Maryland 2024 2024 Regular Session

Maryland House Bill HB86 Chaptered / Bill

Filed 05/02/2024

                     	WES MOORE, Governor 	Ch. 280 
 
– 1 – 
Chapter 280 
(House Bill 86) 
 
AN ACT concerning 
 
Public and Nonpublic Schools – Auto–Injectable Epinephrine and 
Bronchodilators – Use, Availability, Training, and Policies 
 
FOR the purpose of requiring each county board of education and authorizing nonpublic 
schools in the State to update their policies to require certain school nurses and other 
school personnel to complete certain training before they are authorized to 
administer auto–injectable epinephrine to a student who is determined to be, or is 
perceived to be, in anaphylaxis; requiring the State Department of Education, in 
consultation with certain groups the Maryland Department of Health certain groups, 
to identify or develop training for certain school personnel to identify symptoms of 
anaphylaxis, asthma, and respiratory distress in students; requiring each county 
board the Maryland Department of Health, in consultation with county boards, and 
authorizing nonpublic schools in the State to establish a policy to obtain, administer, 
and train certain school nurses and other school personnel to administer in 
emergency situations bronchodilators to a student who is determined to have 
asthma, is be, or is perceived to be, experiencing asthma–related symptoms, 
symptoms or is perceived to be in respiratory distress by a school nurse or any other 
certain designated school personnel; and generally relating to use and availability of 
auto–injectable epinephrine and bronchodilators in public and nonpublic schools in 
the State. 
 
BY repealing and reenacting, with amendments, 
 Article – Education 
Section 7–426.2 and 7–426.3 
 Annotated Code of Maryland 
 (2022 Replacement Volume and 2023 Supplement) 
 
BY adding to 
 Article – Education 
Section 7–426.6 and 7–426.7 
 Annotated Code of Maryland 
 (2022 Replacement Volume and 2023 Supplement) 
 
 SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 
That the Laws of Maryland read as follows: 
 
Article – Education 
 
7–426.2. 
 
 (a) (1) In this section the following words have the meanings indicated.  Ch. 280 	2024 LAWS OF MARYLAND  
 
– 2 – 
 
 (2) “Anaphylaxis” means a sudden, severe, and potentially life–threatening 
allergic reaction that occurs when an individual is exposed to an allergen. 
 
 (3) “Auto–injectable epinephrine” means a portable, disposable drug 
delivery device that contains a premeasured single dose of epinephrine that is used to treat 
anaphylaxis in an emergency situation. 
 
 (b) Each county board shall establish a policy for public schools within its 
jurisdiction to authorize the school nurse and other school personnel to administer  
auto–injectable epinephrine, if available, to a student who is determined BY AN 
INDIVIDUAL WHO HAS U NDERGONE THE TRAININ G PROVIDED UNDER SUB SECTION 
(C) OF THIS SECTION, IF AVAILABLE, to be or perceived to be in anaphylaxis, regardless 
of whether the student: 
 
 (1) Has been identified as having an anaphylactic allergy, as defined in § 
7–426.1 of this subtitle; or 
 
 (2) Has [a prescription for] BEEN PRESCRIBED epinephrine [as 
prescribed] by an authorized licensed health care practitioner under the Health 
Occupations Article. 
 
 (c) (1) THE DEPARTMENT , IN CONSULTATION WITH THE MARYLAND 
DEPARTMENT OF HEALTH, THE AMERICAN LUNG ASSOCIATION, AND THE ASTHMA 
AND ALLERGY FOUNDATION OF AMERICA, SHALL IDENTIFY OR DE VELOP TRAINING 
TO: 
 
 (I) IDENTIFY THE SYMPTOMS OF ASTHMA AND RESPIR ATORY 
DISTRESS; 
 
 (II) IDENTIFY THE SYMPTOMS OF ANAPHYLAXIS ; AND 
 
 (III) DISTINGUISH BETWEEN A NAPHYLAXIS AND ASTHM A OR 
RESPIRATORY DISTRES S. 
 
