(1) This section shall be known and may be cited as the "Colorado Schoolchildren's Asthma, Food Allergy, and Anaphylaxis Health Management Act".
(2) (a) A student with asthma, a food allergy, other severe allergies, or a related, life-threatening condition may possess and self-administer medication to treat the student's asthma, food or other allergy, anaphylaxis, or other related, life-threatening condition if the student has a treatment plan approved pursuant to this subsection (2) or the student's school district board of education has adopted a policy for student possession and administration of prescription medication pursuant to section 22-1-119.3.
(b) A public school shall, and a nonpublic school is encouraged to, approve a treatment plan for a student enrolled in the school to possess and self-administer medication for asthma, a food allergy, or anaphylaxis if all of the following conditions are met:
(I) A health care practitioner has prescribed medication for use by the student during school hours, at school-sponsored activities, and while in transit to or from school or school-sponsored activities and has instructed the student in the correct and responsible use of the medication.
(II) The student demonstrates to the health care practitioner or the health care practitioner's designee and the school nurse or a school administrator the skill level necessary to use the medication and any device that is necessary to administer the medication as prescribed.
(III) The school nurse or a school administrator collaborates with the student's health care practitioner to formulate a written treatment plan for managing asthma, food allergy, or anaphylaxis episodes of the student and for medication use by the student during school hours, at school-sponsored activities, and while in transit to or from school or school-sponsored activities.
(IV) The student's parent or legal guardian completes and submits to the public or nonpublic school the documentation required by rule of the state board of education, including but not limited to:
(A) A written medical authorization that includes the signature of the health care practitioner for the medication prescribed; the name, purpose, prescribed dosage, frequency, and length of time between dosages of the medications to be self-administered; and confirmation from the health care practitioner that the student has been instructed and is capable of self-administration of the prescribed medications;
(B) A written statement from the student's parent or legal guardian releasing the school, school district, any associated entity, and employees and volunteers of the school, school district, and associated entity from liability, except in cases of willful or wanton conduct or disregard of the criteria of the treatment plan; and
(C) A written contract between the school nurse or a school administrator, the student, and the student's parent or legal guardian assigning levels of responsibility to the parent or legal guardian, student, and school employees.
(c) A treatment plan shall be effective only for the school year in which it is approved. The public school shall approve a new treatment plan for each school year so long as the plan meets the conditions specified in paragraph (b) of this subsection (2). The parent or legal guardian shall submit a new treatment plan annually or more often if changes occur to the student's health or prescribed treatment.
(3) A student with a treatment plan approved pursuant to subsection (2) of this section or whose school district board of education has adopted a policy for student possession and administration of prescription medication pursuant to section 22-1-119.3 may possess and self-administer his or her medication while in school, while at school-sponsored activities, and while in transit to or from school or school-sponsored activities.
(4) With the approval of the parent or legal guardian of a student with a treatment plan approved pursuant to subsection (2) of this section, a school may maintain additional asthma, food or other allergy, or anaphylaxis medication to be kept at the school in a location to which the student has immediate access in the event of an asthma, food or other allergy, or anaphylaxis emergency.
(5) Immediately after using an epinephrine auto-injector during school hours, a student shall report to the school nurse, to the designee of the school nurse, or to some adult at the school to enable the school nurse, nurse's designee, or other adult to provide the appropriate follow-up care, which shall include making a 911 emergency call.
(5.5) (a) As used in this subsection (5.5) and in subsection (6) of this section, unless the context otherwise requires:
(I) "Administer" or "administration" means to give a dose of medicine to a student who has asthma or a food or other allergy or who is experiencing anaphylaxis, including the use of an epinephrine auto-injector, an asthma inhaler, or oral medication.
(II) "Designated school personnel" means:
(A) An employee in a school who has been trained on the administration of epinephrine auto-injectors consistent with the rules on administration of epinephrine auto-injectors and to whom a school nurse has delegated the nursing task of administering epinephrine auto-injectors to students; or
(B) An employee in a school who has been trained on the administration of epinephrine auto-injectors consistent with the rules on administration of epinephrine auto-injectors and to whom a nurse has delegated the nursing task of administering epinephrine auto-injectors to students or has been trained by a medical professional licensed under article 36 or article 38 of title 12, C.R.S., and to whom the licensee has delegated the administration of epinephrine auto-injectors under the authority of that person's license.
(III) "Governing authority of a school" means a school district board of education of a public school, the state charter school institute for an institute charter school, or the governing board of a nonpublic school.
(IV) "Prescription" means any order issued in writing, dated and signed by a physician licensed pursuant to article 36 of title 12, C.R.S., a physician assistant licensed in accordance with section 12-36-107.4, C.R.S., or an advanced practice nurse with prescriptive authority in accordance with section 12-38-111.6, C.R.S.
(V) "School" means any public or nonpublic school.
(b) A governing authority of a school may adopt and implement a policy whereby schools under its jurisdiction may acquire and maintain a stock supply of epinephrine auto-injectors.
