EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
Italics indicate opposite chamber/conference committee amendments.
*hb0086*
HOUSE BILL 86
F1 (4lr0815)
ENROLLED BILL
— Ways and Means/Education, Energy, and the Environment —
Introduced by Delegates Boyce, Lehman, McCaskill, and Ruth
Read and Examined by Proofreaders:
_______________________________________________
Proofreader.
_______________________________________________
Proofreader.
Sealed with the Great Seal and presented to the Governor, for his approval this
_______ day of _______________ at ________________________ o’clock, ________M.
______________________________________________
Speaker.
CHAPTER ______
AN ACT concerning 1
Public and Nonpublic Schools – Auto–Injectable Epinephrine and 2
Bronchodilators – Use, Availability, Training, and Policies 3
FOR the purpose of requiring each county board of education and authorizing nonpublic 4
schools in the State to update their policies to require certain school nurses and other 5
school personnel to complete certain training before they are authorized to 6
administer auto–injectable epinephrine to a student who is determined to be, or is 7
perceived to be, in anaphylaxis; requiring the State Department of Education, in 8
consultation with certain groups the Maryland Department of Health certain groups, 9
to identify or develop training for certain school personnel to identify symptoms of 10
anaphylaxis, asthma, and respiratory distress in students; requiring each county 11
board the Maryland Department of Health, in consultation with county boards, and 12
authorizing nonpublic schools in the State to establish a policy to obtain, administer, 13
and train certain school nurses and other school personnel to administer in 14
emergency situations bronchodilators to a student who is determined to have 15 2 HOUSE BILL 86
asthma, is be, or is perceived to be, experiencing asthma–related symptoms, 1
symptoms or is perceived to be in respiratory distress by a school nurse or any other 2
certain designated school personnel; and generally relating to use and availability of 3
auto–injectable epinephrine and bronchodilators in public and nonpublic schools in 4
the State. 5
BY repealing and reenacting, with amendments, 6
Article – Education 7
Section 7–426.2 and 7–426.3 8
Annotated Code of Maryland 9
(2022 Replacement Volume and 2023 Supplement) 10
BY adding to 11
Article – Education 12
Section 7–426.6 and 7–426.7 13
Annotated Code of Maryland 14
(2022 Replacement Volume and 2023 Supplement) 15
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 16
That the Laws of Maryland read as follows: 17
Article – Education 18
7–426.2. 19
(a) (1) In this section the following words have the meanings indicated. 20
(2) “Anaphylaxis” means a sudden, severe, and potentially life–threatening 21
allergic reaction that occurs when an individual is exposed to an allergen. 22