 (2) THE TRAINING IDENTIFI ED OR DEVELOPED UNDE R PARAGRAPH 
(1) OF THIS SUBSECTION S HALL BE PROVIDED TO SCHOOL NURSES AND VO LUNTARY 
SCHOOL PERSONNEL WHO ARE DESIGNATED BY A SCHOOL NURSE AND , IN THE 
CLINICAL JUDGMENT OF THE SCHOOL NURSE , ARE APPROPRIATE RECIPIENTS OF 
THE TRAINING. 
 
 (3) THE TRAINING PROVIDED UNDER THIS SUBSECTIO N SHALL BE A 
PAID PROFESSIONAL DE VELOPMENT TRAINING . 
   	WES MOORE, Governor 	Ch. 280 
 
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 (D) The policy established under subsection (b) of this section shall include: 
 
 (1) [Training for school personnel on how to recognize the symptoms of 
anaphylaxis] THE TRAINING IDENTIFI ED OR DEVELOPED UNDE R SUBSECTION (C) OF 
THIS SECTION; 
 
 (2) Procedures for the emergency administration of auto –injectable 
epinephrine BY A SCHOOL NURSE OR DESIGNATED VOLUNTEER ; 
 
 (3) The proper follow–up emergency procedures; 
 
 (4) A provision authorizing a school nurse to obtain and store at a public 
school auto–injectable epinephrine to be used in an emergency situation; and 
 
 (5) A requirement that each public school develop and implement a method 
for notifying the parents or guardians of students of the school’s policy under this section 
at the beginning of each school year. 
 
 (E) (1) AN AUTHORIZED LICENSE D HEALTH CARE PRACTI TIONER MAY 
PROVIDE AUTO –INJECTABLE EPINEPHRI NE TO A SCHOOL NURSE OR DESIGNATED 
VOLUNTEER FOR USE IN ACCORDANCE WITH THIS SECTION. 
 
 (2) AUTO–INJECTABLE EPINEPHRI NE USED UNDER THIS S ECTION 
MUST BE FROM A LICEN SED PHARMACY OR MANU FACTURER. 
 
 (3) A COUNTY BOARD OR PUBL IC SCHOOL MAY ACCEPT DONATED 
AUTO–INJECTABLE EPINEPHRINE FROM A L	ICENSED PHARMACY OR 
MANUFACTURER . 
 
 (4) A COUNTY BOARD MAY APP LY FOR GRANTS TO OBT AIN FUNDING 
FOR THE PURCHASE OF AUTO–INJECTABLE EPINEPHRI NE FROM A LICENSED 
PHARMACY OR MANUFACT URER. 
 
 [(d)] (F) Except for any willful or grossly negligent act, a school nurse or other 
school personnel who respond in good faith to the anaphylactic reaction of a child in 
accordance with this section may not be held personally liable for any act or omission in the 
course of responding to the reaction. 
 
 [(e)] (G) (1) Each public school shall submit, on the form that the Department 
requires, a report to the Department on each incident at the school or at a related school 
event that required the use of auto–injectable epinephrine. 
 
 (2) The Department shall develop and disseminate a standard form to 
report each incident requiring the use of auto–injectable epinephrine at a public school. 
  Ch. 280 	2024 LAWS OF MARYLAND  
 
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7–426.3. 
 
 (a) (1) In this section the following words have the meanings indicated. 
 
 (2) “Anaphylaxis” means a sudden, severe, and potentially life–threatening 
allergic reaction that occurs when an individual is exposed to an allergen. 
 
 (3) “Auto–injectable epinephrine” means a portable, disposable drug 
delivery device that contains a premeasured single dose of epinephrine that is used to treat 
anaphylaxis in an emergency situation. 
 
 (4) “School personnel” means individuals who are employed by a nonpublic 
school, including part–time employees, teachers and substitute teachers employed by the 
school for at least 7 days each school year, a school nurse, registered nurse case manager, 
delegating nurse, and administrative staff. 
 
