First Regular Session
Seventy-fifth General Assembly
STATE OF COLORADO
ENGROSSED
This Version Includes All Amendments Adopted
on Second Reading in the House of Introduction
LLS NO. 25-1044.01 Kristen Forrestal x4217
SENATE BILL 25-278
Senate Committees House Committees
Health & Human Services
Appropriations
A BILL FOR AN ACT
C
ONCERNING THE ADMINISTRATION OF EMERGENCY -USE EPINEPHRINE101
IN A SCHOOL SETTING.102
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov
.)
For the purpose of encompassing the different ways that
epinephrine may be administered to treat anaphylaxis in a school setting,
the bill changes the term "epinephrine auto-injector" to "emergency-use
epinephrine".
SENATE
2nd Reading Unamended
April 22, 2025
SENATE SPONSORSHIP
Mullica,
HOUSE SPONSORSHIP
Stewart R.,
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing law.
Dashes through the words or numbers indicate deletions from existing law. Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, 22-1-119.5, amend2
(5), (5.5)(a)(I), (5.5)(a)(II), (5.5)(b), (5.5)(c), (5.5)(d), (5.5)(e)3
introductory portion, (5.5)(f), (6), (8)(a), (8)(e), (8)(f), (8)(g) introductory4
portion, (8)(g)(II), and (8)(g)(III); and add (10) as follows:5
22-1-119.5. Asthma, food allergy, and anaphylaxis health6
management - self-administered medication - staff-administered7
medication - rules - definitions. (5) Immediately after using an8
EMERGENCY-USE epinephrine auto-injector during school hours, a student9
shall report to the school nurse, to the designee of the school nurse, or to10
some adult at the school to enable the school nurse,
SCHOOL nurse's11
designee, or other adult to provide the appropriate follow-up care, which12
shall include making a 911 emergency call.13
(5.5) (a) As used in this subsection (5.5) and in subsection (6) of14
this section, unless the context otherwise requires:15
(I) "Administer" or "administration" means to give a dose of16
medicine to a student who has asthma or a food or other allergy or who17
is experiencing anaphylaxis, including the use of an
EMERGENCY-USE18
epinephrine, auto-injector, an asthma inhaler, or oral medication.19
(II) "Designated school personnel" means:20
(A) An employee in a school who has been trained on the21
administration of
EMERGENCY-USE epinephrine auto-injectors
consistent22
with the rules on administration of
EMERGENCY-USE epinephrine23
auto-injectors
and to whom a school nurse has delegated the nursing task24
of administering
EMERGENCY-USE epinephrine auto-injectors
to students;25
or26
(B) An employee in a school who has been trained on the27
278
-2- administration of EMERGENCY-USE epinephrine auto-injectors consistent1
with the rules on administration of
EMERGENCY-USE epinephrine2
auto-injectors
and to whom a SCHOOL nurse has delegated the nursing3
task of administering
EMERGENCY-USE epinephrine auto-injectors
to4
students or
WHO has been trained by a medical professional licensed5
under article 240 of title 12 or part 1 of article 255 of title 12 and to6
whom the licensee has delegated the administration of
EMERGENCY-USE7
epinephrine auto-injectors
under the authority of that person's license.8
(b) A governing authority of a school may adopt and implement9
a policy whereby schools under its jurisdiction may acquire and maintain10
a stock supply of
EMERGENCY-USE epinephrine. auto-injectors.
