Epinephrine Standing Order Frequently Asked Questions

​Related Materials: 

• Epinephrine Standing Order Application
• Education Code 49414
• Administration of Epinephrine Auto-Injectors
• EpiPen4Schools​​​
  

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Will CDPH be distributing Epinephrine auto-injectors?

• CDPH will not be distributing Epinephrine auto-injectors. The CDPH Standing Order generates a standing order that can be used similar to a prescription to obtain Epinephrine auto-injectors. It is acceptable at all California pharmacies but may result in an out-of-pocket cost that is not covered by Medi-Cal. Free auto-injectors are available to schools at EpiPen4Schools. 
  

Is this a one-time program? Can I apply again after the expiration date of December 31, 2024?

• The standing order can be renewed annually by completing another online application form so that a new set of Epinephrine auto-injectors are available for each calendar year. The application to renew standing orders will become available on the first of January each year. Returning users should wait until after January 1^st to renew for another calendar year; do not fill out a second application before this date.

What is the difference between the CDPH Epinephrine Standing Order and the EpiPen4School Program?

• The CDPH Standing Order generates a standing order that can be used to obtain Epinephrine auto-injectors. It is acceptable at California pharmacies but may result in an out-of-pocket cost that is not covered by Medi-Cal. Free auto-injectors are available to schools at EpiPen4Schools.com. The EpiPeen4Schools Program accepts the CDPH standing order and can ship auto-injectors directly to schools, Local Education Agencies, and County Offices of Education. CDPH can not provide any information or updates on orders placed through the EpiPen4Schools program. For questions on the status of your order, please reach out to EpiPens4Schools directly.   
  

How do I update or make changes to my standing order? For example, I need to change the quantity of epinephrine auto-injectors I order.

• Contact SafeSchoolsTeam@cdph.ca.gov to update your current standing.  Please include what information you are looking to update or change in the body of your email. Once changes are made, a new PDF copy of the completed standing order will be sent via email to whomever completed your original application. Do not complete another standing order application.

The EpiPen4Schools Program requires a completed Standing Order Certification Form with a physician's signature. Will CDPH be providing this?

• The CDPH Standing Order will act as both your prescription and certification through the EpiPen4Schools program. The CDPH standing order is signed by California's Public Health Officer, Dr. Tomas Aragon which fulfills the certification requirement. You can upload your CDPH Standing Order PDF for both required fields in the EpPen4Schools program.

How often do standing orders for epi-pen administration in California schools need to be renewed? 

• The CDPH Epinephrine Standing Order will automatically expire one year from the date that it is signed. The standing order can be renewed annually by completing another online application form such that a new set of Epinephrine auto-injectors are available for each school site each year. 
  

Why does the expiration date on the CDPH Epinephrine Standing Order expire December 31, 2024, and not run on an academic calendar July-June?

• CDPH aligns with the EpiPen4Schools Program which runs on a calendar year from January to December. We've received feedback that significant shipping delays often occur during the months of July, August, and September. We highly encourage everyone to order outside of those months to avoid any significant shipping delays.

When an Epinephrine Auto-Injector is used, can I replenish this? Do I need to complete another online application?

• Refills can be obtained within the year if Epinephrine is used in the course of treatment and will not count towards the 4-device limit per school site, per year. You do not need to complete another online application form. The CDPH Standing Order says “Refills as needed" so you will be able to use this again if you need to replenish your EpiPens.

Can we request additional Epinephrine Auto-Injectors for separate facilities, such as athletic facilities, field trips, etc.

• The maximum quantity of auto-injectors allowed by this standing order, either regular or junior, is four per school, per calendar year. 

Are we allowed to use expired epinephrine auto-injectors in the event of an emergency? Can we use adult epinephrine auto-injectors on small children if junior epinephrine auto-injectors are not available?

• We recommend that you work with your district legal counsel to ensure that your planned use of epinephrine during potential life-threaten situations falls in line with Education Code and is covered by California law in regard to life saving medical interventions. We'd also recommend looking at the available resources from the California Department of Education in regards to the administration of epinephrine.

Will CDPH sign documentation outside of this standing order such as a prescription for schools requesting additional Epinephrine auto-injectors?

• Schools will need to work with a local physician if they prefer to use their own methods of obtaining Epinephrine auto-injectors. CDPH will not sign additional paperwork outside of the Epinephrine Standing Order.

Are there resources for teachers/volunteers (field trips)?

• Please visist the EpiPen4Schools Resource page​ for additional information.

Are childcare facilities eligible to apply for the CDPH Epinephrine Standing Order?

• If the Childcare facility is located on a California public school campus, they are eligible to apply under this Standing Order. Unfortunately, if the Childcare facility is not located on a public school campus, they are not eligible. Per Education Code 49414 is delineated specifical for TK-12 Schools which is why our order only applies to this population.