(3) “Auto–injectable epinephrine” means a portable, disposable drug 23
delivery device that contains a premeasured single dose of epinephrine that is used to treat 24
anaphylaxis in an emergency situation. 25
(b) Each county board shall establish a policy for public schools within its 26
jurisdiction to authorize the school nurse and other school personnel to administer 27
auto–injectable epinephrine, if available, to a student who is determined BY AN 28
INDIVIDUAL WHO HAS U NDERGONE THE TRAININ G PROVIDED UNDER SUBSEC TION 29
(C) OF THIS SECTION, IF AVAILABLE, to be or perceived to be in anaphylaxis, regardless 30
of whether the student: 31
(1) Has been identified as having an anaphylactic allergy, as defined in § 32
7–426.1 of this subtitle; or 33
HOUSE BILL 86 3
(2) Has [a prescription for] BEEN PRESCRIBED epinephrine [as 1
prescribed] by an authorized licensed health care practitioner under the Health 2
Occupations Article. 3
(c) (1) THE DEPARTMENT , IN CONSULTATION WITH THE MARYLAND 4
DEPARTMENT OF HEALTH, THE AMERICAN LUNG ASSOCIATION, AND THE ASTHMA 5
AND ALLERGY FOUNDATION OF AMERICA, SHALL IDENTIFY OR DE VELOP TRAINING 6
TO: 7
(I) IDENTIFY THE SYMPTOMS OF ASTHMA AND RESPIR ATORY 8
DISTRESS; 9
(II) IDENTIFY THE SYMPTOMS OF ANAPHYLAXIS ; AND 10
(III) DISTINGUISH BETWEEN A NAPHYLAXIS AND ASTHMA OR 11
RESPIRATORY DISTRESS . 12
(2) THE TRAINING IDENTIFI ED OR DEVELOPED UNDE R PARAGRAPH 13
(1) OF THIS SUBSECTION S HALL BE PROVIDED TO SCHOOL NURSES AND VO LUNTARY 14
SCHOOL PERSONNEL WHO ARE DESIGNATED BY A SCHOOL NURSE AND , IN THE 15
CLINICAL JUDGMENT OF THE SCHOOL NURSE , ARE APPROPRIATE RECI PIENTS OF 16
THE TRAINING. 17
(3) THE TRAINING PROVIDED UNDER THIS SUBSECTIO N SHALL BE A 18
PAID PROFESSIONAL DE VELOPMENT TRAINING . 19
(D) The policy established under subsection (b) of this section shall include: 20
(1) [Training for school personnel on how to recognize the symptoms of 21
anaphylaxis] THE TRAINING IDENTIFI ED OR DEVELOPED UNDE R SUBSECTION (C) OF 22
THIS SECTION; 23
(2) Procedures for the emergency administration of auto –injectable 24
epinephrine BY A SCHOOL NURSE OR DESIGNATED VOLUNTEER ; 25
(3) The proper follow–up emergency procedures; 26
(4) A provision authorizing a school nurse to obtain and store at a public 27
school auto–injectable epinephrine to be used in an emergency situation; and 28
(5) A requirement that each public school develop and implement a method 29
for notifying the parents or guardians of students of the school’s policy under this section 30
at the beginning of each school year. 31
4 HOUSE BILL 86
(E) (1) AN AUTHORIZED LICENSE D HEALTH CARE PRACTI TIONER MAY 1
PROVIDE AUTO –INJECTABLE EPINEPHRINE TO A SCHOOL NURSE OR DESIGNATED 2
VOLUNTEER FOR USE IN ACCORDANCE WITH THIS SECTION. 3
(2) AUTO–INJECTABLE EPINEPHRI NE USED UNDER THIS S ECTION 4
MUST BE FROM A LICEN SED PHARMACY OR MANU FACTURER. 5