 (b) Each nonpublic school in the State may establish a policy authorizing school 
personnel to administer auto–injectable epinephrine, if available, to a student who is 
determined BY AN INDIVIDUAL WHO HAS UNDERGONE THE TR AINING PROVIDED 
UNDER § 7–426.2(C) OF THIS SUBTITLE , IF AVAILABLE, to be or perceived to be in 
anaphylaxis, regardless of whether the student: 
 
 (1) Has been identified as having an anaphylactic allergy, as defined in § 
7–426.1 of this subtitle; or 
 
 (2) Has [a prescription for] BEEN PRESCRIBED epinephrine [as 
prescribed] by an authorized licensed health care practitioner under the Health 
Occupations Article. 
 
 (c) The policy established under subsection (b) of this section shall include: 
 
 (1) [Training for school personnel on how to recognize the signs and 
symptoms of anaphylaxis by a licensed health care practitioner who is authorized to 
administer auto–injectable epinephrine and who has been trained in an established 
protocol on how to recognize the signs and symptoms of anaphylaxis] THE TRAINING 
IDENTIFIED OR DEVELO PED UNDER § 7–426.2(C) OF THIS SUBTITLE FOR SCHOOL 
NURSES AND VOLUNTARY SCHOOL PERSONNEL WHO ARE DESIGNATED BY A SCHOOL 
NURSE AND , IN THE CLINICAL JUDG MENT OF THE SCHOOL N URSE, ARE 
APPROPRIATE RECIPIEN TS OF THE TRAINING ; 
 
 (2) Procedures for the emergency administration of auto –injectable 
epinephrine BY A SCHOOL NURSE OR DESIGNATED VOLUNTEER ; 
 
 (3) The proper follow–up emergency procedures; 
   	WES MOORE, Governor 	Ch. 280 
 
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 (4) A provision authorizing a school nurse or other licensed health care 
practitioner to obtain and, school personnel to store, at a nonpublic school auto–injectable 
epinephrine to be used in an emergency situation; 
 
 (5) A requirement that the nonpublic school develop and implement a 
method for notifying the parents or guardians of students of the school’s policy under this 
section at the beginning of each school year; and 
 
 (6) An ongoing process for oversight and monitoring by a licensed health 
care practitioner of the implementation of the policy established under subsection (b) of this 
section. 
 
 (D) (1) AN AUTHORIZED LICENSE D HEALTH CARE PRACTI TIONER MAY 
PROVIDE AUTO –INJECTABLE EPINEPHRI NE TO A SCHOOL NURSE OR DESIGNATED 
VOLUNTEER FOR USE IN ACCORDANCE WITH THIS SECTION. 
 
 (2) AUTO–INJECTABLE EPINEPHRI NE USED UNDER THIS S ECTION 
MUST BE FROM A LICEN SED PHARMACY OR MANU FACTURER. 
 
 (3) A NONPUBLIC SCHOOL MAY ACCEPT DONATED AUTO –INJECTABLE 
EPINEPHRINE FROM A L ICENSED PHARMACY OR MANUFACT URER. 
 
 (4) A NONPUBLIC SCHOOL MAY APPLY FOR GRANTS TO OBTAIN 
FUNDING FOR THE PURC HASE OF AUTO –INJECTABLE EPINEPHRI NE FROM A 
LICENSED PHARMACY OR MANUFACTURER . 
 
 [(d)] (E) Except for any willful or grossly negligent act, school personnel who 
respond in good faith to the anaphylactic reaction of a child in accordance with this section 
may not be held personally liable for any act or omission in the course of responding to the 
reaction. 
 
7–426.6. 
 
 (A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANI NGS 
INDICATED. 
 
 (2) “ASTHMA” MEANS A CHRONIC LUNG DISEASE THAT INFLAME S 
AND NARROWS AIR PASS AGES, CAUSING RECURRING PE RIODS OF WHEEZING , CHEST 
TIGHTNESS, SHORTNESS OF BREATH , AND COUGHING . 
 
