Maryland 2023 Regular Session

Maryland House Bill HB266 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1
2	2
3	3		EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
4	4		[Brackets] indicate matter deleted from existing law.
5		-	Underlining indicates amendments to bill.
6		-	Strike out indicates matter stricken from the bill by amendment or deleted from the law by
7		-	amendment.
8	5		hb0266
9	6
10	7		HOUSE BILL 266
11	8		F1 3lr1374
12	9		HB 384/22 – W&M
13	10		By: Delegates Boyce, Amprey, Bridges, Edelson, Embry, Healey, Kaufman,
14	11		Lehman, McCaskill, Phillips, Rosenberg, Ruth, Smith, and Stewart
15	12		Introduced and read first time: January 25, 2023
16	13		Assigned to: Ways and Means
17		-	Committee Report: Favorable with amendments
18		-	House action: Adopted
19		-	Read second time: March 1, 2023
20	14
21		-	~~CHAPTER ______~~
	15	+	A BILL ENTITLED
22	16
23	17		AN ACT concerning 1
24	18
25	19		Public and Nonpublic Schools – Bronchodilator and Epinephrine Availability 2
26	20		and Use – Policies 3
27	21
28	22		FOR the purpose of requiring each county board of education and authorizing nonpublic 4
29		-	schools in the State, before a certain school year, to establish a policy to obtain, 5
30		-	administer, and train certain school nurses and authorize a school nurse or certain 6
31		-	other school personnel to administer in emergency situations bronchodilators to a 7
32		-	student who is determined to have asthma and is experiencing asthma–related 8
33		-	symptoms or is perceived to be in respiratory distress by a school nurse or any other 9
34		-	school personnel; requiring each county board and authorizing nonpublic schools in 10
35		-	the State to update their policies to require certain school nurses and other school 11
36		-	personnel to complete certain training before they are authorized to administer 12
37		-	auto–injectable epinephrine to a student who is determined to be, or is perceived to 13
38		-	be, in anaphylaxis; requiring the State Department of Education, in consultation 14
39		-	with certain groups, to identify or develop training for certain school personnel to 15
40		-	identify symptoms of anaphylaxis, asthma, or respiratory distress in students; a 16
41		-	bronchodilator to a student who is experiencing asthma, reactive airway disease, or 17
42		-	asthma–related symptoms; requiring a policy to include certain limitations on the 18
43		-	administration of a bronchodilator, provisions authorizing a school nurse to obtain 19
44		-	and store bronchodilators, and procedures for a school nurse to designate certain 20
45		-	other school personnel to respond to a student who is experiencing asthma, reactive 21
46		-	airway disease, or asthma–related symptoms; requiring the State Department of 22
47		-	Education and the Maryland Department of Health jointly to update certain asthma 23
48		-	guidelines in a certain manner on or before a certain date; requiring each county 24 2 HOUSE BILL 266
	23	+	schools in the State to establish a policy to obtain, administer, and train certain 5
	24	+	school nurses and other school personnel to administer in emergency situations 6
	25	+	bronchodilators to a student who is determined to have asthma and is experiencing 7
	26	+	asthma–related symptoms or is perceived to be in respiratory distress by a school 8
	27	+	nurse or any other school personnel; requiring each county board and authorizing 9
	28	+	nonpublic schools in the State to update their policies to require certain school nurses 10
	29	+	and other school personnel to complete certain training before they are authorized 11
	30	+	to administer auto–injectable epinephrine to a student who is determined to be, or 12
	31	+	is perceived to be, in anaphylaxis; requiring the State Department of Education, in 13
	32	+	consultation with certain groups, to identify or develop training for certain school 14
	33	+	personnel to identify symptoms of anaphylaxis, asthma, or respiratory distress in 15
	34	+	students; and generally relating to bronchodilator and epinephrine availability and 16
	35	+	use policies in public and nonpublic schools in the State. 17
	36	+
	37	+	BY repealing and reenacting, with amendments, 18
	38	+	Article – Education 19
	39	+	Section 7–426.2 and 7–426.3 20
	40	+	Annotated Code of Maryland 21
	41	+	(2022 Replacement Volume) 22
	42	+
	43	+	BY adding to 23
	44	+	Article – Education 24
	45	+	Section 7–426.6 and 7–426.7 25
	46	+	Annotated Code of Maryland 26
	47	+	(2022 Replacement Volume) 27
	48	+	2 HOUSE BILL 266
49	49
50	50
51		-	board to make a good faith effort to adopt certain guidelines before the start of a 1
52		-	certain school year; and generally relating to bronchodilator and epinephrine 2
53		-	availability and use policies in public and nonpublic schools in the State. 3
	51	+	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 1
	52	+	That the Laws of Maryland read as follows: 2
54	53
55		-	BY repealing and reenacting, with amendments, 4
56		-	Article – Education 5
57		-	Section 7–426.2 and 7–426.3 6
58		-	Annotated Code of Maryland 7
59		-	(2022 Replacement Volume) 8
	54	+	Article – Education 3
60	55
61		-	BY adding to 9
62		-	Article – Education 10
63		-	Section 7–426.6 and 7–426.7 11
64		-	Annotated Code of Maryland 12
65		-	(2022 Replacement Volume) 13
	56	+	7–426.2. 4
66	57
67		-	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 14
68		-	That the Laws of Maryland read as follows: 15
	58	+	(a) (1) In this section the following words have the meanings indicated. 5
69	59
70		-	Article – Education 16
	60	+	(2) “Anaphylaxis” means a sudden, severe, and potentially life–threatening 6
	61	+	allergic reaction that occurs when an individual is exposed to an allergen. 7
71	62
72		-	7–426.2. 17
	63	+	(3) “Auto–injectable epinephrine” means a portable, disposable drug 8
	64	+	delivery device that contains a premeasured single dose of epinephrine that is used to treat 9
	65	+	anaphylaxis in an emergency situation. 10
73	66
74		-	(a) (1) In this section the following words have the meanings indicated. 18
	67	+	(b) Each county board shall establish a policy for public schools within its 11
	68	+	jurisdiction to authorize the school nurse and other school personnel to administer 12
