacement;
	(4) the amount of training required for school
	personnel and school volunteers to administer:
	(A) an epinephrine delivery system
	[~~auto-injector~~]; or
	(B) medication for respiratory distress; and
	(5) the types of medication that may be administered
	under Subsection (b-1) to persons experiencing respiratory
	distress, based on a review of the best available medical evidence.
	(d) Each school district, open-enrollment charter school,
	and private school that adopts a policy under Subsection (a) must
	require that each campus have one or more school personnel members
	or school volunteers authorized and trained to administer an
	epinephrine delivery system [~~auto-injector~~] present during all
	hours the campus is open.
	(d-2) A school personnel member or school volunteer may not
	be subject to any penalty or disciplinary action for refusing to
	administer or receive training to administer epinephrine delivery
	systems [~~auto-injectors~~] or medication for respiratory distress,
	as applicable, in accordance with a policy adopted under Subsection
	(a) or (a-1).
	(e) The supply of epinephrine delivery systems
	[~~auto-injectors~~] at each campus must be stored in a secure location
	and be easily accessible to school personnel and school volunteers
	authorized and trained to administer an epinephrine delivery system
	[~~auto-injector~~].
	SECTION 8. Section 38.209, Education Code, is amended to
	read as follows:
	Sec. 38.209. REPORT ON ADMINISTERING EPINEPHRINE DELIVERY
	SYSTEM [~~AUTO-INJECTOR~~]. (a) Not later than the 10th business day
	after the date a school personnel member or school volunteer
	administers an epinephrine delivery system [~~auto-injector~~] in
	accordance with a policy adopted under Section 38.208(a), the
	school shall report the information required under Subsection (b)
	to:
	(1) the school district, the charter holder if the
	school is an open-enrollment charter school, or the governing body
	of the school if the school is a private school;
	(2) the physician or other person who prescribed the
	epinephrine delivery system [~~auto-injector~~]; and
	(3) the commissioner of state health services.
	(b) The report required under this section must include the
	following information:
	(1) the age of the person who received the
	administration of the epinephrine delivery system [~~auto-injector~~];
	(2) whether the person who received the administration
	of the epinephrine delivery system [~~auto-injector~~] was a student, a
	school personnel member or school volunteer, or a visitor;
	(3) the physical location where the epinephrine
	delivery system [~~auto-injector~~] was administered;
	(4) the number of doses of epinephrine delivery system
	[~~auto-injector~~] administered;
	(5) the title of the person who administered the
	epinephrine delivery system [~~auto-injector~~]; and
	(6) any other information required by the commissioner
	of education.
	SECTION 9. Section 38.210(a), Education Code, is amended to
	read as follows:
	(a) Each school district, open-enrollment charter school,
	and private school that adopts a policy under Section 38.208(a) is
	responsible for training school personnel and school volunteers in
	the administration of an epinephrine delivery system
	[~~auto-injector~~]. The training must include information on:
	(1) recognizing the signs and symptoms of anaphylaxis;
	(2) administering an epinephrine delivery system
	[~~auto-injector~~];
	(3) implementing emergency procedures, if necessary,
	after administering an epinephrine delivery system
	[~~auto-injector~~]; and
	(4) properly disposing of used or expired epinephrine
	delivery systems [~~auto-injectors~~].
	SECTION 10. The heading to Section 38.211, Education Code,
	is amended to read as follows:
	Sec. 38.211. PRESCRIPTION OF EPINEPHRINE DELIVERY SYSTEMS
	[~~AUTO-INJECTORS~~] AND MEDICATION FOR RESPIRATORY DISTRESS.
	SECTION 11. Sections 38.211(a), (b), (c), (e), and (f),
	Education Code, are amended to read as follows:
	(a) A physician or person who has been delegated
	prescriptive authority under Chapter 157, Occupations Code, may
	prescribe epinephrine delivery systems [~~auto-injectors~~] or
	medication for respiratory distress in the name of a school
	district, open-enrollment charter school, or private school.
	(b) A physician or other person who prescribes epinephrine
	delivery systems [~~auto-injectors~~] or medication for respiratory
	distress under Subsection (a) shall provide the school district,
	open-enrollment charter school, or private school with a standing
	order for the administration of, as applicable:
	(1) an epinephrine delivery system [~~auto-injector~~] to
	a person reasonably believed to be experiencing anaphylaxis; or
	(2) medication for respiratory distress to a person
	reasonably believed to be experiencing respiratory distress.
	(c) The standing order under Subsection (b) is not required
	to be patient-specific, and the epinephrine delivery system
	[~~auto-injector~~] or medication for respiratory distress may be
	administered to a person without a previously established
	physician-patient relationship.
	(e) An order issued under this section must contain:
	(1) the name and signature of the prescribing
	physician or other person;
	(2) the name of the school district, open-enrollment
	charter school, or private school to which the order is issued;
	(3) as applicable, the quantity and types of
	epinephrine delivery systems [~~auto-injectors~~] or the quantity and
	types of medications for respiratory distress to be obtained and