 (3) “BRONCHODILATOR ” MEANS MEDICATION THA T RELAXES 
BRONCHIAL MUSCLES , RESULTING IN THE EXP ANSION OF BRONCHIAL AIR 
PASSAGES TO PROVIDE FAST TREATMENT OF AS THMA–RELATED SYMPTOMS AND 
SYMPTOMS OF RESPIRAT ORY DISTRESS. 
  Ch. 280 	2024 LAWS OF MARYLAND  
 
– 6 – 
 (4) (I) “SCHOOL PERSONNEL ” MEANS INDIVIDUALS WH O ARE 
EMPLOYED BY A PUBLIC SCHOOL, INCLUDING PART –TIME EMPLOYEES , TEACHERS 
AND SUBSTITUTE TEACHERS EMPLOYED BY THE SCHO OL FOR AT LEAST 7 DAYS EACH 
SCHOOL YEAR , REGISTERED NURSE CAS E MANAGERS , DELEGATING NURSES , AND 
ADMINISTRATIVE STAFF OR, IN THE CASE OF SOME SCHOOL HEALTH STAFF , BY A 
LOCAL HEALTH DEPARTM ENT. 
 
 (II) “SCHOOL PERSONNEL ” INCLUDES PART –TIME EMPLOYEES , 
TEACHERS, SUBSTITUTE TEACHERS EMPLOYED BY THE SCHO OL FOR AT LEAST 7 
DAYS EACH SCHOOL YEA R, REGISTERED NU RSE CASE MANAGERS , DELEGATING 
NURSES, AND ADMINISTRATIVE S TAFF. 
 
 (B) (1) EXCEPT AS PROVIDED IN PARAGRAPH (2) OF THIS SUBSECTION , 
EACH COUNTY BOARD THE MARYLAND DEPARTMENT OF HEALTH, IN 
CONSULTATION WITH CO UNTY BOARDS , SHALL ESTABLISH A PO LICY FOR PUBLIC 
SCHOOLS WITHIN ITS JURISDICTION TO AUTHORIZE THE SCH OOL NURSE AND OTHER 
DESIGNATED SCHOOL PERSONNEL TO ADMINISTER A BRONCHO DILATOR TO A 
STUDENT WHO IS DETER MINED BY AN INDIVIDU AL WHO HAS UNDERGONE THE 
TRAINING PROVIDED UN DER SUBSECTION (C) OF THIS SECTION T O HAVE ASTHMA , 
IS BE, OR IS PERCEIVED TO B E, EXPERIENCING ASTHMA –RELATED SYMPTOMS , OR IS 
PERCEIVED TO BE IN R ESPIRATORY DISTRESS , REGARDLESS OF WHETHE R THE 
STUDENT: 
 
 (I) HAS BEEN DIAGNOSED WI TH ASTHMA OR REACTIV E AIRWAY 
DISEASE; OR 
 
 (II) HAS BEEN PRESCRIBED A BRONCHODILATOR BY AN 
AUTHORIZED LICENSED HEALTH CARE PRACTITI ONER UNDER THE HEALTH 
OCCUPATIONS ARTICLE. 
 
 (2) NEITHER A SCHOOL NURS E NOR ANY OTHER DESIGNATED 
SCHOOL PERSONNEL MAY ADMINISTER A BRONCHO	DILATOR TO A 
PREKINDERGARTEN STUD ENT UNLESS THE STUDENT HAS BEEN DIAGNOSED WITH 
ASTHMA OR A REACTIVE AIRWAY DISEASE AND H AS A PRESCRIPTION FO R A 
BRONCHODILATOR AS PR ESCRIBED BY THE STUD ENT’S HEALTH CARE 
PRACTITIONER . 
 