	69	+	auto–injectable epinephrine, if available, to a student who is determined BY AN 13
	70	+	INDIVIDUAL WHO HAS U NDERGONE THE TRAININ G PROVIDED IN SUBSEC TION (C) OF 14
	71	+	THIS SECTION, IF AVAILABLE, to be or perceived to be in anaphylaxis, regardless of 15
	72	+	whether the student: 16
75	73
76		-	(2) ~~“Anaphylaxis” means a sudden~~, ~~severe, and potentially life–threatening 19~~
77		-	~~allergic reaction that occurs when an individual is exposed to an allergen. 20~~
	74	+	(1) Has been identified as having an anaphylactic allergy, as defined in § 17
	75	+	7–426.1 of this subtitle; or 18
78	76
79		-	(3) ~~“Auto–injectable~~ epinephrine~~” means a portable, disposable drug 21~~
80		-	~~delivery device that contains a premeasured single dose of epinephrine that is used to treat 22~~
81		-	~~anaphylaxis in an emergency situation~~. 23
	77	+	(2) Has [a prescription for] BEEN PRESCRIBED epinephrine [as 19
	78	+	prescribed] by an authorized licensed health care practitioner under the Health 20
	79	+	Occupations Article. 21
82	80
83		-	(b) Each county board shall establish a policy for public schools within its 24
84		-	jurisdiction to authorize the school nurse and other school personnel to administer 25
85		-	auto–injectable epinephrine, if available, to a student who is determined BY AN 26
86		-	INDIVIDUAL WHO HAS U NDERGONE THE TRAININ G PROVIDED IN SUBSEC TION (C) OF 27
87		-	THIS SECTION, IF AVAILABLE, to be or perceived to be in anaphylaxis, regardless of 28
88		-	whether the student: 29
	81	+	(c) (1) THE DEPARTMENT , IN CONSULTATION WITH THE MARYLAND 22
	82	+	DEPARTMENT OF HEALTH, THE AMERICAN LUNG ASSOCIATION, AND THE ASTHMA 23
	83	+	AND ALLERGY FOUNDATION OF AMERICA, SHALL IDENTIFY OR DE VELOP TRAINING 24
	84	+	TO: 25
89	85
90		-	(1) ~~Has been identified as having an anaphylactic allergy,~~ ~~as defined in § 30~~
91		-	~~7–426.1 of this subtitle~~; ~~or 31~~
	86	+	(I) IDENTIFY THE SYMPTOMS OF ASTHMA AND RESPIR ATORY 26
	87	+	DISTRESS; 27
92	88
93		-	(2) Has [a prescription for] BEEN PRESCRIBED epinephrine [as 32
94		-	prescribed] by an authorized licensed health care practitioner under the Health 33
95		-	Occupations Article. 34
96		-	HOUSE BILL 266 3
	89	+	(II) IDENTIFY THE SYMPTOMS OF ANAPHYLAXIS ; AND 28
	90	+
	91	+	(III) DISTINGUISH BETWEEN A NAPHYLAXIS AND ASTHM A OR 29
	92	+	RESPIRATORY DISTRESS . 30
	93	+
	94	+	(2) THE TRAINING IDENTIFIED OR DEVELOPED UNDER PARA GRAPH 31
	95	+	(1) OF THIS SUBSECTION S HALL BE PROVIDED TO SCHOOL NURSES AND VO LUNTARY 32
	96	+	SCHOOL PERSONNEL WHO ARE DESIGNATED BY A SCHOOL NURSE AND , IN THE 33 HOUSE BILL 266 3
97	97
98	98
99		-	(c) (1) THE DEPARTMENT , IN CONSULTATION WITH THE MARYLAND 1
100		-	DEPARTMENT OF HEALTH, THE AMERICAN LUNG ASSOCIATION, AND THE ASTHMA 2
101		-	AND ALLERGY FOUNDATION OF AMERICA, SHALL IDENTIFY OR DE VELOP TRAINING 3
102		-	TO: 4
	99	+	CLINICAL JUDGMENT OF THE SCHOOL NURSE , ARE APPROPRIATE RECI PIENTS OF 1
	100	+	THE TRAINING. 2
103	101
104		-	(I) ~~IDENTIFY~~ THE ~~SYMPTOMS OF ASTHMA AND RESPIRATORY 5~~
105		-	~~DISTRESS; 6~~
	102	+	(3) THE TRAINING PROVIDED UNDER THIS SUBSECTIO N SHALL BE A 3
	103	+	PAID PROFESSIONAL DE VELOPMENT TRAINING . 4
106	104
107		-	(II) ~~IDENTIFY~~ THE ~~SYMPTOMS~~ OF ~~ANAPHYLAXIS ; AND 7~~
	105	+	(D) The policy established under subsection (b) of this section shall include: 5
108	106
109		-	(III) DISTINGUISH BETWEEN A NAPHYLAXIS AND ASTHM A OR 8
110		-	RESPIRATORY DISTRESS . 9
	107	+	(1) [Training for school personnel on how to recognize the symptoms of 6
	108	+	anaphylaxis] THE TRAINING IDENTIFI ED OR DEVELOPED UNDE R SUBSECTION (C) OF 7
	109	+	THIS SECTION; 8
111	110
112		-	(2) THE TRAINING IDENTIFI ED OR DEVELOPED UNDE R PARAGRAPH 10
113		-	(1) OF THIS SUBSECTION S HALL BE PROVIDED TO SCHOOL N URSES AND VOLUNTARY 11
114		-	SCHOOL PERSONNEL WHO ARE DESIGNATED BY A SCHOOL NURSE AND , IN THE 12
115		-	CLINICAL JUDGMENT OF THE SCHOOL NURSE , ARE APPROPRIATE RECI PIENTS OF 13
116		-	THE TRAINING. 14
	111	+	(2) Procedures for the emergency administration of auto –injectable 9
	112	+	epinephrine BY A SCHOOL NURSE OR DESIGNATED VOLUNTEER ; 10
117	113
118		-	(3) THE TRAINING PROVIDED UNDER THIS SUBSECTIO N SHALL BE A 15
119		-	PAID PROFESSIONAL DEVELOP MENT TRAINING . 16
	114	+	(3) The proper follow–up emergency procedures; 11
120	115
121		-	(D) The policy established under subsection (b) of this section shall include: 17
	116	+	(4) A provision authorizing a school nurse to obtain and store at a public 12
	117	+	school auto–injectable epinephrine to be used in an emergency situation; and 13
122	118
123		-	(1) ~~[Training for~~ school ~~personnel on how to recognize the symptoms of 18~~
124		-	~~anaphylaxis]~~ THE ~~TRAINING IDENTIFI ED~~ OR ~~DEVELOPED UNDE R SUBSECTION (C)~~ OF 19
125		-	~~THIS SECTION;~~ 20
	119	+	(5) A requirement that each public school develop and implement a method 14
	120	+	for notifying the parents or guardians of students of the school’s policy under this section 15
	121	+	at the beginning of each school year. 16
126	122
127		-	(2) Procedures for the emergency administration of auto –injectable 21
128		-	epinephrine BY A SCHOOL NURSE OR DESIGNATED VOLUNTEER ; 22
	123	+	(E) (1) AN AUTHORIZED LICENSE D HEALTH CARE PRACTI TIONER MAY 17
	124	+	PROVIDE AUTO –INJECTABLE EPINEPHRI NE TO A SCHOOL NURSE OR DESIGNATED 18
	125	+	VOLUNTEER FOR USE IN ACCORDANCE WITH THIS SECTION. 19
	126	+
	127	+	(2) AUTO–INJECTABLE EPINEPHRI NE USED UNDER THIS S ECTION 20
	128	+	MUST BE FROM A LICEN SED PHARMACY OR MANU FACTURER. 21
	129	+
	130	+	(3) A COUNTY BOARD OR PUBL IC SCHOOL MAY ACCEPT DONATED 22
	131	+	AUTO–INJECTABLE EPINEPHRI NE FROM A LIC ENSED PHARMACY OR 23
	132	+	MANUFACTURER . 24
	133	+
	134	+	(4) A COUNTY BOARD MAY APP LY FOR GRANTS TO OBT AIN FUNDING 25
	135	+	FOR THE PURCHASE OF AUTO–INJECTABLE EPINEPHRI NE FROM A LICENSED 26
	136	+	PHARMACY OR MANUFACT URER. 27
	137	+
	138	+	[(d)] (F) Except for any willful or grossly negligent act, a school nurse or other 28
	139	+	school personnel who respond in good faith to the anaphylactic reaction of a child in 29
	140	+	accordance with this section may not be held personally liable for any act or omission in the 30
