Epinephrine Auto-injector Law

Recreation camps, colleges, universities, preschools day-care facilities, nursing homes, boarding care homes, home care providers, and food and beverage establishments may obtain and use epinephrine auto-injectors

Anaphylaxis is a severe allergic reaction that is rapid in onset and can be life-threatening. Injecting a dose of epinephrine into an individual experiencing anaphylaxis can lessen the intensity of the allergic reaction and save the individual’s life.

Minn. Stat. § 144.999 allows authorized entities including recreation camps, colleges, universities, preschools and day-care facilities to obtain, store, and use epinephrine auto-injectors without a prescription. The law authorizes the Commissioner of Health to add additional categories of authorized entities, and licensed nursing homes, boarding care homes, home care providers, and food and beverage establishments have been added. After successfully completing an anaphylaxis training program, owners, managers, employees and/or agents of an authorized entity may provide or administer an epinephrine auto-injector to an individual whom they believe in good faith is experiencing anaphylaxis.

Starting on August 1, 2019, an individual may also complete an approved training program, and may obtain epinephrine auto-injectors from a licensed wholesale pharmacy. An authorized individual is responsible for storage and control of epinephrine auto-injectors the individual possesses. An authorized individual may provide or administer an epinephrine auto-injector to an individual whom they believe in good faith is experiencing anaphylaxis.

Under the law, authorized entities and individuals are under no duty or obligation to obtain or store epinephrine auto-injectors, or administer an epinephrine auto-injector shot. 

See Minn. Stat. § 144.999.

What organizations are considered an “authorized entity” under this law?

• Recreation camps as defined in Minn. Stats. §§ 327.14 -.28.
• Colleges and universities as defined in Minn. Stats. §§ 136A.62 - .821.
• “Day-care facilities” and “preschools” including both licensed and licensed-exempt programs that provide day care or preschool services to children. Minnesota laws governing licensed child-care programs are found in Minnesota Statutes Chapter 245A; Minnesota Rules Chapter 9502 (family child care); and Minnesota Rules Chapter 9503 (child care centers). 
• Nursing homes as defined in Minn. Stat. § 144A and Minnesota Rule 4658.
• Home care providers as defined in Minn. Stat. 144A.43-.484.
• Boarding care homes as defined in Minnesota Rule 4655.
• Food and beverages establishments licensed under Minnesota Statutes Chapter 157.

If your authorized entity is licensed, you must still abide by all licensing requirements. If you have questions about how this law impacts your compliance with licensing requirements, please contact your licensing agency. For nursing homes and boarding care homes, see Health Regulation Information Bulletin 19-04, and for home care providers, see Health Regulation Information Bulletin 19-05.

Recreation camps, colleges and universities, and preschools and daycares are listed in the statute. Nursing homes and home care providers were added by the Commissioner of Health in November 2016. Food and beverage establishments were added by the Commissioner of Health in March 2022.

Who must get training?

Owners, managers, employees or agents of an authorized entity who choose to obtain and possess epinephrine auto-injectors without a prescription must successfully complete anaphylaxis training.   

Every two years, an individual must complete an anaphylaxis-training program that is conducted by:

• A nationally recognized organization that is experienced in training laypersons in emergency health treatment;
• A statewide organization with experience providing training on allergies and anaphylaxis under the supervision of board-certified allergy medical advisors; or
• An entity or individual approved by the Commissioner of the Minnesota Department of Health to provide an anaphylaxis training program.

After successfully completing training, an authorized individual may administer an injection to an individual experiencing anaphylaxis or provide the auto-injector device to the individual or the individual’s caregiver or legal guardian for administration. 

There is no limit in the number of owners, managers, employees or agents of an authorized entity who may complete anaphylaxis training. An authorized entity shall designate employees or agents who have completed training to be responsible for storing, maintaining, and controlling the epinephrine auto-injectors. 

Where can I get training?

• The American Red Cross
• Anaphylaxis and Food Allergy Association of Minnesota
• AllerTrain
• Wilderness Medical Associates International
• Mid-Minnesota EMS Education, Inc.
• Health & Safety Institute
• Code Ana
• Food Allergy Research and Education (FARE)
• Online Anaphylaxis Training by ProTrainings

The training program shall issue a certificate to each individual who completes the anaphylaxis-training program, and the certification of completion is valid for two years from the date issued. 

There is no required form for the training certificate, but each certificate should contain at least the following information:

• Name of the trainer or training organization.
• Date training completed.
• The topics covered in the training.

Where do we get epinephrine auto-injectors?

Epinephrine auto-injectors are available from pharmacies licensed by the Minnesota Board of Pharmacy as wholesale drug distributors under Minn. Stat. § 151.47. Not all pharmacies are licensed wholesalers. To locate licensed pharmacy wholesalers, go to:

Minnesota Board of Pharmacy Licensee / Registrant Search

You can also call your local community or hospital pharmacy to inquire if they are licensed as a wholesaler. Note that an authorized individual must present a valid training certificate to the pharmacy/wholesaler in order to purchase epinephrine auto-injectors. 

How do we store the epinephrine auto-injectors?

Epinephrine auto-injectors must be stored in a readily-accessible location for emergency use and in accordance with the device’s instructions. An authorized entity shall designate employees or agents who have completed the required anaphylaxis training the task of storing, maintaining, and controlling the epinephrine auto-injectors.

Are there legal protections for owners, managers, employees or agents of authorized entities, or other authorized individuals, who administer epinephrine auto-injectors?

Yes. Under Minnesota’s Good Samaritan Law, Minn. Stat. § 604A.01, providing or administering an epinephrine auto-injector to an individual experiencing anaphylaxis is considered to be emergency care, advice, or assistance. The Good Samaritan protections also apply to pharmacies and manufacturers that dispense epinephrine auto-injectors under Minn. Stat. § 144.999.

Do authorized entities or individuals need to get on a list in order to possess the epinephrine auto-injectors?

No. Neither the Commissioner of Health nor other state agencies maintain a list of organizations or individuals that choose to obtain epinephrine auto-injectors under this statute. Authorized individuals who have completed training may submit their respective training certificates to an authorized wholesale pharmacy to obtain the epinephrine auto-injectors.

I belong to an organization that is not currently an authorized entity. How can other types of organizations become an authorized entity?

The Commissioner of Health may add additional authorized entity categories. Please direct your request to Division Director’s Office, Health Regulation Division, Minnesota Department of Health, P.O. Box 64900, St. Paul, MN, 55164-0900. In the meantime, if you have questions, please contact Matt Heffron, J.D., Health Regulation Division at 651-201-4221 and Matthew.Heffron@state.mn.us.