 (C) (1) THE TRAINING IDENTIFI ED OR DEVELOPED UNDE R § 7–426.2(C) 
OF THIS SUBTITLE SHALL BE PROVIDED TO SCHOOL NURSES AND VO LUNTARY 
SCHOOL PERSONNEL WHO ARE DESIGNATED BY A SCHOOL NURSE AND , IN THE 
CLINICAL JUDGMENT OF THE SCHOOL NURSE , ARE APPROPRIATE RECI PIENTS OF 
THE TRAINING. 
   	WES MOORE, Governor 	Ch. 280 
 
– 7 – 
 (2) THE TRAINING PROVIDED UNDER THIS SUBSECTIO N SHALL BE A 
PAID PROFESSIONAL DE VELOPMENT TRAINING . 
 
 (C) (1) THE DEPARTMENT , IN CONSULTATION WITH THE MARYLAND 
DEPARTMENT OF HEALTH, THE AMERICAN LUNG ASSOCIATION, AND THE ASTHMA 
AND ALLERGY FOUNDATION OF AMERICA, SHALL IDENTIFY OR DE VELOP TRAINING 
TO: 
 
 (I) IDENTIFY THE SYMPTOMS OF ASTHMA AND RESPIR ATORY 
DISTRESS; 
 
 (II) IDENTIFY THE SYMPTOMS OF ANAPHYLAXIS ; AND 
 
 (III) DISTINGUISH BETWEEN A NAPHYLAXIS AND ASTHM A OR 
RESPIRATORY DISTRESS . 
 
 (2) THE TRAINING IDENTIFI ED OR DEVELOPED UNDE R PARAGRAPH 
(1) OF THIS SUBSECTION SHALL BE PROVIDED TO SCHOO L NURSES AND VOLUNTA RY 
SCHOOL PERSONNEL WHO ARE DESIGNATED BY A SCHOOL NURSE AND , IN THE 
CLINICAL JUDGMENT OF THE SCHOOL NURSE , ARE APPROPRIATE RECI PIENTS OF 
THE TRAINING. 
 
 (3) THE TRAINING PROVIDED UNDER THIS SUBSECTION SHALL BE A 
PAID PROFESSIONAL DE VELOPMENT TRAINING .  
 
 (D) THE POLICY ESTABLISHE D UNDER SUBSECTION (B) OF THIS SECTION 
SHALL INCLUDE : 
 
 (1) THE TRAINING REQUIRED UNDER SUBSECTION (C) OF THIS 
SECTION; 
 
 (2) PROCEDURES FOR THE EM ERGENCY ADMINISTR ATION OF A 
BRONCHODILATOR BY A SCHOOL NURSE OR DESI GNATED VOLUNTEER SCHOOL 
PERSONNEL ; 
 
 (3) PROCEDURES FOR RECOGN IZING THE NEED TO AD MINISTER A 
BRONCHODILATOR AND F OR ADMINISTERING A B RONCHODILATOR BASED ON THE 
SEVERITY OF THE SYMP TOMS BEING EXPERIENC ED BY A STUDENT;  
 
 (3) (4) THE PROPER FOLLOW –UP EMERGENCY PROCEDU RES; 
 
 (4) (5) A PROVISION AUTHORIZING A SCHOOL NURSE TO OBTAIN 
AND STORE AT A PUBLIC SC HOOL REQUIRING THAT BRONCHODILATORS AND MODES  Ch. 280 	2024 LAWS OF MARYLAND  
 
– 8 – 
OF DELIVERY , INCLUDING INHALERS W ITH SPACERS , BE STORED IN PUBLIC 
SCHOOLS TO BE USED IN AN EME RGENCY SITUATION ; AND 
 
 (6) A PROVISION AUTHORIZIN G A COUNTY BOARD TO OBTAIN A 
STANDING ORDER FOR T HE ADMINISTRATION OF BRONCHODILATORS ; AND  
 
 (5) (7) A REQUIREMENT THAT EAC H PUBLIC SCHOOL DEVE LOP 
AND IMPLEMENT A METH OD FOR NOTIFYING THE PARENTS OR GUARDIANS OF 
STUDENTS OF THE SCHO OL’S POLICY UNDER THIS SECTION AT THE BEGIN NING OF 
EACH SCHOOL YEAR . 
 
