Nurses warn of legal and implementation problems with bill to allow use of "any available" epinephrine

Substitute SB 5,240 would change the circumstances under which school-supplied epinephrine and auto-injectors may be administered. Under the bill, if a student has a prescription on file, a school nurse or designated trained school personnel could administer any available epinephrine on school property by any route; when no prescription is on file, only a school nurse may administer epinephrine.

Megan Wargacki briefed the bill and explained the reimbursement requirement if a school uses epinephrine that is not school supplied. School nurses and their representatives testified with implementation concerns: Taylor Mason, a Wenatchee school nurse representing the School Nurse Organization of Washington, said the bill would allow a nurse to use one student's prescription on another and that the Washington State Board of Nursing has raised concerns that such use could violate statutes prohibiting use of a drug without a prescription and the Nurse Practice Act.

Nurses urged pursuing alternative solutions such as securing stock epinephrine under standing orders (a program passed in 2024 that some districts have used), which can supply free or low-cost pens and avoid using another student's prescribed medicine. The School Nurse Organization and other witnesses asked the committee to pause the bill to resolve legal and ethical implications and to focus on expanding standing orders and stock availability.

Other witnesses, including independent-school representatives, asked that training and parity be ensured for personnel expected to administer epinephrine on field trips or when nurses are not present.

Committee staff noted the bill contains no definition limiting the form or concentration of the term "any available epinephrine," prompting questions about dosing, multi-dose vials versus auto-injectors and safe implementation. No vote was taken during the hearing.