IOA Helps Improve Access to EAI Devices in Indiana

We know that Anaphylaxis, the life-threatening allergic reaction, can be successfully treated with an epinephrine auto-injector (EAI). Without an EAI, the results are often tragic. Many families that have experienced this tragedy are working to promote awareness of anaphylaxis and the need for improved access to EAI’s. In Wisconsin, this has been the work Angel and George Mueller to honor of their 18-year-old son Dillon who died of anaphylaxis after being stung by a bee. When Tabitha Arnett, the Executive Director of the Indiana Osteopathic Association (IOA), met Angel, she was moved by her story and her efforts. Inspired and using Wisconsin’s “Dillion’s Law” as a model, Tabitha successfully created a coalition to help provide increased access to EAIs in Indiana.

IOA Helps Improve Access to EAI devices in Indiana

Tabitha Arnett, Indiana Osteopathic Association's Executive Director
Tabitha Arnett, Indiana Osteopathic Association's Executive
Photos used with permission by Indiana Osteopathic Association.

New Law Expands Access to Epinephrine Auto-Injectors

By Kristen Stewart
July 15th, 2020

Anaphylaxis, a life-threatening allergic reaction, strikes about 1 in 50 people in the United States. The good news is it can be treated — but only if there is an epinephrine auto-injector (EAI) immediately at hand. Some states including Indiana are working to make that goal a more frequent reality.

While many people with diagnosed serious allergies carry their own EAIs, life isn't perfect and sometimes they can be forgotten. Other individuals may be allergic but not even know it as in the case of insect allergies where up to half of people who died from a sting had no history of a previous reaction. There is no doubt the more epinephrine auto-injectors available in society, the more lives that can be saved. Enter Indiana's new law HB1207.

While institutions such as schools have previously been able to carry epinephrine auto-injector devices for urgent use, most need for this life saving intervention is more immediate according to Dr. Brian H. Black, President of the Indiana Osteopathic Association (IOA) who practices Emergency Medicine at Putnam County Hospital. "This law was needed to expand immediate availability anywhere, for those who may not even know they need it. Anaphylaxis is a true life-threatening event that can threaten an airway in minutes."

"The Indiana Osteopathic Association is proud to have led the charge at the state level in pushing through this urgent measure," said Dr. Black. "Our board is committed to assisting in ongoing awareness and education on use of epinephrine autoinjectors by trained public members."

New Indiana Legislation

Signed on March 18, 2020 by the Indiana Governor, the law allows individuals who go through a state-approved training program to be able to purchase an EAI, carry it, and if needed, administer it to someone who is having an anaphylactic reaction. Specifically, after successfully going through the one-time-only training program an individual will be issued a standing order to be able to buy the EAI at the pharmacy. People will purchase the EAI themselves presumably at the cash price.

Background

The idea for this new law began in June 2019 when Tabitha Arnett, the Executive Director of the Indiana Osteopathic Association (IOA), learned about Wisconsin's Dillon's Law while attending the Wisconsin Association of Osteopathic Physicians & Surgeons conference. Spearheaded by Angel and George Mueller in honor of their 18-year-old son Dillon who died of anaphylaxis after being stung by a bee, the law expanded on existing legislation to allow trained individuals to carry epinephrine and administer it to someone in need free of personal liability.

Tabitha met Angel in person in July 2019 at the American Osteopathic Association House of Delegates meeting and after unofficially undergoing epinephrine auto-injector training with her felt called to the cause.

"I was moved by Angel's story, her passion to save lives and to prevent this tragedy from happening to other parents," she said. "She led me through the training program and told me her story. I was moved and thought to myself, 'This law could save lives in Indiana! If our children got stung by a bee, I want to be prepared to potentially save their life.' Indiana citizens should have the same opportunity to get trained, purchase an EAI, and be better prepared to save someone's life."

Back home in Indiana, Tabitha got to work. First she met with the Board of the IOA for their approval. That was followed by meetings with their lobbyists and the State Department of Health Commissioner who was receptive to the idea of modeling it on a similar piece of legislation passed in Minnesota. Next came the support of a collection of physicians and pharmacists in the House and Senate where the bill got folded into another pharmacy-related bill. Along the way Angel was an invaluable resource providing important information, answering questions, sharing her contacts, and encouraging her with her energy and commitment to the cause. The overall process lasted just several months and the bill was supported by most legislators.

While everyone is excited about the passage of the bill the next steps have been affected by COVID-19. The law goes into effect on July 1, 2020 but it cannot be implemented until training programs have been submitted and approved. In addition, momentum and opportunities for publicity got understandably overshadowed by a shift in focus on how to manage the pandemic.

Expanding to Additional States

So far the law (or one similar) has passed in Wisconsin, Minnesota and now Indiana. Angel Mueller and others would love to see it go nationwide at the federal level but until that happens individual states can still work in their areas.

Tabitha has several suggestions for states hoping to enact this type of legislation including contacting Angel and the Dillon Mueller Memorial Fund and/or the Wisconsin Association of Osteopathic Physicians & Surgeons to learn more about the current laws and which other states may also be working on bills. Getting the House and Senate health committees on board and finding support of legislators who are physicians can be very helpful. Lawmakers with a severe allergy or a family member with a severe allergy can also make key allies. Having at least a minimal budget for publicity and getting the word out when the new bill passes would also be beneficial.

While at times the legislation process can seem involved and overwhelming, its’ important to remember the goal. "Epinephrine autoinjectors need to be part of our first-aid kit at home and on the road," says Tabitha. "Whether this law saves 100 lives, 10 lives or just one life in Indiana — EVERY life saved is important and worth the effort."***

*** Editor’s note: Epi Near You NY is our association's anaphylaxis emergency training program. Our training seminar is NYS approved, provides the latest medical information and is FREE of charge.

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