(3) A COUNTY BOARD OR PUBL IC SCHOOL MAY ACCEPT DONATED 6
AUTO–INJECTABLE EPINEPHRI NE FROM A LICENSED P HARMACY OR 7
MANUFACTURER . 8
(4) A COUNTY BOARD MAY APP LY FOR GRANTS TO OBT AIN FUNDING 9
FOR THE PURCHASE OF AUTO–INJECTABLE EPINEPHRI NE FROM A LICENSED 10
PHARMACY OR MANUFACT URER. 11
[(d)] (F) Except for any willful or grossly negligent act, a school nurse or other 12
school personnel who respond in good faith to the anaphylactic reaction of a child in 13
accordance with this section may not be held personally liable for any act or omission in the 14
course of responding to the reaction. 15
[(e)] (G) (1) Each public school shall submit, on the form that the Department 16
requires, a report to the Department on each incident at the school or at a related school 17
event that required the use of auto–injectable epinephrine. 18
(2) The Department shall develop and disseminate a standard form to 19
report each incident requiring the use of auto–injectable epinephrine at a public school. 20
7–426.3. 21
(a) (1) In this section the following words have the meanings indicated. 22
(2) “Anaphylaxis” means a sudden, severe, and potentially life–threatening 23
allergic reaction that occurs when an individual is exposed to an allergen. 24
(3) “Auto–injectable epinephrine” means a portable, disposable drug 25
delivery device that contains a premeasured single dose of epinephrine that is used to treat 26
anaphylaxis in an emergency situation. 27
(4) “School personnel” means individuals who are employed by a nonpublic 28
school, including part–time employees, teachers and substitute teachers employed by the 29
school for at least 7 days each school year, a school nurse, registered nurse case manager, 30
delegating nurse, and administrative staff. 31
(b) Each nonpublic school in the State may establish a policy authorizing school 32
personnel to administer auto–injectable epinephrine, if available, to a student who is 33
determined BY AN INDIVIDUAL WHO HAS UNDERGONE THE TR AINING PROVIDED 34 HOUSE BILL 86 5
UNDER § 7–426.2(C) OF THIS SUBTITLE , IF AVAILABLE, to be or perceived to be in 1
anaphylaxis, regardless of whether the student: 2
(1) Has been identified as having an anaphylactic allergy, as defined in § 3
7–426.1 of this subtitle; or 4
(2) Has [a prescription for] BEEN PRESCRIBED epinephrine [as 5
prescribed] by an authorized licensed health care practitioner under the Health 6
Occupations Article. 7
(c) The policy established under subsection (b) of this section shall include: 8
(1) [Training for school personnel on how to recognize the signs and 9
symptoms of anaphylaxis by a licensed health care practitioner who is authorized to 10
administer auto–injectable epinephrine and who has been trained in an established 11
protocol on how to recognize the signs and symptoms of anaphylaxis] THE TRAINING 12
IDENTIFIED OR DEVELO PED UNDER § 7–426.2(C) OF THIS SUBTITLE FOR SCHOOL 13