11
(c) A governing authority of a school may adopt a policy for12
schools within its jurisdiction to authorize the school nurse or other13
designated school personnel to administer an EMERGENCY-USE14
epinephrine auto-injector to any student that the school nurse or15
designated school personnel in good faith believes is experiencing16
anaphylaxis, in accordance with standing orders and protocols from a17
licensed physician, physician assistant, or advanced practice registered18
nurse with prescriptive authority, regardless of whether the student has a19
prescription for an EMERGENCY-USE epinephrine. auto-injector.20
(d) A governing authority of a school may enter into arrangements21
with manufacturers of
EMERGENCY-USE epinephrine auto-injectors
or22
third-party suppliers of
EMERGENCY-USE epinephrine auto-injectors
to23
obtain
EMERGENCY-USE epinephrine auto-injectors
at fair-market or24
reduced prices or for free.25
(e) The governing authority of a public school that decides to26
maintain a supply of
EMERGENCY-USE epinephrine auto-injectors
as27
278
-3- described in this subsection (5.5) shall:1
(f) To qualify for the protections in subsection (6) of this section,2
the governing authority of a nonpublic school that decides to maintain a3
supply of
EMERGENCY-USE epinephrine auto-injectors
as described in this4
subsection (5.5) must implement a plan based on the rules adopted by the5
state board of education as described in subsection (8) of this section.6
(6) Unless the damages were caused by willful or wanton conduct7
or disregard of the criteria of an approved treatment plan, if the provisions8
of this section are met, a school, school district, school district director,9
or school or school district employee not otherwise provided for under10
section 13-21-108 C.R.S., shall not be liable in a suit for damages as a11
result of an act or omission related to:12
(a) A student's own use of the student's
EMERGENCY-USE13
epinephrine auto-injector
or any other medication contained in an14
approved treatment plan; or15
(b) The good faith administration of an EMERGENCY-USE16
epinephrine auto-injector in accordance with a policy and standing orders17
and protocols on the administration of
EMERGENCY-USE epinephrine18
auto-injectors
as described in paragraph (c) of subsection (5.5) of this19
section SUBSECTION (5.5)(c) OF THIS SECTION and pursuant to a plan20
adopted pursuant to paragraph (e) or (f) of subsection (5.5) of this section21
SUBSECTION (5.5)(e) OR (5.5)(f) OF THIS SECTION.22
(8) The state board of education, with assistance from the23
department of public health and environment, shall promulgate and24
revise, as necessary, rules for treatment plans for the management of25
students with life-threatening allergies pursuant to this section. The state26
board of education shall adopt rules on or before December 31, 2013, to27
278
-4- include but not be limited to:1
(a) Education and training for school nurses and designated school2
personnel on the management of students with life-threatening allergies,3
including training related to the administration of an EMERGENCY-USE4
epinephrine. auto-injector. In developing the rules on education and5
training, the state board shall solicit input from an organization that6
represents school nurses.7
(e) Requirements for each school to submit, on a form developed8
by the department of education, a report of each incident at the school or9
a related-school event involving a severe allergic reaction or the10
administration of an EMERGENCY-USE epinephrine auto-injector or both;11
(f) Requirements for school nurses in schools that have adopted12
a policy allowing for the administration of
EMERGENCY-USE epinephrine13
auto-injectors
pursuant to subsection (5.5) of this section to report to the14
department
OF EDUCATION whether the school nurse has trained and15
designated any school personnel to administer
EMERGENCY-USE16
epinephrine auto-injectors
and, if so, the number of employees in the17
school or school district that have been trained and designated to18
administer
EMERGENCY-USE epinephrine; auto-injectors;
19
(g) Detailed standards for training programs that must be20
completed by school nurses and designated school personnel in order to21
administer an EMERGENCY-USE epinephrine auto-injector in accordance22
with subsection (5.5) of this section. Training may be conducted online23
and, at a minimum, shall cover:24
(II) Standards and procedures for the storage and administration25
of an EMERGENCY-USE epinephrine; auto-injector; and26
(III) Emergency follow-up procedures after administering an27
278
-5- EMERGENCY-USE epinephrine. auto-injector.1
(10) A
S USED IN THIS SECTION, "EMERGENCY-USE EPINEPHRINE"2
MEANS A PORTABLE, DISPOSABLE DRUG DELIVERY DEVICE OR PRODUCT3
APPROVED BY THE FEDERAL FOOD AND DRUG ADMINISTRATION THAT4
CONTAINS A PREMEASURED , SINGLE DOSE OF EPINEPHRINE THAT IS USED5
TO TREAT ANAPHYLAXIS IN AN EMERGENCY SITUATION .6
SECTION 2. In Colorado Revised Statutes, 22-2-135, amend7
(3)(a) introductory portion, (3)(a)(III), and (3)(a)(IV) as follows:8
22-2-135. Food allergy and anaphylaxis management - rules.9
(3) (a) On or before January 1, 2010, the state board of education, in10
consultation with the department of public health and environment, shall11
promulgate rules for the management of food allergies and anaphylaxis12
among students enrolled in the public schools of the state. The rules shall
13
MUST include, but need not be limited to, the following:14
(III) The provision of emergency anaphylaxis treatment training15
for appropriate staff to prepare them to respond appropriately in the event16
that a student suffers anaphylaxis as a result of an allergic reaction to17
food, which training shall MUST include but need not be limited to18
training in the administration of self-injectable epinephrine; and19
(IV) Procedures to ensure the availability of a student's20
self-injectable epinephrine to faculty and administrative staff of the21
school in the event that a student suffers anaphylaxis and requires22
emergency medical treatment.23
SECTION 3. Safety clause. The general assembly finds,24
determines, and declares that this act is necessary for the immediate25
preservation of the public peace, health, or safety or for appropriations for26
278
-6- the support and maintenance of the departments of the state and state1
institutions.2
278
-7-