	141	+	course of responding to the reaction. 31
	142	+	4 HOUSE BILL 266
	143	+
	144	+
	145	+	[(e)] (G) (1) Each public school shall submit, on the form that the Department 1
	146	+	requires, a report to the Department on each incident at the school or at a related school 2
	147	+	event that required the use of auto–injectable epinephrine. 3
	148	+
	149	+	(2) The Department shall develop and disseminate a standard form to 4
	150	+	report each incident requiring the use of auto–injectable epinephrine at a public school. 5
	151	+
	152	+	7–426.3. 6
	153	+
	154	+	(a) (1) In this section the following words have the meanings indicated. 7
	155	+
	156	+	(2) “Anaphylaxis” means a sudden, severe, and potentially life–threatening 8
	157	+	allergic reaction that occurs when an individual is exposed to an allergen. 9
	158	+
	159	+	(3) “Auto–injectable epinephrine” means a portable, disposable drug 10
	160	+	delivery device that contains a premeasured single dose of epinephrine that is used to treat 11
	161	+	anaphylaxis in an emergency situation. 12
	162	+
	163	+	(4) “School personnel” means individuals who are employed by a nonpublic 13
	164	+	school, including part–time employees, teachers and substitute teachers employed by the 14
	165	+	school for at least 7 days each school year, a school nurse, registered nurse case manager, 15
	166	+	delegating nurse, and administrative staff. 16
	167	+
	168	+	(b) Each nonpublic school in the State may establish a policy authorizing school 17
	169	+	personnel to administer auto–injectable epinephrine, if available, to a student who is 18
	170	+	determined BY AN INDIVIDUAL WHO HAS UNDERGONE THE TR AINING PROVIDED 19
	171	+	UNDER § 7–426.6(C) OF THIS SUBTITLE , IF AVAILABLE, to be or perceived to be in 20
	172	+	anaphylaxis, regardless of whether the student: 21
	173	+
	174	+	(1) Has been identified as having an anaphylactic allergy, as defined in § 22
	175	+	7–426.1 of this subtitle; or 23
	176	+
	177	+	(2) Has [a prescription for] BEEN PRESCRIBED epinephrine [as 24
	178	+	prescribed] by an authorized licensed health care practitioner under the Health 25
	179	+	Occupations Article. 26
	180	+
	181	+	(c) The policy established under subsection (b) of this section shall include: 27
	182	+
	183	+	(1) [Training for school personnel on how to recognize the signs and 28
	184	+	symptoms of anaphylaxis by a licensed health care practitioner who is authorized to 29
	185	+	administer auto–injectable epinephrine and who has been trained in an established 30
	186	+	protocol on how to recognize the signs and symptoms of anaphylaxis] THE TRAINING 31
	187	+	IDENTIFIED OR DEVELO PED UNDER § 7–426.2(C) OF THIS SUBTITLE FOR SCHOOL 32
	188	+	NURSES AND VOLUNTARY SCHOOL PERSONNEL WHO ARE DESIGNATED BY A SCHOOL 33
	189	+	NURSE AND , IN THE CLINICAL JUDG MENT OF THE SCHOOL N URSE, ARE 34
	190	+	APPROPRIATE RECIPIEN TS OF THE TRAINING ; 35 HOUSE BILL 266 5
	191	+
	192	+
	193	+
	194	+	(2) Procedures for the emergency administration of auto –injectable 1
	195	+	epinephrine BY A SCHOOL NURSE OR DESIGNATED VOLUNTEER ; 2
	196	+
	197	+	(3) The proper follow–up emergency procedures; 3
	198	+
	199	+	(4) A provision authorizing a school nurse or other licensed health care 4
	200	+	practitioner to obtain and, school personnel to store, at a nonpublic school auto–injectable 5
	201	+	epinephrine to be used in an emergency situation; 6
	202	+
	203	+	(5) A requirement that the nonpublic school develop and implement a 7
	204	+	method for notifying the parents or guardians of students of the school’s policy under this 8
	205	+	section at the beginning of each school year; and 9
	206	+
	207	+	(6) An ongoing process for oversight and monitoring by a licensed health 10
	208	+	care practitioner of the implementation of the policy established under subsection (b) of this 11
	209	+	section. 12
	210	+
	211	+	(D) (1) AN AUTHORIZED LICENSE D HEALTH CARE PRACTI TIONER MAY 13
	212	+	PROVIDE AUTO –INJECTABLE EPINEPHRI NE TO A SCHOOL NURSE OR DESIGNATED 14
	213	+	VOLUNTEER FOR USE IN ACCORDANCE WI TH THIS SECTION. 15
	214	+
	215	+	(2) AUTO–INJECTABLE EPINEPHRI NE USED UNDER THIS S ECTION 16
	216	+	MUST BE FROM A LICEN SED PHARMACY OR MANU FACTURER. 17
	217	+
	218	+	(3) A NONPUBLIC SCHOOL MAY ACCEPT DONATED AUTO –INJECTABLE 18
	219	+	EPINEPHRINE FROM A L ICENSED PHARMACY OR MANUFACTU RER. 19
	220	+
	221	+	(4) A NONPUBLIC SCHOOL MAY APPLY FOR GRANTS TO OBTAIN 20
	222	+	FUNDING FOR THE PURC HASE OF AUTO –INJECTABLE EPINEPHRI NE FROM A 21
	223	+	LICENSED PHARMACY OR MANUFACTURER . 22
	224	+
	225	+	[(d)] (E) Except for any willful or grossly negligent act, school personnel who 23
	226	+	respond in good faith to the anaphylactic reaction of a child in accordance with this section 24
	227	+	may not be held personally liable for any act or omission in the course of responding to the 25
	228	+	reaction. 26
	229	+
	230	+	7–426.6. 27
	231	+
	232	+	(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 28
	233	+	INDICATED. 29
	234	+
	235	+	(2) “ASTHMA” MEANS A CHRONIC LUNG DISEASE THAT INFLAME S 30
	236	+	AND NARROWS AIR PASS AGES, CAUSING RECURRING PE RIODS OF WHEEZING , CHEST 31
	237	+	TIGHTNESS, SHORTNESS OF BREATH , AND COUGHING . 32 6 HOUSE BILL 266
	238	+
	239	+
	240	+
	241	+	(3) “BRONCHODILATOR” MEANS MEDICATION THA T RELAXES 1
	242	+	BRONCHIAL MUSCLES , RESULTING IN THE EXP ANSION OF BRONCHIAL AIR 2
	243	+	PASSAGES TO PROVIDE FAST TREATMENT OF AS THMA–RELATED SYMPTOMS AND 3
	244	+	SYMPTOMS OF RESPIRAT ORY DISTRESS. 4
	245	+
	246	+	(4) “SCHOOL PERSONNEL ” MEANS INDIVIDUALS WH O ARE EMPLOYED 5
	247	+	BY A PUBLIC SCHOOL , INCLUDING PART –TIME EMPLOYEES , TEACHERS AND 6
	248	+	SUBSTITUTE TEACHERS EMPLOYED BY THE SCHO OL FOR AT LEAST 7 DAYS EACH 7
	249	+	SCHOOL YEAR , REGISTERED NURSE CAS E MANAGERS , DELEGATING NURSES , AND 8
	250	+	ADMINISTRATIVE STAFF . 9
	251	+
	252	+	(B) (1) EXCEPT AS PROVI DED IN PARAGRAPH (2) OF THIS SUBSECTION , 10
	253	+	EACH COUNTY BOARD SH ALL ESTABLISH A POLI CY FOR PUBLIC SCHOOL S WITHIN ITS 11
	254	+	JURISDICTION TO AUTH ORIZE THE SCHOOL NUR SE AND OTHER SCHOOL PERSONNEL 12
	255	+	TO ADMINISTER A BRON CHODILATOR TO A STUDENT WHO IS DETERMINED BY AN 13
	256	+	INDIVIDUAL WHO HAS UNDER GONE THE TRAINING PR OVIDED IN SUBSECTION (C) OF 14