 (E) (1) AN AUTHORIZED LICENSE D HEALTH CARE PRACTI TIONER MAY 
PROVIDE BRONCHODILAT ORS TO A SCHOOL NURS E OR DESIGNATED VOLUNTEER 
SCHOOL PERSONNEL FOR USE IN ACCORDANC E WITH THIS SECTION . 
 
 (2) BRONCHODILATORS AND M	ODES OF ADMINISTRATI ON, 
INCLUDING INHALERS W ITH SPACERS, USED BY A SCHOOL NUR SE OR ANY OTHER 
DESIGNATED SCHOOL PERSONNEL MUS T BE FROM A LICENSED PHARMACY OR 
MANUFACTURER . 
 
 (3) A COUNTY BOARD OR PUBL IC SCHOOL MAY ACCEPT DONATED 
BRONCHODILATORS AND MODES OF ADMINISTRAT ION, INCLUDING INHALERS W ITH 
SPACERS, FROM A LICENSED PHAR MACY OR MANUFACTURER . 
 
 (4) A COUNTY BOARD MAY APP LY FOR GRANTS TO OBT AIN FUNDING 
FOR THE PURCHASE OF BRON CHODILATORS AND MODE S OF ADMINISTRATION , 
INCLUDING INHALERS W ITH SPACERS. 
 
 (F) (1) EXCEPT FOR ANY WILLFU L OR GROSSLY NEGLIGE NT ACT, A 
SCHOOL NURSE OR ANY OTHER SCHOOL PERSONN EL WHO RESPOND IN GO OD FAITH 
TO THE ASTHMA ATTACK OR RESPIRATORY DISTRESS OF A C HILD IN ACCORDANCE 
WITH THIS SECTION MA Y NOT BE HELD PERSON ALLY LIABLE FOR ANY ACT OR 
OMISSION IN THE COUR SE OF RESPONDING TO THE CHILD IN DISTRES S. 
 
 (2) EXCEPT FOR ANY WILLFU L OR GROSSLY NEGLIGE NT ACT, A 
HEALTH CARE PROVIDER WHO PRES CRIBES OR DISPENSES A BRONCHODILATOR 
USED TO TREAT A CHIL D IN ACCORDANCE WITH PARAGRAPH (1) OF THIS 
SUBSECTION MAY NOT B E HELD PERSONALLY LI ABLE FOR ANY ACT OR OMISSION 
THAT OCCURS IN THE C OURSE OF RESPONDING TO THE CHILD IN DIST RESS.  
 
 (G) (1) (I) FOR EACH INCIDENT AT THE S CHOOL OR AT A RELATE D 
SCHOOL EVENT THAT RE QUIRES THE USE OF A BRONCHODILATOR STOCK   	WES MOORE, Governor 	Ch. 280 
 
– 9 – 
BRONCHODILATOR IN AC CORDANCE WITH THIS S ECTION, EACH PUBLIC SCHOOL 
SHALL: 
 
 1. NOTIFY THE STUDENT ’S PARENT OR LEGAL 
GUARDIAN OF THE INCI DENT; AND 
 
 2. MAKE A RECORD OF THE INCIDENT, ON THE FORM 
THAT THE DEPARTMENT REQUIRES , AND FILE THE FORM IN THE STUDENT’S SCHOOL 
MEDICAL RECORD . 
 
 (II) EACH PUBLIC SCHOOL SH	ALL SUBMIT TO THE 
DEPARTMENT A REPORT , ON THE FORM AND SCHE DULE REQUIRED BY THE 
DEPARTMENT , ON THE NUMBER OF INC IDENTS AT THE SCHOOL OR AT A RELATED 
SCHOOL EVENT THAT RE QUIRED THE USE OF A BRONCHODILATOR STOCK 
BRONCHODILATOR IN AC CORDANCE WITH THIS S ECTION. 
 