(c) A governing authority of a school may adopt a policy for schools within its jurisdiction to authorize the school nurse or other designated school personnel to administer an epinephrine auto-injector to any student that the school nurse or designated school personnel in good faith believes is experiencing anaphylaxis, in accordance with standing orders and protocols from a licensed physician, physician assistant, or advance practice nurse with prescriptive authority, regardless of whether the student has a prescription for an epinephrine auto-injector.
(d) A governing authority of a school may enter into arrangements with manufacturers of epinephrine auto-injectors or third-party suppliers of epinephrine auto-injectors to obtain epinephrine auto-injectors at fair-market or reduced prices or for free.
(e) The governing authority of a public school that decides to maintain a supply of epinephrine auto-injectors as described in this subsection (5.5) shall:
(I) Implement a plan based on the rules developed pursuant to subsection (8) of this section for the management of students with life-threatening allergies enrolled in schools under its jurisdiction; and
(II) Make such plan available on such governing authority's website or the website of each school under the governing authority's jurisdiction, or if such websites do not exist, make such plan available to parents and other interested persons through other practical means as determined by such governing authority.
(f) To qualify for the protections in subsection (6) of this section, the governing authority of a nonpublic school that decides to maintain a supply of epinephrine auto-injectors as described in this subsection (5.5) must implement a plan based on the rules adopted by the state board of education as described in subsection (8) of this section.
(g) The department of education shall develop and publish an annual report compiling, summarizing, and analyzing all incident reports submitted to the department pursuant to paragraph (e) of subsection (8) of this section.
(6) Unless the damages were caused by willful or wanton conduct or disregard of the criteria of an approved treatment plan, if the provisions of this section are met, a school, school district, school district director, or school or school district employee not otherwise provided for under section 13-21-108, C.R.S., shall not be liable in a suit for damages as a result of an act or omission related to:
(a) A student's own use of the student's epinephrine auto-injector or any other medication contained in an approved treatment plan; or
(b) The good-faith administration of an epinephrine auto-injector in accordance with a policy and standing orders and protocols on the administration of epinephrine auto-injectors as described in paragraph (c) of subsection (5.5) of this section and pursuant to a plan adopted pursuant to paragraph (e) or (f) of subsection (5.5) of this section.
(7) Nothing in this section shall be interpreted to create a cause of action or increase or diminish the liability of any person.
(8) The state board of education, with assistance from the department of public health and environment, shall promulgate and revise, as necessary, rules for treatment plans for the management of students with life-threatening allergies pursuant to this section. The state board of education shall adopt rules on or before December 31, 2013, to include, but not be limited to:
(a) Education and training for school nurses and designated school personnel on the management of students with life-threatening allergies, including training related to the administration of an epinephrine auto-injector. In developing the rules on education and training, the state board shall solicit input from an organization that represents school nurses.
(b) Procedures for responding to life-threatening allergic reactions;
(c) A process for the development of individualized health care and allergy action plans for every student with a known life-threatening allergy, including the self-administration of medications pursuant to subsection (2) of this section;
(d) Protocols to prevent exposure to allergens;
(e) Requirements for each school to submit, on a form developed by the department of education, a report of each incident at the school or a related-school event involving a severe allergic reaction or the administration of an epinephrine auto-injector or both;
(f) Requirements for school nurses in schools that have adopted a policy allowing for the administration of epinephrine auto-injectors pursuant to subsection (5.5) of this section to report to the department whether the school nurse has trained and designated any school personnel to administer epinephrine auto-injectors and, if so, the number of employees in the school or school district that have been trained and designated to administer epinephrine auto-injectors;
(g) Detailed standards for training programs that must be completed by school nurses and designated school personnel in order to administer an epinephrine auto-injector in accordance with subsection (5.5) of this section. Training may be conducted online and, at a minimum, shall cover:
(I) Techniques on how to recognize symptoms of severe allergic reactions, including anaphylaxis;
(II) Standards and procedures for the storage and administration of an epinephrine auto-injector; and
(III) Emergency follow-up procedures after administering an epinephrine auto-injector.
(9) The department of public health and environment is authorized to audit school records for the determination of asthma and severe allergy rates within the schools and to determine the proportion of those students with asthma and severe allergies in the schools that have treatment plans allowing for self-administration of asthma and severe allergy medications. The audit shall define the extent of asthma and severe allergies among students and determine the effect of this section on the well-being of children with asthma and severe allergies in schools. The audit shall be conducted in conformance with the requirements of the "Family Educational Rights and Privacy Act of 1974", 20 U.S.C. sec. 1232g.
Source: L. 2005: Entire section added, p. 257, 2, effective April 14. L. 2009: (1), (2)(a), (2)(b), and (4) amended, (SB 09-226), ch. 245, p. 1106, 7, effective August 5. L. 2011: (2)(a) and (3) amended, (SB 11-012), ch. 62, p. 161, 1, effective March 25. L. 2013: (5.5) added and (6) and (8) amended, (HB 13-1171), ch. 348, p. 2022, 1, effective May 28.
Cross references: For the legislative declaration contained in the 2005 act enacting this section, see section 1 of chapter 71, Session Laws of Colorado 2005. For the legislative declaration contained in the 2009 act amending subsections (1), (2)(a), (2)(b), and (4), see section 1 of chapter 245, Session Laws of Colorado 2009.