	257	+	THIS SECTION TO HAVE ASTHMA , IS EXPERIENCING ASTH MA–RELATED SYMPTOMS , 15
	258	+	OR IS PERCEIVED TO B E IN RESPIRATORY DIS TRESS, REGARDLESS OF WHETHE R THE 16
	259	+	STUDENT: 17
	260	+
	261	+	(I) HAS BEEN DIAGNOSED WI TH ASTHMA OR REACTIVE AIRWA Y 18
	262	+	DISEASE; OR 19
	263	+
	264	+	(II) HAS BEEN PRESCRIBED A BRONCHODILATOR BY AN 20
	265	+	AUTHORIZED LICENSED HEALTH CARE PRACTITI ONER UNDER THE HEALTH 21
	266	+	OCCUPATIONS ARTICLE. 22
	267	+
	268	+	(2) NEITHER A SCHOOL NURS E NOR ANY OTHER SCHO OL PERSONNEL 23
	269	+	MAY ADMINISTER A BRONCHODILATOR TO A PREKINDERGARTEN STUD ENT UNLESS 24
	270	+	THE STUDENT HAS BEEN DIAGNOSED WITH ASTHM A OR A REACTIVE AIRW AY DISEASE 25
	271	+	AND HAS A PRESCRIPTI ON FOR A BRONCHODILA TOR AS PRESCRIBED BY THE 26
	272	+	STUDENT’S HEALTH CARE PRACTI TIONER. 27
	273	+
	274	+	(C) (1) THE TRAINING IDENTIFI ED OR DEVELOPED UNDER § 7–426.2(C) 28
	275	+	OF THIS SUBTITLE SHA LL BE PROVIDED TO SC HOOL NURSES AND OTHE R 29
	276	+	VOLUNTARY SCHOOL PER SONNEL WHO ARE DESIG NATED BY A SCHOOL NU RSE AND, 30
	277	+	IN THE CLINICAL JUDG MENT OF THE SCHOOL N URSE, ARE APPROPRIATE 31
	278	+	RECIPIENTS OF THE TR AINING. 32
	279	+
	280	+	(2) THE TRAINING PROVIDED UNDER THIS SUBSECTIO N SHALL BE A 33
	281	+	PAID PROFESSIONAL DE VELOPMENT TRAINING . 34
	282	+	HOUSE BILL 266 7
	283	+
	284	+
	285	+	(D) THE POLICY ESTABLISHE D UNDER SUBSECTION (B) OF THIS SECTION 1
	286	+	SHALL INCLUDE : 2
	287	+
	288	+	(1) THE TRAINING REQUIRED UNDER SUBSECTION (C) OF THIS 3
	289	+	SECTION; 4
	290	+
	291	+	(2) PROCEDURES FOR THE EM ERGENCY ADMINISTRATI ON OF A 5
	292	+	BRONCHODILATOR BY A SCHOOL NURSE OR DESI GNATED VOLUNTEER ; 6
	293	+
	294	+	(3) THE PROPER FOLLOW –UP EMERGENCY PROCEDU RES; 7
	295	+
	296	+	(4) A PROVISION AUTHORIZIN G A SCHOOL NURSE TO OBTAIN AND 8
	297	+	STORE AT A PUBLIC SC HOOL BRONCHODILATOR S AND MODES OF DELIV ERY, 9
	298	+	INCLUDING INHALERS W ITH SPACERS, TO BE USED IN AN EME RGENCY SITUATION ; 10
	299	+	AND 11
	300	+
	301	+	(5) A REQUIREMENT THAT EAC H PUBLIC SCHOOL DEVE LOP AND 12
	302	+	IMPLEMENT A METHOD F OR NOTIFYING THE PAR ENTS OR GUARDIANS OF STUDENTS 13
	303	+	OF THE SCHOOL ’S POLICY UNDER THIS SECTION AT THE BEGINNING OF EACH 14
	304	+	SCHOOL YEAR . 15
	305	+
	306	+	(E) (1) AN AUTHORIZED LICENSE D HEALTH CARE PRACTI TIONER MAY 16
	307	+	PROVIDE BRONCHODILAT ORS TO A SCHOOL NURS E OR DESIGNATED VOLU NTEER 17
	308	+	FOR USE IN ACCORDANC E WITH THIS SECTION . 18
	309	+
	310	+	(2) BRONCHODILATORS AND M ODES O F ADMINISTRATION , 19
	311	+	INCLUDING INHALERS W ITH SPACERS, USED BY A SCHOOL NUR SE OR ANY OTHER 20
	312	+	SCHOOL PERSONNEL MUS T BE FROM A LICENSED PHARMACY OR MANUFACT URER. 21
	313	+
	314	+	(3) A COUNTY BOARD OR PUBL IC SCHOOL MAY ACCEPT DONATED 22
	315	+	BRONCHODILATORS AND MODES OF ADMINISTRAT ION, INCLUDING INHALERS W ITH 23
	316	+	SPACERS, FROM A LICENSED PHAR MACY OR MANUFACTURER . 24
	317	+
	318	+	(4) A COUNTY BOARD MAY APP LY FOR GRANTS TO OBT AIN FUNDING 25
	319	+	FOR THE PURCHASE OF BRONCHODILATORS AND MODES OF ADMINISTRAT ION, 26
	320	+	INCLUDING INHALERS W ITH SPACERS. 27
	321	+
	322	+	(F) EXCEPT FOR ANY WILLFUL OR GROSS LY NEGLIGENT ACT , A SCHOOL 28
	323	+	NURSE OR ANY OTHER S CHOOL PERSONNEL WHO RESPOND IN GOOD FAIT H TO THE 29
	324	+	ASTHMA ATTACK OR RES PIRATORY DISTRESS OF A CHILD IN ACCORDANC E WITH 30
	325	+	THIS SECTION MAY NOT BE HELD PERSONALLY L IABLE FOR ANY ACT OR OMISSION 31
	326	+	IN THE COURSE OF RESP ONDING TO THE CHILD IN DISTRESS. 32
	327	+	8 HOUSE BILL 266
	328	+
	329	+
	330	+	(G) (1) (I) FOR EACH INCIDENT AT THE SCHOOL OR AT A R ELATED 1
	331	+	SCHOOL EVENT THAT RE QUIRES THE USE OF A BRONCHO DILATOR, EACH PUBLIC 2
	332	+	SCHOOL SHALL : 3
	333	+
	334	+	1. NOTIFY THE STUDENT ’S PARENT OR LEGAL 4
	335	+	GUARDIAN OF TH E INCIDENT; AND 5
	336	+
	337	+	2. MAKE A RECORD OF THE INCIDENT, ON THE FORM 6
	338	+	THAT THE DEPARTMENT REQUIRES , AND FILE THE FORM IN THE STUDENT’S SCHOOL 7
	339	+	MEDICAL RECORD . 8
	340	+
	341	+	(II) EACH PUBLIC SCHOOL SH ALL SUBMIT TO THE 9
	342	+	DEPARTMENT A REPORT , ON THE FORM AND SCHE DULE REQUIRE D BY THE 10
	343	+	DEPARTMENT , ON THE NUMBER OF INC IDENTS AT THE SCHOOL OR AT A RELATED 11
	344	+	SCHOOL EVENT THAT RE QUIRED THE USE OF A BRONCHODILATOR . 12
	345	+
	346	+	(2) THE DEPARTMENT SHALL DEVE LOP AND DISSEMINATE 13
	347	+	STANDARD FORMS TO RE CORD EACH INCIDENT A ND REPORT INCIDENTS REQUIRING 14
	348	+	THE USE OF A BRONCHO DILATOR AT A PUBLIC SCHOOL. 15
	349	+
	350	+	7–426.7. 16
	351	+
	352	+	(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 17
	353	+	INDICATED. 18
	354	+
	355	+	(2) “ASTHMA” MEANS A CHRONIC LUNG DISEASE THAT INFLAME S 19
	356	+	AND NARROWS AIR PASS AGES, CAUSING RECURRING PE RIODS OF WHEEZING , CHEST 20
	357	+	TIGHTNESS, SHORTNESS OF BREATH , AND COUGHING . 21
	358	+
	359	+	(3) “BRONCHODILATOR ” MEANS MEDICATION THA T RELAXES 22
	360	+	BRONCHIAL MUSCLES , RESULTING IN THE EXP ANSION OF BRONCHIAL AIR 23
	361	+	PASSAGES TO PROVIDE FAST TREATMENT OF AS THMA–RELATED SYMPTOMS AND 24
	362	+	SYMPTOMS OF RESPIRAT ORY DISTRESS. 25
	363	+
	364	+	(4) “SCHOOL PERSONNEL ” MEANS INDIVIDUALS WH O ARE EMPLOYED 26
	365	+	BY A NONPUBLIC SCHOO L, INCLUDING PART –TIME EMPLOYEES , TEACHERS AND 27
	366	+	SUBSTITUTE TEACHERS EMPLOYED BY THE SCHO OL FOR AT LEAST 7 DAYS EACH 28
	367	+	SCHOOL YEAR , REGISTERED NURSE CAS E MANAGERS , DELEGATING NURSES , AND 29
	368	+	ADMINISTRATIVE STAFF . 30
	369	+
	370	+	(B) (1) EXCEPT AS PROVIDED IN PARAGRAPH (2) OF THIS SUBSECTION , 31
	371	+	EACH NONPUBLIC SCHOOL IN THE STATE MAY ESTABLISH A POLICY AUTHORIZING 32
	372	+	THE SCHOOL NURSE AND OTHER SCHOOL PERSONN EL TO ADMINISTER A 33
	373	+	BRONCHODILATOR TO A STUDENT WHO IS D ETERMINED BY AN INDI VIDUAL WHO HAS 34 HOUSE BILL 266 9
	374	+
	375	+
	376	+	UNDERGONE THE TRAINI NG PROVIDED UNDER § 7–426.2(C) OF THIS SUBTITLE TO 1
	377	+	HAVE ASTHMA , IS EXPERIENCING ASTH MA–RELATED SYMPTOMS , OR IS PERCEIVED 2
	378	+	TO BE IN RESPIRATORY DISTRESS, REGARDLESS OF WHETHE R THE STUDENT: 3
	379	+
	380	+	(I) HAS BEEN DIAGNOSED WI TH ASTHMA OR REACTIV E AIRWAY 4
	381	+	DISEASE; OR 5
	382	+
	383	+	(II) HAS BEEN PRESCRIBED A BRONCHODILATOR BY AN 6
	384	+	AUTHORIZED LICENSED HEALTH CARE PRACTITI ONER UNDER THE HEALTH 7