NURSES AND VOLUNTARY SCHOOL PERSONNEL WHO ARE DE SIGNATED BY A SCHOOL 14
NURSE AND , IN THE CLINICAL JUDG MENT OF THE SCHOOL N URSE, ARE 15
APPROPRIATE RECIPIEN TS OF THE TRAINING ; 16
(2) Procedures for the emergency administration of auto –injectable 17
epinephrine BY A SCHOOL NURSE OR DESIGNATED VOLUNTEER ; 18
(3) The proper follow–up emergency procedures; 19
(4) A provision authorizing a school nurse or other licensed health care 20
practitioner to obtain and, school personnel to store, at a nonpublic school auto–injectable 21
epinephrine to be used in an emergency situation; 22
(5) A requirement that the nonpublic school develop and implement a 23
method for notifying the parents or guardians of students of the school’s policy under this 24
section at the beginning of each school year; and 25
(6) An ongoing process for oversight and monitoring by a licensed health 26
care practitioner of the implementation of the policy established under subsection (b) of this 27
section. 28
(D) (1) AN AUTHORIZED LICENSE D HEALTH CARE PRACTI TIONER MAY 29
PROVIDE AUTO –INJECTABLE EPINEPHRI NE TO A SCHOOL NURSE OR DESIGNATED 30
VOLUNTEER FOR USE IN ACCORDANCE WITH THIS SECTION. 31
(2) AUTO–INJECTABLE EPINEPHRI NE USED UNDER THIS S ECTION 32
MUST BE FROM A LICEN SED PHARMACY OR MANU FACTURER. 33
6 HOUSE BILL 86
(3) A NONPUBLIC SCHOOL MAY ACCEPT DONATED AUTO –INJECTABLE 1
EPINEPHRINE FROM A L ICENSED PHARMACY OR MANUFACTURER . 2
(4) A NONPUBLIC SCHOOL MAY APPLY FOR GRANTS TO OBTAIN 3
FUNDING FOR THE PURC HASE OF AUTO –INJECTABLE EPINEPHRI NE FROM A 4
LICENSED PHARMACY OR MANUFACTURER . 5
[(d)] (E) Except for any willful or grossly negligent act, school personnel who 6
respond in good faith to the anaphylactic reaction of a child in accordance with this section 7
may not be held personally liable for any act or omission in the course of responding to the 8
reaction. 9
7–426.6. 10
(A) (1) IN THIS SECTION THE FOLL OWING WORDS HAVE THE MEANINGS 11
INDICATED. 12
(2) “ASTHMA” MEANS A CHRONIC LUNG DISEASE THAT INFLAME S 13
AND NARROWS AIR PASS AGES, CAUSING RECURRING PE RIODS OF WHEEZING , CHEST 14
TIGHTNESS, SHORTNESS OF BREATH , AND COUGHING . 15
(3) “BRONCHODILA TOR” MEANS MEDICATION THA T RELAXES 16
BRONCHIAL MUSCLES , RESULTING IN THE EXP ANSION OF BRONCHIAL AIR 17
PASSAGES TO PROVIDE FAST TREATMENT OF AS THMA–RELATED SYMPTOMS AND 18
SYMPTOMS OF RESPIRAT ORY DISTRESS. 19
(4) (I) “SCHOOL PERSONNEL ” MEANS INDIVIDUALS WH O ARE 20
EMPLOYED BY A PUBLIC SCHOOL, INCLUDING PART –TIME EMPLOYEES , TEACHERS 21
AND SUBSTITUTE TEACHERS EMPLOYED BY THE SCHO OL FOR AT LEAST 7 DAYS EACH 22
SCHOOL YEAR , REGISTERED NURSE CAS E MANAGERS , DELEGATING NURSES , AND 23
ADMINISTRATIVE STAFF OR, IN THE CASE OF SOME SCHOOL HEALTH STAFF , BY A 24
LOCAL HEALTH DEPARTM ENT. 25
(II) “SCHOOL PERSONNEL ” INCLUDES PART –TIME EMPLOYEES , 26
TEACHERS, SUBSTITUTE TEACHERS EMPLOYED BY THE SCHO OL FOR AT LEAST 7 27
