SB 25-278
Fiscal Note
Legislative Council Staff
Nonpartisan Services for Colorado’s Legislature
SB 25-278: EPINEPHRINE ADMINISTRATION IN SCHOOLS
Prime Sponsors:
Sen. Mullica
Rep. Stewart R.
Published for: Senate Health & Human Services
Drafting number: LLS 25-1044
Fiscal Analyst:
Kristine McLaughlin, 303-866-4776
kristine.mclaughlin@coleg.gov
Version: Initial Fiscal Note
Date: April 8, 2025
Fiscal note status: The fiscal note reflects the introduced bill.
Summary Information
Overview. The bill broadens the use of epinephrine on school property by changing the phrase
“epinephrine auto-injector” to “emergency-use epinephrine.”
Types of impacts. The bill is projected to affect the following areas on a temporary basis:
State Expenditures School Districts
Appropriations. For FY 2025-26, the bill requires an appropriation of $18,758 to the Department of
Education.
Table 1
State Fiscal Impacts
Type of Impact
1
Budget Year
FY 2025-26
Out Year
FY 2026-27
State Revenue $0 $0
State Expenditures $22,987 $0
Transferred Funds $0 $0
Change in TABOR Refunds $0 $0
Change in State FTE 0.2 FTE 0.0 FTE
1
Fund sources for these impacts are shown in the tables below. Page 2
April 8, 2025 SB 25-278
Table 1A
State Expenditures
Fund Source
Budget Year
FY 2025-26
Out Year
FY 2026-27
General Fund $18,758 $0
Cash Funds $0 $0
Federal Funds $0 $0
Centrally Appropriated $4,229 $0
Total Expenditures $22,987 $0
Total FTE 0.2 FTE 0.0 FTE
Summary of Legislation
The bill broadens the use of epinephrine on school property by changing the phrase
“epinephrine auto-injector” to “emergency-use epinephrine.” Emergency-use epinephrine is
defined as a portable, disposable drug delivery device or product approved by the federal Food
and Drug Administration (FDA) that contains a premeasured, single dose of epinephrine that is
used to treat anaphylaxis in an emergency situation.
Background
The new definition of epinephrine is inclusive of the recently FDA-approved nasal epinephrine
spray.
During the 2023-24 school year, Colorado K-12 schools reported 226 anaphylaxis events that
included 179 students and 47 non-students. Of those experiencing anaphylaxis, 66 percent had
a known allergy, 27 percent had no known allergy, and the allergy status of 7 percent was
unknown. School nurses administered 89 doses of emergency epinephrine at school, and
non-school nurses administered 112 doses. Stock epinephrine was used 127 times, and a
student’s epinephrine was used 74 times. Of the 226 anaphylaxis events at school, 25 events did
not result in school staff administering epinephrine at school. Of the 201 events, 127 events
occurred in the classroom, 32 in the cafeteria, 16 on the playground, 17 in the health office, 2 on
the bus, and 27 in other locations.
State Expenditures
The bill increases state expenditures in the Department of Education by $23,000 in FY 2025-26
and in any future fiscal year the FDA approves a new form of epinephrine. These costs, paid
from the General Fund, are summarized in Table 2 and discussed below. Page 3
April 8, 2025 SB 25-278
Table 2
State Expenditures
Department of Education
Cost Component
Budget Year
FY 2025-26
Out Year
FY 2026-27
Personal Services $18,758 $0
Centrally Appropriated Costs $4,229 $0
Total Costs $22,987 $0
Total FTE 0.2 FTE 0.0 FTE
Department of Education
CDE’s Student Health Services division requires 0.2 FTE Nurse Consultant in FY 2025-26 only to
update all rules, guidance documents, trainings, and reporting procedures concerning
anaphylaxis treatments on school grounds to allow for the use of nasal epinephrine. This cost
may reoccur in any future years when a new form of emergency epinephrine receives FDA
approval.
Centrally Appropriated Costs
Pursuant to a Joint Budget Committee policy, certain costs associated with this bill are
addressed through the annual budget process and centrally appropriated in the Long Bill or
supplemental appropriations bills, rather than in this bill. These costs, which may include
employee insurance, supplemental employee retirement payments, leased space, and indirect
cost assessments, are shown in the expenditure table above.
School Districts
Workload will minimally increase for school districts to update policies concerning epinephrine
use on school property and to train staff on new anaphylaxis treatments.
Effective Date
The bill takes effect upon signature of the Governor, or upon becoming law without his signature.
State Appropriations
For FY 2025-26, the bill requires a General Fund appropriation of $18,758 to the Department of
Education, and 0.2 FTE. Page 4
April 8, 2025 SB 25-278
State and Local Government Contacts
Education
Judicial
Public Health and Environment
School Districts
The revenue and expenditure impacts in this fiscal note represent changes from current law under the bill for each
fiscal year. For additional information about fiscal notes, please visit the General Assembly website.