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Bill

A 4656

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

2026-2027 Regular Session Introduced by Linda Carter

Allows broader administration of one unit dose epinephrine in schools, colleges, and camps by trained designees, with policies, training, and liability protections.

Introduced, Referred to Assembly Health Committee
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Bill Summary · A 4656

Summary of New Jersey Bill A-4656 (Session 222)

Purpose and Intent

A-4656 broadens how epinephrine can be administered in emergencies in schools, higher education institutions, and youth camps. By replacing references to a specific “pre-filled auto-injector mechanism” with the broader term “one unit dose epinephrine,” the bill aims to allow use of other delivery forms (including nasal spray) and accommodate future medical advances, while expanding who may administer epinephrine in certain settings.

Key Provisions and Changes

  • Schools (K-12) and Nonpublic Schools

    • Requires school districts and nonpublic schools to develop an emergency epinephrine policy aligned with Department of Education guidelines.
    • Policies must:
    • Require written authorization and physician/nurse orders for a pupil to receive epinephrine for anaphylaxis.
    • Include liability notices and indemnification by parents/guardians.
    • Ensure epinephrine is stored securely yet accessibly to the school nurse or designees; have a back-up supply.
    • Require on-site nurse presence and transportation of the pupil to the hospital after administration.
    • Allow school nurses or trained designees to administer “one unit dose epinephrine” to pupils without a known history of anaphylaxis or when parent requirements are not met, in good faith belief of anaphylaxis.
    • Mandate that all schools maintain a supply of epinephrine auto-injectors under a standing protocol.

  • Designees and Training (Schools)

    • The school nurse determines designee eligibility; designees must be trained using standardized DOE health guidelines.
    • Licensed athletic trainers may serve as designees without violating Athletic Training Licensure Act provisions.

  • Self-Administration (Students)

    • Maintains authority for pupil self-administration of asthma or other life-threatening illnesses, including epinephrine, under written authorization and physician certification.
    • Students may carry a predecessor auto-injector option and other prescribed medications, provided safety is maintained.
    • Immunity from civil/criminal liability for action taken in good faith under the act.

  • Higher Education Institutions

    • Reframes terminology to “one unit dose epinephrine” and defines key roles:
    • Licensed campus medical professionals (physicians, PAs, APNs, RNs) oversee programs.
    • “Trained designee” is a campus community member trained to administer epinephrine in anaphylactic events when a medical professional isn’t available.
    • Institutions may develop policies to permit designees to administer epinephrine and to carry epi supplies under standing protocols.
    • Requires a licensed campus medical professional to establish and supervise training and distribution protocols for epinephrine.

  • Youth Camps (and New Jersey Youth Camp Safety Act)

    • Allows camp operators to implement epinephrine emergency policies when a health professional is not immediately available.
    • Requires standardized training protocols, secure storage, and a standing physician-prescribed supply of epinephrine.
    • Defines roles for youth camp health directors and trained designees, with options if a health director is not a medical professional.

  • Effective Date

    • The act takes effect immediately upon enactment.

Who Is Affected

  • Public and nonpublic K-12 schools, higher education institutions, and youth camps in New Jersey.
  • Students/pupils with potential or known risk of anaphylaxis.
  • School nurses, designees, athletic trainers, campus medical professionals, health directors, youth camp operators, and staff.
  • Parents/guardians of affected students.

Procedural and Timeline Aspects

  • Requires development and adoption of policies by educational institutions and youth camps.
  • Policies and training must align with Department of Education and Department of Health guidelines and standing protocols.
  • Annual renewal of certain permissions and consent provisions when extending beyond a school year.

Note: The bill text specifies shifting terminology from “pre-filled auto-injector mechanism” to “one unit dose epinephrine,” enabling broader administration methods while preserving safety, liability, and training requirements.

Compiled from official sources — confirm details with the bill’s official record.

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