 (2) THE DEPARTMENT SHALL DEVE LOP AND DISSEMINATE 
STANDARD FORMS TO RE CORD EACH INCIDEN T AND REPORT INCIDEN TS REQUIRING 
THE USE OF A BRONCHO DILATOR AT A PUBLIC SCHOOL. 
 
7–426.7. 
 
 (A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 
INDICATED. 
 
 (2) “ASTHMA” MEANS A CHRONIC LUNG DISEASE THAT INFLAME S 
AND NARROWS AIR PASS AGES, CAUSING RECURRING PERIODS OF WHEEZING, CHEST 
TIGHTNESS, SHORTNESS OF BREATH , AND COUGHING . 
 
 (3) “BRONCHODILATOR ” MEANS MEDICATION THA T RELAXES 
BRONCHIAL MUSCLES , RESULTING IN THE EXP ANSION OF BRONCHIAL AIR 
PASSAGES TO PROVIDE FAST TREATMENT OF AS THMA–RELATED SYMPTOMS AND 
SYMPTOMS OF RESPIRAT ORY DISTRESS. 
 
 (4) “SCHOOL PERSONNEL ” MEANS INDIVIDUALS WH O ARE EMPLOYED 
BY A NONPUBLIC SCHOO L, INCLUDING PART –TIME EMPLOYEES , TEACHERS AND 
SUBSTITUTE TEACHERS EMPLOYED BY THE SCHO OL FOR AT LEAST 7 DAYS EACH 
SCHOOL YEAR , REGISTERED NURSE CAS E MANAGERS , DELEGATING NURSES , AND 
ADMINISTRATIVE STAFF . 
 
 (B) (1) EXCEPT AS PROVIDED IN PARAGRAPH (2) OF THIS SUBSECTION , 
EACH NONPUBLIC SCHOOL IN THE STATE MAY ESTABLISH A POLICY AUTHORIZING 
THE SCHOOL NURSE AND OTHER DESIGNATED SCHOOL PERSONNEL TO ADMINISTER 
A BRONCHODILATOR TO A STUDENT WHO IS DET ERMINED BY AN INDIVI DUAL WHO  Ch. 280 	2024 LAWS OF MARYLAND  
 
– 10 – 
HAS UNDERGONE THE TR AINING PROVIDED UNDER § 7–426.2(C) DEVELOPED 
UNDER § 7–426.6(C) OF THIS SUBTITLE TO HAVE ASTHMA , IS BE, OR IS PERCEIVED 
TO BE, EXPERIENC ING ASTHMA–RELATED SYMPTOMS, SYMPTOMS OR IS PERCEIVED 
TO BE IN RESPIRATORY DISTRESS, REGARDLESS OF WHETHE R THE STUDENT : 
 
 (I) HAS BEEN DIAGNOSED WI TH ASTHMA OR REACTIV E AIRWAY 
DISEASE; OR 
 
 (II) HAS BEEN PRESCRIBED A BRONCHODILATOR BY AN 
AUTHORIZED LIC ENSED HEALTH CARE PR ACTITIONER UNDER THE HEALTH 
OCCUPATIONS ARTICLE. 
 
 (2) A SCHOOL NURSE OR ANY OTHER DESIGNATED SCHOOL 
PERSONNEL MAY NOT AD MINISTER A BRONCHODI LATOR TO A PREKINDER GARTEN 
STUDENT UNLESS THE S TUDENT HAS BEEN DIAG NOSED WITH ASTHMA OR A 
REACTIVE AIRWAY DISEASE AND HAS A PRESCRIPTI ON FOR A BRONCHODILA TOR AS 
PRESCRIBED BY THE ST UDENT’S HEALTH CARE PRACTI TIONER. 
 