	maintained under the order; and
	(4) the date of issue.
	(f) A pharmacist may dispense an epinephrine delivery
	system [~~auto-injector~~] or medication for respiratory distress to a
	school district, open-enrollment charter school, or private school
	without requiring the name or any other identifying information
	relating to the user.
	SECTION 12. Section 38.215(a), Education Code, is amended
	to read as follows:
	(a) A person who in good faith takes, or fails to take, any
	action under this subchapter is immune from civil or criminal
	liability or disciplinary action resulting from that action or
	failure to act, including:
	(1) issuing an order for epinephrine delivery systems
	[~~auto-injectors~~] or medication for respiratory distress;
	(2) supervising or delegating the administration of an
	epinephrine delivery system [~~auto-injector~~] or medication for
	respiratory distress;
	(3) possessing, maintaining, storing, or disposing of
	an epinephrine delivery system [~~auto-injector~~] or medication for
	respiratory distress;
	(4) prescribing an epinephrine delivery system
	[~~auto-injector~~] or medication for respiratory distress;
	(5) dispensing:
	(A) an epinephrine delivery system
	[~~auto-injector~~]; or
	(B) medication for respiratory distress;
	(6) administering, or assisting in administering, an
	epinephrine delivery system [~~auto-injector~~] or medication for
	respiratory distress;
	(7) providing, or assisting in providing, training,
	consultation, or advice in the development, adoption, or
	implementation of policies, guidelines, rules, or plans; or
	(8) undertaking any other act permitted or required
	under this subchapter.
	SECTION 13. The heading to Subchapter Y-1, Chapter 51,
	Education Code, is amended to read as follows:
	SUBCHAPTER Y-1. MAINTENANCE, STORAGE, ADMINISTRATION, AND
	DISPOSAL OF EPINEPHRINE DELIVERY SYSTEMS [~~AUTO-INJECTORS~~]
	SECTION 14. Section 51.881, Education Code, is amended by
	adding Subdivision (4-a) to read as follows:
	(4-a) "Epinephrine delivery system" means a medical
	delivery device approved by the United States Food and Drug
	Administration that delivers a dose of epinephrine intended for use
	to treat anaphylaxis, including:
	(A) an epinephrine auto-injector; and
	(B) an epinephrine nasal spray.
	SECTION 15. The heading to Section 51.882, Education Code,
	is amended to read as follows:
	Sec. 51.882. MAINTENANCE, STORAGE, ADMINISTRATION, AND
	DISPOSAL OF EPINEPHRINE DELIVERY SYSTEMS [~~AUTO-INJECTORS~~].
	SECTION 16. Sections 51.882(a), (b), (c), (d), and (e),
	Education Code, are amended to read as follows:
	(a) Each institution of higher education may adopt and
	implement a policy regarding the maintenance, storage,
	administration, and disposal of epinephrine delivery systems
	[~~auto-injectors~~] on the institution's campus.
	(b) If a policy is adopted under Subsection (a), the policy:
	(1) must provide that personnel or volunteers who are
	authorized and trained may administer an epinephrine delivery
	system [~~auto-injector~~] to a person who is reasonably believed to be
	experiencing anaphylaxis on the institution's campus; and
	(2) may provide that personnel or volunteers who are
	authorized and trained may administer an epinephrine delivery
	system [~~auto-injector~~] to a person who is reasonably believed to be
	experiencing anaphylaxis at an off-campus event or while in transit
	to or from an off-campus event sponsored by the institution of
	higher education.
	(c) The executive commissioner of the Health and Human
	Services Commission [~~state health services~~] with advice from the
	advisory committee shall adopt rules regarding the maintenance,
	storage, administration, and disposal of an epinephrine delivery
	system [~~auto-injector~~] on the campus of an institution of higher
	education subject to a policy adopted under Subsection (a). The
	rules must establish:
	(1) the number of epinephrine delivery systems
	[~~auto-injectors~~] available at each campus;
	(2) the process for each institution of higher
	education to check the inventory of epinephrine delivery systems
	[~~auto-injectors~~] at regular intervals for expiration and
	replacement; and
	(3) the amount of training required for personnel or
	volunteers to administer an epinephrine delivery system
	[~~auto-injector~~].
	(d) Each institution of higher education that adopts a
	policy under Subsection (a):
	(1) must require that the institution's campuses have
	personnel or volunteers authorized and trained to administer an
	epinephrine delivery system [~~auto-injector~~] present; and
	(2) shall include the policy in the institution's
	student handbook or similar publication and publish the policy on
	the institution's Internet website.
	(e) The supply of epinephrine delivery systems
	[~~auto-injectors~~] at a campus must be stored in a secure location and
	be easily accessible to personnel or volunteers authorized and
	trained to administer an epinephrine delivery system
	[~~auto-injector~~].
	SECTION 17. Section 51.883, Education Code, is amended to
	read as follows:
	Sec. 51.883. REPORT ON ADMINISTERING EPINEPHRINE DELIVERY
	SYSTEM [~~AUTO-INJECTOR~~]. (a) Not later than the 10th business day
	after the date a personnel member or volunteer administers an
	epinephrine delivery system [~~auto-injector~~] in accordance with a
	policy adopted under Section 51.882(a), the institution of higher
	education shall report the information required under Subsection
	(b) to:
	(1) the physician who prescribed the epinephrine