DAYS EACH SCHOOL YEA R, REGISTERED NU RSE CASE MANAGERS , DELEGATING 28
NURSES, AND ADMINISTRATIVE S TAFF. 29
(B) (1) EXCEPT AS PROVIDED IN PARAGRAPH (2) OF THIS SUBSECTION , 30
EACH COUNTY BOARD THE MARYLAND DEPARTMENT OF HEALTH, IN 31
CONSULTATION WITH CO UNTY BOARDS , SHALL ESTABLISH A PO LICY FOR PUBLIC 32
SCHOOLS WITHIN ITS JURISDICTION TO AUTHORIZE THE SCH OOL NURSE AND OTHER 33
DESIGNATED SCHOOL PERSONNEL TO ADMINISTER A BRONCHO DILATOR TO A 34
STUDENT WHO IS DETER MINED BY AN INDIVIDU AL WHO HAS UNDERGONE THE 35 HOUSE BILL 86 7
TRAINING PROVIDED U NDER SUBSECTION (C) OF THIS SECTION TO HAVE ASTHMA , 1
IS BE, OR IS PERCEIVED TO B E, EXPERIENCING ASTHMA –RELATED SYMPTOMS , OR IS 2
PERCEIVED TO BE IN R ESPIRATORY DISTRESS , REGARDLESS OF WHETHE R THE 3
STUDENT: 4
(I) HAS BEEN DIAGNOSED WI TH ASTHMA OR REACTIV E AIRWAY 5
DISEASE; OR 6
(II) HAS BEEN PRESCRIBED A BRONCHODILATOR BY AN 7
AUTHORIZED LICENSED HEALTH CARE PRACTITI ONER UNDER THE HEALTH 8
OCCUPATIONS ARTICLE. 9
(2) NEITHER A SCHOOL NURS E NOR ANY OTHER DESIGNATED 10
SCHOOL PERSONNEL MAY ADMINISTER A BRONCHO DILATOR TO A 11
PREKINDERGARTEN STUD ENT UNLESS THE STUDE NT HAS BEEN DIAGNOSE D WITH 12
ASTHMA OR A REACTIVE AIRWAY DISEASE AND H AS A PRESCRIPTION FO R A 13
BRONCHODILATOR AS PR ESCRIBED BY THE STUD ENT’S HEALTH CARE 14
PRACTITIONER . 15
(C) (1) THE TRAINING IDENTIFI ED OR DEVELOPE D UNDER § 7–426.2(C) 16
OF THIS SUBTITLE SHA LL BE PROVIDED TO SC HOOL NURSES AND VOLU NTARY 17
SCHOOL PERSONNEL WHO ARE DESIGNATED BY A SCHOOL NURSE AND , IN THE 18
CLINICAL JUDGMENT OF THE SCHOOL NURSE , ARE APPROPRIATE RECI PIENTS OF 19
THE TRAINING. 20
(2) THE TRAINING PROVIDED UNDER THIS SUBSECTION SHALL BE A 21
PAID PROFESSIONAL DE VELOPMENT TRAINING . 22
(C) (1) THE DEPARTMENT , IN CONSULTATION WITH THE MARYLAND 23
DEPARTMENT OF HEALTH, THE AMERICAN LUNG ASSOCIATION, AND THE ASTHMA 24
AND ALLERGY FOUNDATION OF AMERICA, SHALL IDENT IFY OR DEVELOP TRAIN ING 25
TO: 26
(I) IDENTIFY THE SYMPTOMS OF ASTHMA AND RESPIR ATORY 27
DISTRESS; 28
(II) IDENTIFY THE SYMPTOMS OF ANAPHYLAXIS ; AND 29
(III) DISTINGUISH BETWEEN A NAPHYLAXIS AND ASTHM A OR 30
RESPIRATORY DISTRESS . 31
(2) THE TRAINING IDENTIFI ED OR DEVELOPED UNDER PARA GRAPH 32
(1) OF THIS SUBSECTION S HALL BE PROVIDED TO SCHOOL NURSES AND VO LUNTARY 33
SCHOOL PERSONNEL WHO ARE DESIGNATED BY A SCHOOL NURSE AND , IN THE 34 8 HOUSE BILL 86
CLINICAL JUDGMENT OF THE SCHOOL NURSE , ARE APPROPRIATE RECI PIENTS OF 1
THE TRAINING. 2
(3) THE TRAINING PROVIDED UNDER THIS SUBSECTIO N SHALL BE A 3
PAID PROFESSIONAL DE VELOPMENT TRAINING . 4
(D) THE POLICY ESTABLISHE D UNDER SUBSECTION (B) OF THIS SECTION 5
SHALL INCLUDE : 6
(1) THE TRAINING REQUIRED UNDER SUBSECTION (C) OF THIS 7
SECTION; 8
(2) PROCEDURES FOR THE EM ERGENCY ADMINISTRATI ON OF A 9
BRONCHODILATOR BY A SCHOOL NURSE OR DESI GNATED VOLUNTEER SCHOOL 10
PERSONNEL ; 11