	385	+	OCCUPATIONS ARTICLE. 8
	386	+
	387	+	(2) A SCHOOL NURSE OR ANY OTHER SCHOOL PERSONNEL MAY NOT 9
	388	+	ADMINISTER A BRONCHO DILATOR TO A PREKIND ERGARTEN STUDENT UNL ESS THE 10
	389	+	STUDENT HAS BEEN DIA GNOSED WITH ASTHMA O R A REACTIVE AIRWAY DISEASE 11
	390	+	AND HAS A PRESCRIPTI ON FOR A BRONCHODILA TOR AS PRESCRIBED BY THE 12
	391	+	STUDENT’S HEALTH CARE PRACTI TIONER. 13
	392	+
	393	+	(C) THE POLICY ESTABLISHE D UNDER SUBSECTION (B) OF THIS SECTION 14
	394	+	SHALL INCLUDE : 15
	395	+
	396	+	(1) THE TRAINING IDENTIFI ED OR DEVELOPED UNDE R § 16
	397	+	7–426.2(C) OF THIS SUBTITLE FOR SCHOOL NURSES AND VO LUNTARY SCHOOL 17
	398	+	PERSONNEL WHO ARE DE SIGNATED BY A SCHOOL NURSE AND, IN THE CLINICAL 18
	399	+	JUDGMENT OF THE SCHO OL NURSE, ARE APPROPRIATE RECI PIENTS OF THE 19
	400	+	TRAINING; 20
	401	+
	402	+	(2) PROCEDURES FOR THE EM ERGENCY ADMINISTRATI ON OF A 21
	403	+	BRONCHODILATOR BY A SCHOOL NURSE OR DESI GNATED VOLUNTEER ; 22
129	404
130	405		(3) THE PROPER FOLLOW –UP EMERGENCY PROCEDU RES; 23
131	406
132		-	(4) A provision authorizing a school nurse to obtain and store at a public 24
133		-	school auto–injectable epinephrine to be used in an emergency situation; and 25
	407	+	(4) A PROVISION AUTHORIZIN G A SCHOOL NURSE OR ANY OTHER 24
	408	+	LICENSED HEALTH CARE PRACTITIONER TO OBTA IN, AND A SCHOOL NURSE O R ANY 25
	409	+	OTHER SCHOOL PERSONN EL TO STORE, AT A NONPUBLIC SCHOO L FOR USE IN AN 26
	410	+	EMERGENCY SITUATION BRONCHODILATORS AND MODES OF DELIVERY , INCLUDING 27
	411	+	INHALERS WITH SPACER S; 28
134	412
135		-	(5) A requirement that each public school develop and implement a method 26
136		-	for notifying the parents or guardians of students of the school’s policy under this section 27
137		-	at the beginning of each school year. 28
138		-
139		-	(E) (1) AN AUTHORIZED LICENSE D HEALTH CARE PRACTI TIONER MAY 29
140		-	PROVIDE AUTO –INJECTABLE EPINEPHRI NE TO A SCHOOL NURSE OR DESIGNATED 30
141		-	VOLUNTEER FOR USE IN ACCORDANCE WITH THIS SECTION. 31
142		-	4 HOUSE BILL 266
	413	+	(5) A REQUIREMENT THAT THE NONPUBLIC SCHOOL DEV ELOP AND 29
	414	+	IMPLEMENT A METHOD F OR NOTIFYING THE PAR ENTS OR GUARDIANS OF STUDENTS 30
	415	+	OF THE SCHOOL ’S POLICY UNDER THIS SECTION AT THE BEGIN NING OF EACH 31
	416	+	SCHOOL YEAR ; AND 32
	417	+	10 HOUSE BILL 266
143	418
144	419
145		-	(2) AUTO–INJECTABLE EPINE PHRINE USED UNDER TH IS SECTION 1
146		-	MUST BE FROM A LICEN SED PHARMACY OR MANU FACTURER. 2
	420	+	(6) AN ONGOING PROCESS FOR OVER SIGHT AND MONITORING BY A 1
	421	+	LICENSED HEALTH CARE PRACTITIONER OF THE IMPLEMENTATION OF TH E POLICY 2
	422	+	ESTABLISHED UNDER SU BSECTION (B) OF THIS SECTION. 3
147	423
148		-	(3) ~~A COUNTY BOARD OR PUBL IC SCHOOL~~ MAY ~~ACCEPT DONATED 3~~
149		-	~~AUTO–INJECTABLE EPINEPHRI NE FROM~~ A ~~LICENSED P HARMACY~~ OR 4
150		-	~~MANUFACTURER~~ . 5
	424	+	(D) (1) AN AUTHORIZED LICENSE D HEALTH CARE PRACTI TIONER MAY 4
	425	+	PROVIDE BRONCHODILAT ORS TO A SCHOOL NURSE OR DESI GNATED VOLUNTEER 5
	426	+	FOR USE IN ACCORDANC E WITH THIS SECTION . 6
151	427
152		-	(4) ~~A COUNTY BOARD MAY APP LY FOR GRANTS TO O BTAIN FUNDING 6~~
153		-	~~FOR THE PURCHASE OF AUTO–INJECTABLE EPINEPHRI NE FROM~~ A ~~LICENSED 7~~
154		-	PHARMACY OR ~~MANUFACT URER~~. 8
	428	+	(2) BRONCHODILATOR S AND MODES OF ADMINISTRATION , 7
	429	+	INCLUDING INHALERS W ITH SPACERS, USED BY A SCHOOL NUR SE OR ANY OTHER 8
	430	+	SCHOOL PERSONNEL MUS T BE FROM A LICENSED PHARMACY OR MANUFACTURER . 9
155	431
156		-	[(d)] (F) Except for any willful or grossly negligent act, a school nurse or other 9
157		-	school personnel who respond in good faith to the anaphylactic reaction of a child in 10
158		-	accordance with this section may not be held personally liable for any act or omission in the 11
159		-	course of responding to the reaction. 12
	432	+	(3) A NONPUBLIC SCHOOL MAY ACCEPT DONATED 10
	433	+	BRONCHODILATORS AND MODES OF ADMINISTRAT ION, INCLUDING INHALERS W ITH 11
	434	+	SPACERS, FROM A LICENSED PHAR MACY OR MANUFACTURER . 12
160	435
161		-	~~[(e)]~~ (G) ~~(1) Each public~~ school ~~shall submit,~~ ~~on the form that the Department~~ 13
162		-	~~requires, a report to~~ the ~~Department on each incident at the school or at a related school~~ 14
163		-	~~event that required the use of auto–injectable epinephrine~~. 15
	436	+	(4) A NONPUBLIC SCHOOL MAY APPLY FOR GRANTS TO OBTAIN 13
	437	+	FUNDING FOR THE PUR CHASE OF BRONCHODILA TORS AND MODES OF 14
	438	+	ADMINISTRATION , INCLUDING INHALERS W ITH SPACERS. 15
164	439
165		-	(2) The Department shall develop and disseminate a standard form to 16
166		-	report each incident requiring the use of auto–injectable epinephrine at a public school. 17
	440	+	(E) EXCEPT FOR ANY WILLFU L OR GROSSLY NEGLIGE NT ACT, A SCHOOL 16
	441	+	NURSE OR ANY OTHER S CHOOL PERSONNEL WHO RESPOND IN GOOD FAIT H TO THE 17
	442	+	ASTHMA ATTACK OR RES PIRATORY DISTRES S OF A CHILD IN ACCO RDANCE WITH 18
	443	+	THIS SECTION MAY NOT BE HELD PERSONALLY L IABLE FOR ANY ACT OR OMISSION 19
	444	+	IN THE COURSE OF RES PONDING TO THE CHILD IN DISTRESS. 20
167	445
168		-	7–426.3. 18
169		-
170		-	(a) (1) In this section the following words have the meanings indicated. 19
171		-
172		-	(2) “Anaphylaxis” means a sudden, severe, and potentially life–threatening 20
173		-	allergic reaction that occurs when an individual is exposed to an allergen. 21
174		-
175		-	(3) “Auto–injectable epinephrine” means a portable, disposable drug 22
176		-	delivery device that contains a premeasured single dose of epinephrine that is used to treat 23
177		-	anaphylaxis in an emergency situation. 24
178		-
179		-	(4) “School personnel” means individuals who are employed by a nonpublic 25
180		-	school, including part–time employees, teachers and substitute teachers employed by the 26
181		-	school for at least 7 days each school year, a school nurse, registered nurse case manager, 27
182		-	delegating nurse, and administrative staff. 28
183		-
184		-	(b) Each nonpublic school in the State may establish a policy authorizing school 29
185		-	personnel to administer auto–injectable epinephrine, if available, to a student who is 30
186		-	determined BY AN INDIVIDUAL WHO HAS UNDERGONE THE TR AINING PROVI DED 31
