The purpose of this bulletin is to inform the public that the Minnesota Department of Health (MDH) has added licensed nursing homes and boarding care homes to the list of authorized entities that may obtain, store, and use epinephrine auto-injectors under Minn. Stat. § 144.999, subd. 1(c).

Owners, managers, employees, and agents of authorized entities may obtain and store epinephrine auto-injectors on site after successfully completing an approved anaphylaxis training program. A list of approved training providers is available on the MDH website at Epinephrine Auto-injector Law. During an anaphylaxis emergency, an authorized entity may give the epinephrine auto-injector to the individual or the individual’s caregiver for immediate use, or administer the epinephrine auto-injector.

There is no limit to 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 anaphylaxis training to be responsible for storing, maintaining, and controlling the epinephrine auto-injectors.

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

What is anaphylaxis?

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.

Who can provide and/or administer an epinephrine auto-injector shot?

After successfully completing an anaphylaxis training program as listed under Minn. Stat. § 144.999, an owner, manager, employee, or agent of a licensed nursing home or boarding care home may provide and/or administer an epinephrine auto-injector to any individual believed to be experiencing anaphylaxis. This includes, but is not limited to the following.

Residents
Staff members
Members of the public, including visitors to the facility.

Applicable State and Federal Licensing and Certification Requirements

Use of an epinephrine auto-injector must comply with Minn. Stat. § 144.999, the nursing home requirements of Minn. Rule 4658, boarding care home requirements of Minn. Rule 4655, and federal long term care regulations, except as indicated below.

For unlicensed nursing personnel, Minn. Stat. § 144.999 supersedes Minn. Rule 4655.7860 and Minn. Rule 4658.1325, and therefore permits unlicensed nursing personnel to administer epinephrine auto-injectors as authorized by Minn. Stat. § 144.999.

For other unlicensed personnel, Minn. Stat. § 144.999 permits unlicensed personnel to administer epinephrine auto-injectors as authorized by Minn. Stat. § 144.999.

If the facility is Medicare/Medicaid certified, the facility must comply with all federal requirements. These include, but are not limited to:

42 CFR § 483.45 Pharmacy Services, F755 and F761
42 CFR § 483.35, F726 Competent Staffing

Do licensed health professionals, such as nurses and physicians, need to complete the training under Minn. Stat. § 144.999?

All staff must be competent under 42 CFR § 483.35, F726 Competent Staffing and/or state licensing requirements. The specific training under Minn. Stat. § 144.999 is not required when the equivalent training is part of the health professional’s licensure requirements.

Resources

MDH Website: Epinephrine Auto-Injector Law

Minn. Stat. § 144.999

Minn. Rule 4655 - Minnesota Boarding Care Home Rules

Minn. Rule 4658 - Minnesota Nursing Home Rules

Federal Long Term Care Regulation (Appendix PP) (PDF)