(3) PROCEDURES FOR RECOGN IZING THE NEED TO AD MINISTER A 12
BRONCHODILATOR AND F OR ADMINISTERING A B RONCHODILATOR BASED ON THE 13
SEVERITY OF THE SYMPTOMS B EING EXPERIENCED BY A STUDENT; 14
(3) (4) THE PROPER FOLLOW –UP EMERGENCY PROCEDU RES; 15
(4) (5) A PROVISION AUTHORIZING A SCHOOL NURSE TO OBTAIN 16
AND STORE AT A PUBLIC SC HOOL REQUIRING THAT BRONCHODILATORS AND MODES 17
OF DELIVERY , INCLUDING INHALERS W ITH SPACERS , BE STORED IN PUBLIC 18
SCHOOLS TO BE USED IN AN EME RGENCY SITUATION ; AND 19
(6) A PROVISION AUTHORIZIN G A COUNTY BOARD TO OBTAIN A 20
STANDING ORDER FOR T HE ADMINISTRATION OF BRONCHODILATORS ; AND 21
(5) (7) A REQUIREMENT THAT EAC H PUBLIC SCHOOL DEVE LOP 22
AND IMPLEMENT A METH OD FOR NOTIFYING THE PARENTS OR GUARDIANS OF 23
STUDENTS OF THE SCHO OL’S POLICY UNDER THIS SECTION AT THE BEGIN NING OF 24
EACH SCHOOL YEAR . 25
(E) (1) AN AUTHORIZED LICENSE D HEALTH CARE PRACTITIONER MAY 26
PROVIDE BRONCHODILAT ORS TO A SCHOOL NURS E OR DESIGNATED VOLUNTEER 27
SCHOOL PERSONNEL FOR USE IN ACCORDANC E WITH THIS SECTION . 28
(2) BRONCHODILATORS AND M ODES OF ADMINISTRATI ON, 29
INCLUDING INHALERS W ITH SPACERS, USED BY A SCHOOL NUR SE OR ANY OTHER 30
DESIGNATED SCHOOL PERSONNEL MUS T BE FROM A LICENSED PHARMACY OR 31
MANUFACTURER . 32
HOUSE BILL 86 9
(3) A COUNTY BOARD OR PUBL IC SCHOOL MAY ACCEPT DONATED 1
BRONCHODILATORS AND MODES OF ADMINISTRATION , INCLUDING INHALERS W ITH 2
SPACERS, FROM A LICENSED PHAR MACY OR MANUFACTURER . 3
(4) A COUNTY BOARD MAY APP LY FOR GRANTS TO OBT AIN FUNDING 4
FOR THE PURCHASE OF BRONCHODILATORS AND MODES OF ADMINISTRAT ION, 5
INCLUDING INHALE RS WITH SPACERS . 6
(F) (1) EXCEPT FOR ANY WILLFU L OR GROSSLY NEGLIGE NT ACT, A 7
SCHOOL NURSE OR ANY OTHER SCHOOL PERSONN EL WHO RESPOND IN GO OD FAITH 8
TO THE ASTHMA ATTACK OR RESPIRATORY DISTR ESS OF A CHILD IN AC CORDANCE 9
WITH THIS SECTION MA Y NOT BE HELD PERSO NALLY LIABLE FOR ANY ACT OR 10
OMISSION IN THE COUR SE OF RESPONDING TO THE CHILD IN DISTRES S. 11
(2) EXCEPT FOR ANY WILLFU L OR GROSSLY NEGLIGE NT ACT, A 12
HEALTH CARE PROVIDER WHO PRESCRIBES OR DI SPENSES A BRONCHODIL ATOR 13
USED TO TREAT A CHIL D IN ACCORDANCE WITH PARAGRAPH (1) OF THIS 14
SUBSECTION MAY NOT B E HELD PERSONALLY LI ABLE FOR ANY ACT OR OMISSION 15
THAT OCCURS IN THE C OURSE OF RESPONDING TO THE CHILD IN DIST RESS. 16
(G) (1) (I) FOR EACH INCIDENT AT THE SCHOOL OR AT A R ELATED 17
SCHOOL EVENT THAT RE QUIRES THE USE O F A BRONCHODILATOR STOCK 18
BRONCHODILATOR IN AC CORDANCE WITH THIS S ECTION, EACH PUBLIC SCHOOL 19
SHALL: 20
1. NOTIFY THE STUDENT ’S PARENT OR LEGAL 21
GUARDIAN OF THE INCI DENT; AND 22
2. MAKE A RECORD OF THE INCIDENT, ON THE FORM 23
THAT THE DEPARTMENT REQUIRES , AND FILE THE FORM IN THE STUDENT’S SCHOOL 24
MEDICAL RECORD . 25
(II) EACH PUBLIC SCHOOL SH ALL SUBMIT TO THE 26
DEPARTMENT A REPORT , ON THE FORM AND SCHE DULE REQUIRED BY THE 27