187		-	UNDER § 7–426.6(C) OF THIS SUBTITLE , IF AVAILABLE, to be or perceived to be in 32
188		-	anaphylaxis, regardless of whether the student: 33
189		-	HOUSE BILL 266 5
190		-
191		-
192		-	(1) Has been identified as having an anaphylactic allergy, as defined in § 1
193		-	7–426.1 of this subtitle; or 2
194		-
195		-	(2) Has [a prescription for] BEEN PRESCRIBED epinephrine [as 3
196		-	prescribed] by an authorized licensed health care practitioner under the Health 4
197		-	Occupations Article. 5
198		-
199		-	(c) The policy established under subsection (b) of this section shall include: 6
200		-
201		-	(1) [Training for school personnel on how to recognize the signs and 7
202		-	symptoms of anaphylaxis by a licensed health care practitioner who is authorized to 8
203		-	administer auto–injectable epinephrine and who has been trained in an established 9
204		-	protocol on how to recognize the signs and symptoms of anaphylaxis] THE TRAINING 10
205		-	IDENTIFIED OR DEVELO PED UNDER § 7–426.2(C) OF THIS SUBTITLE FOR SCHOOL 11
206		-	NURSES AND VOLUNTARY SCHOOL PERSONNEL WHO ARE DESIGNATED BY A SCHOOL 12
207		-	NURSE AND , IN THE CLINICAL JUDG MENT OF THE SCHOOL N URSE, ARE 13
208		-	APPROPRIATE RECI PIENTS OF THE TRAINI NG; 14
209		-
210		-	(2) Procedures for the emergency administration of auto –injectable 15
211		-	epinephrine BY A SCHOOL NURSE OR DESIGNATED VOLUNTEER ; 16
212		-
213		-	(3) The proper follow–up emergency procedures; 17
214		-
215		-	(4) A provision authorizing a school nurse or other licensed health care 18
216		-	practitioner to obtain and, school personnel to store, at a nonpublic school auto–injectable 19
217		-	epinephrine to be used in an emergency situation; 20
218		-
219		-	(5) A requirement that the nonpublic school develop and implement a 21
220		-	method for notifying the parents or guardians of students of the school’s policy under this 22
221		-	section at the beginning of each school year; and 23
222		-
223		-	(6) An ongoing process for oversight and monitoring by a licensed health 24
224		-	care practitioner of the implementation of the policy established under subsection (b) of this 25
225		-	section. 26
226		-
227		-	(D) (1) AN AUTHORIZED LICENSE D HEALTH CARE PRACTI TIONER MAY 27
228		-	PROVIDE AUTO –INJECTABLE EPINEPHRI NE TO A SCHOOL NURSE OR DESIGNATED 28
229		-	VOLUNTEER FOR USE IN ACCORDANCE WITH THIS SECTION. 29
230		-
231		-	(2) AUTO–INJECTABLE EPINEPH RINE USED UNDER THIS SECTION 30
232		-	MUST BE FROM A LICEN SED PHARMACY OR MANU FACTURER. 31
233		-
234		-	(3) A NONPUBLIC SCHOOL MAY ACCEPT DONATED AUTO –INJECTABLE 32
235		-	EPINEPHRINE FROM A L ICENSED PHARMACY OR MANUFACTURER . 33
236		-	6 HOUSE BILL 266
237		-
238		-
239		-	(4) A NONPUBLIC SCHOOL MAY APPLY FOR GRANTS TO OBTAIN 1
240		-	FUNDING FOR THE PURCHASE OF AUTO–INJECTABLE EPINEPHRI NE FROM A 2
241		-	LICENSED PHARMACY OR MANUFACTURER . 3
242		-
243		-	[(d)] (E) Except for any willful or grossly negligent act, school personnel who 4
244		-	respond in good faith to the anaphylactic reaction of a child in accordance with this section 5
245		-	may not be held personally liable for any act or omission in the course of responding to the 6
246		-	reaction. 7
247		-
248		-	7–426.6. 8
249		-
250		-	(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 9
251		-	INDICATED. 10
252		-
253		-	(2) “ASTHMA” MEANS A CHRONIC LUNG DISEASE THAT INFLAMES 11
254		-	AND NARROWS AIR PASS AGES, CAUSING RECURRING PE RIODS OF WHEEZING , CHEST 12
255		-	TIGHTNESS, SHORTNESS OF BREATH , AND COUGHING . 13
256		-
257		-	(3) “BRONCHODILATOR ” MEANS MEDICATION THA T RELAXES 14
258		-	BRONCHIAL MUSCLES , RESULTING IN THE EXP ANSION OF BRONCHIAL AIR 15
259		-	PASSAGES TO P ROVIDE FAST TREATMEN T OF ASTHMA –RELATED SYMPTOMS AND 16
260		-	SYMPTOMS OF RESPIRAT ORY DISTRESS. 17
261		-
262		-	(4) “SCHOOL PERSONNEL ” MEANS INDIVIDUALS WH O ARE EMPLOYED 18
263		-	BY A PUBLIC SCHOOL , INCLUDING PART –TIME EMPLOYEES , TEACHERS AND 19
264		-	SUBSTITUTE TEACHERS EMPLOYED BY THE SCHO OL FOR AT LEAST 7 DAYS EACH 20
265		-	SCHOOL YEAR , REGISTERED NURSE CAS E MANAGERS , DELEGATING NURSES , AND 21
266		-	ADMINISTRATIVE STAFF . 22
267		-
268		-	(B) (1) EXCEPT AS PROVIDED IN PARAGRAPH (2) OF THIS SUBSECTION , 23
269		-	EACH COUNTY BOARD SH ALL ESTABLISH A POLI CY FOR PUBLIC SCHOOL S WITHIN ITS 24
270		-	JURISDICTION TO AUTHOR IZE THE SCHOOL NURSE AND OTHER SCHOOL PER SONNEL 25
271		-	TO ADMINISTER A BRON CHODILATOR TO A STUD ENT WHO IS DETERMINE D BY AN 26
272		-	INDIVIDUAL WHO HAS U NDERGONE THE TRAININ G PROVIDED IN SUBSEC TION (C) OF 27
273		-	THIS SECTION TO HAVE ASTHMA, IS EXPERIENCING AST HMA–RELATED SYMPTOMS , 28
274		-	OR IS PERCEIVED TO B E IN RESPIRATORY DIS TRESS, REGARDLESS OF WHETHE R THE 29
275		-	STUDENT: 30
276		-
277		-	(I) HAS BEEN DIAGNOSED WI TH ASTHMA OR REACTIV E AIRWAY 31
278		-	DISEASE; OR 32
279		-
280		-	(II) HAS BEEN PRESCRIBED A BRONCHODILATOR BY AN 33
281		-	AUTHORIZED LICENSED HEALTH CARE PRACTITIONER UN DER THE HEALTH 34
282		-	OCCUPATIONS ARTICLE. 35 HOUSE BILL 266 7
283		-
284		-
285		-
286		-	(2) NEITHER A SCHOOL NURS E NOR ANY OTHER SCHO OL PERSONNEL 1
287		-	MAY ADMINISTER A BRONCHO DILATOR TO A PREKIND ERGARTEN STUDENT UNL ESS 2
288		-	THE STUDENT HAS BEEN DIAGNOSED WITH ASTHM A OR A REACTIVE AIRW AY DISEASE 3
289		-	AND HAS A PRESCRIPTI ON FOR A BRONCHODILA TOR AS PRESCRIBED BY THE 4
290		-	STUDENT’S HEALTH CARE PRACTI TIONER. 5
291		-
292		-	(C) (1) THE TRAINING IDENTIFI ED OR DEVELOPED UNDE R § 7–426.2(C) 6
293		-	OF THIS SUBTITLE SHA LL BE PROVIDED TO SC HOOL NURSES AND OTHE R 7
294		-	VOLUNTARY SCHOOL PER SONNEL WHO ARE DESIGNATED B Y A SCHOOL NURSE AND , 8
295		-	IN THE CLINICAL JUDG MENT OF THE SCHOOL N URSE, ARE APPROPRIATE 9
296		-	RECIPIENTS OF THE TR AINING. 10
297		-
298		-	(2) THE TRAINING PROVIDED UNDER THIS SUBSECTIO N SHALL BE A 11
299		-	PAID PROFESSIONAL DE VELOPMENT TRAINING . 12
300		-
301		-	(D) THE POLICY ESTA BLISHED UNDER SUBSEC TION (B) OF THIS SECTION 13
302		-	SHALL INCLUDE : 14
303		-
304		-	(1) THE TRAINING REQUIRED UNDER SUBSECTION (C) OF THIS 15
305		-	SECTION; 16
306		-
307		-	(2) PROCEDURES FOR THE EM ERGENCY ADMINISTRATI ON OF A 17
308		-	BRONCHODILATOR BY A SCHOOL NURSE OR DESI GNATED VOLUNTEER ; 18