LEGISLATIVE BUDGET BOARD
Austin, Texas

FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION


March 17, 2025

TO:	Honorable Brandon Creighton, Chair, Senate Committee on Education K-16

FROM:	Jerry McGinty, Director, Legislative Budget Board

IN RE:	SB1619 by Zaffirini (Relating to the use of an epinephrine delivery device by certain entities.), As Introduced

No significant fiscal implication to the State is anticipated.

It is assumed that any costs associated with the bill could be absorbed using existing resources.

Local Government Impact

No significant fiscal implication to units of local government is anticipated.

Source Agencies:

405 Department of Public Safety, 407 Commission on Law Enforcement, 503 Texas Medical Board, 515 Board of Pharmacy, 529 Health and Human Services Commission, 537 State Health Services, Department of, 701 Texas Education Agency, 710 Texas A&M University System Administrative and General Offices, 720 The University of Texas System Administration

LBB Staff:

JMc, JPE, THO, NAz

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Frequently Asked Questions

Common questions about SB1619

What does Texas SB1619 do?

SB1619 fundamentally redefines emergency anaphylaxis protocols by replacing the specific term "epinephrine auto-injector" with the broader "epinephrine delivery system. " This amendment authorizes schools, day-cares, higher education institutions, and opt-in entities (venues, restaurants) to procure and administer FDA-approved nasal sprays in addition to traditional EpiPens. While this offers procurement flexibility, it creates an immediate liability risk if your standing orders and training manuals are not updated to match the specific device types in your inventory.

Who authored SB1619?

SB1619 was authored by Texas Senator Judith Zaffirini during the Regular Session.

When was SB1619 signed into law?

SB1619 was signed into law by Governor Greg Abbott on May 19, 2025.

Which agencies enforce SB1619?

SB1619 is enforced by Health and Human Services Commission, Department of State Health Services, Texas Education Agency, Texas State Board of Pharmacy and Texas Commission on Law Enforcement.

How urgent is compliance with SB1619?

The compliance urgency for SB1619 is rated as "moderate". Businesses and organizations should review the requirements and timeline to ensure timely compliance.

What is the cost impact of SB1619?

The cost impact of SB1619 is estimated as "low". This may vary based on industry and implementation requirements.

What topics does SB1619 address?

SB1619 addresses topics including day care, education, education--higher, education--higher--general and education--primary & secondary.

Legislative data provided by LegiScanLast updated: November 25, 2025

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