DEPARTMENT , ON THE NUMBER OF INC IDENTS AT THE SCHOOL OR AT A RELATED 28
SCHOOL EVENT THAT R EQUIRED THE USE OF A BRONCHODILATOR STOCK 29
BRONCHODILATOR IN AC CORDANCE WITH THIS S ECTION. 30
(2) THE DEPARTMENT SHALL DEVE LOP AND DISSEMINATE 31
STANDARD FORMS TO RE CORD EACH INCIDENT A ND REPORT INCIDENTS REQUIRING 32
THE USE OF A BRONCHO DILATOR AT A PUBLIC SCHOOL. 33
7–426.7. 34
10 HOUSE BILL 86
(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 1
INDICATED. 2
(2) “ASTHMA” MEANS A CHRONIC LUNG DISEASE THAT INFLAME S 3
AND NARROWS AIR PASS AGES, CAUSING RECURRING PE RIODS OF WHEEZING , CHEST 4
TIGHTNESS, SHORTNESS OF BREATH , AND COUGHING. 5
(3) “BRONCHODILATOR ” MEANS MEDICATION THA T RELAXES 6
BRONCHIAL MUSCLES , RESULTING IN THE EXP ANSION OF BRONCHIAL AIR 7
PASSAGES TO PROVIDE FAST TREATMENT OF AS THMA–RELATED SYMPTOMS AND 8
SYMPTOMS OF RESPIRAT ORY DISTRESS. 9
(4) “SCHOOL PERSONNEL ” MEANS INDIVIDUALS WHO AR E EMPLOYED 10
BY A NONPUBLIC SCHOO L, INCLUDING PART –TIME EMPLOYEES , TEACHERS AND 11
SUBSTITUTE TEACHERS EMPLOYED BY THE SCHO OL FOR AT LEAST 7 DAYS EACH 12
SCHOOL YEAR , REGISTERED NURSE CAS E MANAGERS , DELEGATING NURSES , AND 13
ADMINISTRATIVE STAFF . 14
(B) (1) EXCEPT AS PROVIDED IN PARAGRAPH (2) OF THIS SUBSECTION , 15
EACH NONPUBLIC SCHOOL IN THE STATE MAY ESTABLISH A POLICY AUTHORIZING 16
THE SCHOOL NURSE AND OTHER DESIGNATED SCHOOL PERSONNEL TO ADMINISTER 17
A BRONCHODILATOR TO A STUDENT WHO IS DET ERMINED BY AN INDIVI DUAL WHO 18
HAS UNDERGONE THE TR AINING PROVIDED UNDER § 7–426.2(C) DEVELOPED 19
UNDER § 7–426.6(C) OF THIS SUBTITLE TO HAVE ASTHMA , IS BE, OR IS PERCEIVED 20
TO BE, EXPERIENC ING ASTHMA–RELATED SYMPTOMS, SYMPTOMS OR IS PERCEIVED 21
TO BE IN RESPIRATORY DISTRESS, REGARDLESS OF WHETHE R THE STUDENT : 22
(I) HAS BEEN DIAGNOSED WI TH ASTHMA OR REACTIV E AIRWAY 23
DISEASE; OR 24
(II) HAS BEEN PRESCRIBED A BRONCHODILATOR BY AN 25
AUTHORIZED LIC ENSED HEALTH CARE PR ACTITIONER UNDER THE HEALTH 26
OCCUPATIONS ARTICLE. 27
(2) A SCHOOL NURSE OR ANY OTHER DESIGNATED SCHOOL 28
PERSONNEL MAY NOT AD MINISTER A BRONCHODI LATOR TO A PREKINDER GARTEN 29
STUDENT UNLESS THE S TUDENT HAS BEEN DIAG NOSED WITH ASTHMA OR A 30
REACTIVE AIRWAY DISEASE AND HAS A PRESCRIPTI ON FOR A BRONCHODILA TOR AS 31
PRESCRIBED BY THE ST UDENT’S HEALTH CARE PRACTI TIONER. 32
(C) THE POLICY ESTABLISHE D UNDER SUBSECTION (B) OF THIS SECTION 33
SHALL INCLUDE : 34
HOUSE BILL 86 11
(1) THE TRAINING IDENTIFI ED OR DEVELOPED UNDE R § 1
7–426.2(C) § 7–426.6(C) OF THIS SUBTITLE FOR SCHOOL NURSES AND VO LUNTARY 2
SCHOOL PERSONNEL WHO ARE DESIGNATED BY A SCHOOL NURSE AND , IN THE 3
CLINICAL JUDGMENT OF THE SCHOOL NURSE , ARE APPROPRIATE RECI PIENTS OF 4
THE TRAINING; 5
(2) PROCEDURES FOR THE EM ERGENCY ADMINISTRATION OF A 6
BRONCHODILATOR BY A SCHOOL NURSE OR DESI GNATED VOLUNTEER SCHOOL 7
PERSONNEL ; 8
(3) PROCEDURES FOR RECOGN IZING THE NEED TO AD MINISTER A 9