309		-
310		-	(3) THE PROPER FOLLOW –UP EMERGENCY PROCEDU RES; 19
311		-
312		-	(4) A PROVISION AUTHORIZIN G A SCHOOL NURSE TO OBTAIN AND 20
313		-	STORE AT A PUBLIC SC HOOL BRONCHODILATORS AND MODES OF DELIVER Y, 21
314		-	INCLUDING INHALERS W ITH SPACERS, TO BE USED IN AN EME RGENCY SITUATION ; 22
315		-	AND 23
316		-
317		-	(5) A REQUIREM ENT THAT EACH PUBLIC SCHOOL DEVELOP AND 24
318		-	IMPLEMENT A METHOD F OR NOTIFYING THE PAR ENTS OR GUARDIANS OF STUDENTS 25
319		-	OF THE SCHOOL ’S POLICY UNDER THIS SECTION AT THE BEGIN NING OF EACH 26
320		-	SCHOOL YEAR . 27
321		-
322		-	(E) (1) AN AUTHORIZED LICENSE D HEALTH CARE PRACTI TIONER MAY 28
323		-	PROVIDE BRONCHODILATORS TO A SCHOOL NURSE OR DESIGNATED VOLUNTEER 29
324		-	FOR USE IN ACCORDANC E WITH THIS SECTION . 30
325		-
326		-	(2) BRONCHODILATORS AND M ODES OF ADMINISTRATI ON, 31
327		-	INCLUDING INHALERS W ITH SPACERS, USED BY A SCHOOL NUR SE OR ANY OTHER 32
328		-	SCHOOL PERSONNEL MUS T BE FROM A LICENSED PHARMACY OR MANUFACT URER. 33 8 HOUSE BILL 266
329		-
330		-
331		-
332		-	(3) A COUNTY BOARD OR PUBL IC SCHOOL MAY ACCEPT DONATED 1
333		-	BRONCHODILATORS AND MODES OF ADMINISTRAT ION, INCLUDING INHALERS W ITH 2
334		-	SPACERS, FROM A LICENSED PHAR MACY OR MANUFACTURER . 3
335		-
336		-	(4) A COUNTY BOARD MAY APP LY FOR GRANTS TO OBT AIN FUNDING 4
337		-	FOR THE PURCHASE OF BRONCHODILATORS AND MODES OF ADMINISTRAT ION, 5
338		-	INCLUDING INHALERS W ITH SPACERS. 6
339		-
340		-	(B) (1) SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , BEFORE THE 7
341		-	2024–2025 SCHOOL YEAR , EACH COUNTY BOARD SHALL ESTABLIS H A POLICY FOR 8
342		-	PUBLIC SCHOOLS WITHI N ITS JURISDICTION T O AUTHORIZE A SCHOOL NURSE OR 9
343		-	OTHER SCHOOL PERSONN EL DESIGNATED BY THE SCHOOL NURSE TO ADMI NISTER A 10
344		-	BRONCHODILATOR TO A STUDENT WHO IS EXPER IENCING ASTHMA , REACTIVE 11
345		-	AIRWAY DISEASE , OR ASTHMA–RELATED SYMPTOMS . 12
346		-
347		-	(2) THE POLICY ESTABLISHE D UNDER THIS SUBSECT ION SHALL 13
348		-	LIMIT THE ADMINISTRA TION OF A BRONCHODIL ATOR TO CASES IN WHI CH A 14
349		-	STUDENT HAS BEEN PRE SCRIBED A BRONCHODIL ATOR BY AN AUTHORIZE D, 15
350		-	LICENSED HEALTH CARE PRACTITIONER IN ACCO RDANCE WITH THE HEALTH 16
351		-	OCCUPATIONS ARTICLE. 17
352		-
353		-	(C) THE POLICY REQUIRED U NDER SUBSECTION (B) OF THIS SECTION 18
354		-	SHALL INCLUDE : 19
355		-
356		-	(1) PROVISIONS AUTHORIZIN G A SCHOOL NURSE TO OBTAIN AND 20
357		-	STORE AT A PUBLIC SC HOOL BRONCHODILATORS TO BE USED IN AN EME RGENCY 21
358		-	SITUATION; AND 22
359		-
360		-	(2) PROCEDURES FOR THE DE SIGNATION OF SCHOOL PERSONNEL BY 23
361		-	A SCHOOL NURSE , IN ACCORDANCE WITH T HE HEALTH OCCUPATIONS ARTICLE, TO 24
362		-	RESPOND TO A STUDENT EXPERIENCING ASTHMA , REACTIVE AIRWAY DISE ASE, OR 25
363		-	ASTHMA–RELATED SYMPTOMS IN AN EMERGENCY SETTING . 26
364		-
365		-	(F) (D) EXCEPT FOR ANY WILLFU L OR GROSSLY NEGLIGE NT ACT, A 27
366		-	SCHOOL NURSE OR ANY OTHER SCHOOL PERSONN EL WHO RESPOND IN GO OD FAITH 28
367		-	TO THE ASTHMA ATTACK OR RESPIRATORY DISTR ESS OF A CHILD IN AC CORDANCE 29
368		-	WITH THIS SECTION MA Y NOT BE HELD PERSON ALLY LIABLE FO R ANY ACT OR 30
369		-	OMISSION IN THE COUR SE OF RESPONDING TO THE CHILD IN DISTRES S. 31
370		-
371		-	(G) (E) (1) (I) FOR EACH INCIDENT AT THE SCHOOL OR AT A 32
372		-	RELATED SCHOOL EVENT THAT RE QUIRES THE USE OF A BRONCHODILATOR , EACH 33
373		-	PUBLIC SCHOOL SHALL : 34
374		-	HOUSE BILL 266 9
375		-
376		-
377		-	1. NOTIFY THE STUDENT ’S PARENT OR LEGAL 1
378		-	GUARDIAN OF THE INCI DENT; AND 2
379		-
380		-	2. MAKE A RECORD OF THE INCIDENT, ON THE FORM 3
381		-	THAT THE DEPARTMENT REQUIRES , AND FILE THE FORM IN THE STUDENT’S SCHOOL 4
382		-	MEDICAL RECORD . 5
383		-
384		-	(II) EACH PUBLIC SCHOOL SH ALL SUBMIT TO THE 6
385		-	DEPARTMENT A REPORT , ON THE FORM AND SCHE DULE REQUIRED BY THE 7
386		-	DEPARTMENT , ON THE NUMBER OF INC IDENTS AT THE SCHOOL OR AT A RELATED 8
387		-	SCHOOL EVENT THAT RE QUIRED THE USE OF A BRONCHODILATOR IN ACCORDANCE 9
388		-	WITH THE COUNTY B OARD’S POLICY UNDER SUBSE CTION (B) OF THIS SECTION. 10
389		-
390		-	(2) THE DEPARTMENT SHALL DEVE LOP AND DISSEMINATE 11
391		-	STANDARD FORMS TO RE CORD EACH INCIDENT A ND REPORT INCIDENTS REQUIRING 12
392		-	THE USE OF A BRONCHO DILATOR IN ACCORDANCE WITH T HE COUNTY BOARD ’S 13
393		-	POLICY UNDER SUB SECTION (B) OF THIS SECTION AT A PUBLIC SCHOOL . 14
394		-
395		-	7–426.7. 15
396		-
397		-	(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 16
398		-	INDICATED. 17
399		-
400		-	(2) “ASTHMA” MEANS A CHRONIC LUNG DISEASE THAT INFLAME S 18
401		-	AND NARROWS AIR PASS AGES, CAUSING RECURRING PE RIODS OF WHEEZING , CHEST 19
402		-	TIGHTNESS, SHORTNESS OF BREATH , AND COUGHING . 20
403		-
404		-	(3) “BRONCHODILATOR ” MEANS MEDICATION THA T RELAXES 21
405		-	BRONCHIAL MUSCLES , RESULTING IN THE EXP ANSION OF BRONCHIAL AIR 22
406		-	PASSAGES TO PROVIDE FAST TREATMENT OF AS THMA–RELATED SYMPTOMS AND 23
407		-	SYMPTOMS OF RESPIRAT ORY DISTRESS. 24
408		-
409		-	(4) “SCHOOL PERSONNEL ” MEANS INDIVIDUALS WH O ARE EMPLOYED 25
410		-	BY A NONPUBLIC SCHOO L, INCLUDING PART –TIME EMPLOYEES , TEACHERS AND 26
411		-	SUBSTITUTE TEACHERS EMPLOYED BY THE SCHO OL FOR AT LEAST 7 DAYS EACH 27
412		-	SCHOOL YEAR , REGISTERED NURSE CAS E MANAGERS , DELEGATING NURSES , AND 28
413		-	ADMINISTRATIVE STAFF . 29
414		-
415		-	(B) (1) EXCEPT AS PROVIDED IN PARAGRAPH (2) OF THIS SUBSECTION , 30
416		-	EACH NONPUBLIC SCHOO L IN THE STATE MAY ESTABLISH A POLICY AUTHORIZING 31
417		-	THE SCHOOL NURSE AND OTHER SCHOOL PERSONN EL TO ADMINISTER A 32
418		-	BRONCHODILATOR TO A STUDENT WHO IS DETERMINED BY AN IND IVIDUAL WHO HAS 33
419		-	UNDERGONE THE TRAINI NG PROVIDED UNDER § 7–426.2(C) OF THIS SUBTITLE TO 34 10 HOUSE BILL 266
420		-
421		-
422		-	HAVE ASTHMA , IS EXPERIENCING ASTH MA–RELATED SYMPTOMS , OR IS PERCEIVED 1
423		-	TO BE IN RESPIRATORY DISTRESS, REGARDLESS OF WHETHE R THE STUDENT: 2
424		-
425		-	(I) HAS BEEN DIAGNOSED WI TH ASTHMA OR REACTIV E AIRWAY 3
426		-	DISEASE; OR 4
427		-
428		-	(II) HAS BEEN PRESCRIBED A BRONCHODILATOR BY AN 5
429		-	AUTHORIZED LICENSED HEALTH CARE PRACTITI ONER UNDER THE HEALTH 6
430		-	OCCUPATIONS ARTICLE. 7
431		-
432		-	(2) A SCHOOL NURSE OR ANY OTHER SCHOOL PE RSONNEL MAY NOT 8
433		-	ADMINISTER A BRONCHO DILATOR TO A PREKIND ERGARTEN STUDENT UNL ESS THE 9
434		-	STUDENT HAS BEEN DIA GNOSED WITH ASTHMA O R A REACTIVE AIRWAY DISEASE 10
435		-	AND HAS A PRESCRIPTI ON FOR A BRONCHODILA TOR AS PRESCRIBED BY THE 11
436		-	STUDENT’S HEALTH CARE PRACTI TIONER. 12
437		-
438		-	(C) THE POLICY ESTABLISHE D UNDER SUBSECTION (B) OF THIS SECTION 13
439		-	SHALL INCLUDE : 14
440		-
441		-	(1) THE TRAINING IDENTIFI ED OR DEVELOPED UNDE R § 15
442		-	7–426.2(C) OF THIS SUBTITLE FOR SCHOOL NURSES AND VO LUNTARY SCHOOL 16
443		-	PERSONNEL WHO ARE DE SIGNATED BY A SCHOOL NURSE AND, IN THE CLINICAL 17
444		-	JUDGMENT OF THE SCHO OL NURSE, ARE APPROPRIATE RECI PIENTS OF THE 18
445		-	TRAINING; 19
446		-
447		-	(2) PROCEDURES FOR THE EM ERGENCY ADMINISTRATI ON OF A 20
448		-	BRONCHODILATOR BY A SCHOOL NURSE OR DESI GNATED VOLUNTEER ; 21
449		-
450		-	(3) THE PROPER FOLLOW –UP EMERGENCY PROCEDU RES; 22
451		-
452		-	(4) A PROVISION AUTHORIZIN G A SCHOOL NURSE OR ANY OTHER 23
453		-	LICENSED HEALTH CARE PRACTITIONER TO OBTA IN, AND A SCHOOL NURSE O R ANY 24
454		-	OTHER SCHOOL PERSONN EL TO STORE, AT A NONPUBLIC SCHOO L FOR USE IN AN 25
455		-	EMERGENCY SITUATION BRONCHODILATORS AND MODES OF DELIVERY , INCLUDING 26
456		-	INHALERS WITH SPACER S; 27
457		-
458		-	(5) A REQUIREMENT THAT THE NONPUBLIC SCHOOL DEV ELOP AND 28
459		-	IMPLEMENT A METHOD F OR NOTIFYING THE PAR ENTS OR GUARDIANS OF STUDENTS 29
460		-	OF THE SCHOOL ’S POLICY UNDER THIS SECTION AT THE BEGIN NING OF EACH 30
461		-	SCHOOL YEAR ; AND 31
462		-
463		-	(6) AN ONGOING PROCESS FOR OVERSIGHT AND MONITO RING BY A 32
464		-	LICENSED HEALTH CARE PRACTITIONER OF THE IMPLEMENTATION OF TH E POLICY 33
465		-	ESTABLISHED UNDER SU BSECTION (B) OF THIS SECTION. 34 HOUSE BILL 266 11
466		-
467		-
468		-
469		-	(D) (1) AN AUTHORIZED LICENSE D HEALTH CARE PRACTI TIONER MAY 1
470		-	PROVIDE BRONCHODILAT ORS TO A SCHOOL NURSE OR DESIGNATED VOLUNTEER 2
471		-	FOR USE IN ACCORDANC E WITH THIS SECTION . 3
472		-
473		-	(2) BRONCHODILATORS AND M ODES OF ADMINISTRATI ON, 4
474		-	INCLUDING INHALERS W ITH SPACERS, USED BY A SCHOOL NUR SE OR ANY OTHER 5
475		-	SCHOOL PERSONNEL MUS T BE FROM A LICENSED PHARMACY O R MANUFACTURER . 6
476		-
477		-	(3) A NONPUBLIC SCHOOL MAY ACCEPT DONATED 7
478		-	BRONCHODILATORS AND MODES OF ADMINISTRAT ION, INCLUDING INHALERS W ITH 8
479		-	SPACERS, FROM A LICENSED PHAR MACY OR MANUFACTURER . 9
480		-
481		-	(4) A NONPUBLIC SCHOOL MAY APPLY FOR GRANTS TO OBTAIN 10
482		-	FUNDING FOR THE P URCHASE OF BRONCHODI LATORS AND MODES OF 11
483		-	ADMINISTRATION , INCLUDING INHALERS W ITH SPACERS. 12
484		-
485		-	(B) (1) SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , BEFORE THE 13
486		-	2024–2025 SCHOOL YEAR , EACH NONPUBLIC SCHOO L IN THE STATE MAY ESTABLISH 14
487		-	A POLICY FOR PUBLIC SCHOOLS WITHIN ITS JURISDICT ION TO AUTHORIZE THE 15
488		-	SCHOOL NURSE OR OTHE R SCHOOL PERSONNEL D ESIGNATED BY THE SCH OOL 16
489		-	NURSE TO ADMINISTER A BRONCHODILATOR TO A STUDENT WHO IS EXP ERIENCING 17
490		-	ASTHMA, REACTIVE AIRWAY DISE ASE, OR ASTHMA–RELATED SYMPTOMS . 18
491		-
492		-	(2) A POLICY ESTA BLISHED UNDER THIS S UBSECTION SHALL LIMI T 19
493		-	THE ADMINISTRATION O F A BRONCHODILATOR T O CASES IN WHICH A S TUDENT HAS 20
494		-	BEEN PRESCRIBED A BR ONCHODILATOR BY AN A UTHORIZED, LICENSED HEALTH 21
495		-	CARE PRACTITIONER IN ACCORDANCE WITH THE HEALTH OCCUPATIONS ARTICLE. 22
496		-
497		-	(C) A POLICY ESTABLISHED U NDER SUBSECTION (B) OF THIS SECTION 23
498		-	SHALL INCLUDE : 24
499		-
500		-	(1) PROVISIONS AUTHORIZIN G A SCHOOL NURSE TO OBTAIN AND 25
501		-	STORE AT A NONPUBLIC SCHOOL BRONCHODILATO RS TO BE USED IN AN 26
502		-	EMERGENCY SITUATION ; AND 27
503		-
504		-	(2) PROCEDURES FOR THE DE SIGNATION OF SCHOOL PERSONNEL B Y 28
505		-	A SCHOOL NURSE , IN ACCORDANCE WITH T HE HEALTH OCCUPATIONS ARTICLE, TO 29
506		-	RESPOND TO A STUDENT EXPERIENCING ASTHMA , REACTIVE AIRWAY DISE ASE, OR 30
507		-	ASTHMA–RELATED SYMPTOMS IN AN EMERGENCY SETTING . 31
508		-
509		-	(E) (D) EXCEPT FOR ANY WILLFU L OR GROSSLY NEGLIGE NT ACT, A 32
510		-	SCHOOL NURSE OR ANY OTHER SCHOOL PERSONN EL WHO RESPOND IN GO OD FAITH 33
511		-	TO THE ASTHMA ATTACK OR RESPIRATORY DISTR ESS OF A CHILD IN AC CORDANCE 34 12 HOUSE BILL 266
512		-
513		-
514		-	WITH THIS SECTION MA Y NOT BE HELD PERSON ALLY LIABLE FOR ANY ACT OR 1
515		-	OMISSION IN THE COUR SE OF RESPONDING TO THE CHILD IN DISTRES S. 2
516		-
517		-	SECTION 2. AND BE IT FURTHER ENACTED, That: 3
518		-
519		-	(a) (1) Subject to paragraph (2) of this subsection, on or before August 1, 2023, 4
520		-	the State Department of Education and the Maryland Department of Health jointly shall 5
521		-	update the Maryland State school health service guidelines for the management of students 6
522		-	with asthma. 7
523		-
524		-	(2) In updating the guidelines under this subsection, the State Department 8
525		-	of Education and the Maryland Department of Health shall provide guidance to school 9
526		-	nurses and other school personnel on distinguishing between asthma or reactive airway 10
527		-	disease and anaphylaxis. 11
528		-
529		-	(b) Before the start of the 2023–2024 school year, each county board of education, 12
530		-	including the Baltimore City Board of School Commissioners, shall make a good faith effort 13
531		-	to adopt and implement guidelines in accordance with § 7–426.6 of the Education Article, 14
532		-	as enacted by Section 1 of this Act, and following the Maryland State school health service 15
533		-	guidelines updated under subsection (a) of this section. 16
534		-
535		-	SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 17
536		-	July 1, 2023. 18
537		-
538		-
539		-
540		-
541		-	Approved:
542		-	________________________________________________________________________________
543		-	Governor.
544		-	________________________________________________________________________________
545		-	Speaker of the House of Delegates.
546		-	________________________________________________________________________________
547		-	President of the Senate.
	446	+	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 21
	447	+	1, 2023. 22