BRONCHODILATOR AND F OR ADMINISTERING A B RONCHODILATOR BASED ON THE 10
SEVERITY OF THE SYMP TOMS BEING EX PERIENCED BY A STUDE NT; 11
(3) (4) THE PROPER FOLLOW –UP EMERGENCY PROCEDU RES; 12
(4) (5) A PROVISION AUTHORIZING A SCHOOL NURSE OR ANY 13
OTHER LICENSED HEALTH CARE PRACTITIONER TO OBTA IN, AND A SCHOOL NURSE 14
OR ANY OTHER SCHOOL PERSONN EL TO STORE, AT A NONPUBLIC SCHOOL FOR USE 15
IN AN EMERGENCY SITUATION REQUIRING THAT BRONCHODILATORS AND MODES OF 16
DELIVERY, INCLUDING INHALERS W ITH SPACERS , BE STORED IN NONPUBL IC 17
SCHOOLS TO BE USED I N AN EMERGENCY SITUA TION; 18
(5) (6) A REQUIREMENT THAT THE NONPUBLIC SCHOO L DEVELOP 19
AND IMPLEMENT A METH OD FOR NOTIFYING THE PARENTS OR GUARDIANS OF 20
STUDENTS OF THE SCHO OL’S POLICY UNDER THIS SECTION AT THE BEGIN NING OF 21
EACH SCHOOL YEAR ; AND 22
(7) A PROVISION AUTHORIZIN G A NONPUBLIC SCHOOL TO OBTAIN A 23
STANDING ORDER FOR T HE ADMINISTRATION OF BRONC HODILATORS ; AND 24
(6) (8) AN ONGOING PROCESS FO R OVERSIGHT AND MONI TORING 25
BY A LICENSED HEALTH CARE PRACTITIONER OF THE IMPLEMENTATION O F THE 26
POLICY ESTABLISHED U NDER SUBSECTION (B) OF THIS SECTION. 27
(D) (1) AN AUTHORIZED LICENSE D HEALTH CARE PRACTITION ER MAY 28
PROVIDE BRONCHODILAT ORS TO A SCHOOL NURS E OR DESIGNATED VOLU NTEER 29
FOR USE IN ACCORDANC E WITH THIS SECTION . 30
(2) BRONCHODILATORS AND M ODES OF ADMINISTRATI ON, 31
INCLUDING INHALERS W ITH SPACERS, USED BY A SCHOOL NUR SE OR ANY OTHER 32
DESIGNATED SCHOOL PERSONNEL MUS T BE FROM A LICENSED PHARMACY OR 33
MANUFACTURER . 34
12 HOUSE BILL 86
(3) A NONPUBLIC SCHOOL MAY ACCEPT DONATED 1
BRONCHODILATORS AND MODES OF ADMINISTRAT ION, INCLUDING INHALERS W ITH 2
SPACERS, FROM A LICENSED PHAR MACY OR MANUFACTURER . 3
(4) A NONPUBLIC SCHOOL MAY APP LY FOR GRANTS TO OBT AIN 4
FUNDING FOR THE PURC HASE OF BRONCHODILAT ORS AND MODES OF 5
ADMINISTRATION , INCLUDING INHALERS W ITH SPACERS. 6
(E) (1) EXCEPT FOR ANY WILLFU L OR GROSSLY NEGLIGE NT ACT, A 7
SCHOOL NURSE OR ANY OTHER SCHOOL PERSONN EL WHO RESPOND IN GOOD FA ITH 8
TO THE ASTHMA ATTACK OR RESPIRATORY DISTR ESS OF A CHILD IN AC CORDANCE 9
WITH THIS SECTION MA Y NOT BE HELD PERSON ALLY LIABLE FOR ANY ACT OR 10
OMISSION IN THE COUR SE OF RESPONDING TO THE CHILD IN DISTRES S. 11
(2) EXCEPT FOR ANY WILLFU L OR GROSSLY NEGLIGENT AC T, A 12
HEALTH CARE PROVIDER WHO PRESCRIBES OR DI SPENSES A BRONCHODIL ATOR 13
USED TO TREAT A CHIL D IN ACCORDANCE WITH PARAGRAPH (1) OF THIS 14
SUBSECTION MAY NOT B E HELD PERSONALLY LI ABLE FOR ANY ACT OR OMISSION 15
THAT OCCURS IN THE C OURSE OF RES PONDING TO THE CHILD IN DISTRESS. 16
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 17
1, 2024. 18
Approved:
________________________________________________________________________________
Governor.
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Speaker of the House of Delegates.
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President of the Senate.