 (C) THE POLICY ESTABLISHE D UNDER SUBSECTION (B) OF THIS SECTION 
SHALL INCLUDE : 
 
 (1) THE TRAINING IDENTIFI ED OR DEVELOPED UNDE	R §  
7–426.2(C) § 7–426.6(C) OF THIS SUBTITLE FOR SCHOOL NURSES AND VO LUNTARY 
SCHOOL PERSONNEL WHO ARE DESIGNATED BY A SCHOOL NURSE AND , IN THE 
CLINICAL JUDGMENT OF THE SCHOOL NURSE , ARE APPROPRIATE RECI PIENTS OF 
THE TRAINING; 
 
 (2) PROCEDURES FOR THE EM ERGENCY ADMINISTRATION OF A 
BRONCHODILATOR BY A SCHOOL NURSE OR DESI GNATED VOLUNTEER SCHOOL 
PERSONNEL ; 
 
 (3) PROCEDURES FOR RECOGN IZING THE NEED TO AD MINISTER A 
BRONCHODILATOR AND F OR ADMINISTERING A B RONCHODILATOR BASED ON THE 
SEVERITY OF THE SYMP TOMS BEING EX PERIENCED BY A STUDE NT;  
 
 (3) (4) THE PROPER FOLLOW –UP EMERGENCY PROCEDU RES; 
 
 (4) (5) A PROVISION AUTHORIZING A SCHOOL NURSE OR ANY 
OTHER LICENSED HEALTH CARE PRACTITIONER TO OBTA IN, AND A SCHOOL NURSE 
OR ANY OTHER SCHOOL PERSONN EL TO STORE, AT A NONPUBLIC SCHOOL FOR USE 
IN AN EMERGENCY SITUATION REQUIRING THAT BRONCHODILATORS AND MODES OF 
DELIVERY, INCLUDING INHALERS W ITH SPACERS , BE STORED IN NONPUBL IC 
SCHOOLS TO BE USED I N AN EMERGENCY SITUA TION;   	WES MOORE, Governor 	Ch. 280 
 
– 11 – 
 
 (5) (6) A REQUIREMENT THAT THE NONPUBLIC SCHOO L DEVELOP 
AND IMPLEMENT A METH OD FOR NOTIFYING THE PARENTS OR GUARDIANS OF 
STUDENTS OF THE SCHO OL’S POLICY UNDER THIS SECTION AT THE BEGIN NING OF 
EACH SCHOOL YEAR ; AND 
 
 (7) A PROVISION AUTHORIZIN G A NONPUBLIC SCHOOL TO OBTAIN A 
STANDING ORDER FOR T HE ADMINISTRATION OF BRONC HODILATORS ; AND  
 
 (6) (8) AN ONGOING PROCESS FO R OVERSIGHT AND MONI TORING 
BY A LICENSED HEALTH CARE PRACTITIONER OF THE IMPLEMENTATION O F THE 
POLICY ESTABLISHED U NDER SUBSECTION (B) OF THIS SECTION. 
 
 (D) (1) AN AUTHORIZED LICENSE D HEALTH CARE PRACTITI ONER MAY 
PROVIDE BRONCHODILAT ORS TO A SCHOOL NURS E OR DESIGNATED VOLU NTEER 
FOR USE IN ACCORDANC E WITH THIS SECTION . 
 
 (2) BRONCHODILATORS AND M	ODES OF ADMINISTRATI ON, 
INCLUDING INHALERS W ITH SPACERS, USED BY A SCHOOL NUR SE OR ANY OTHER 
DESIGNATED SCHOOL PERSONNEL MUS T BE FROM A LICENSED PHARMACY OR 
MANUFACTURER . 
 
 (3) A NONPUBLIC SCHOOL MAY ACCEPT DONATED 
BRONCHODILATORS AND MODES OF ADMINISTRAT ION, INCLUDING INHALERS W ITH 
SPACERS, FROM A LICENSED PHAR MACY OR MANUFACTURER . 
 
 (4) A NONPUBLIC SCHOOL MAY APPLY FOR GRANTS TO OBTAIN 
FUNDING FOR THE PURC HASE OF BRONCHODILAT ORS AND MODES OF 
ADMINISTRATION , INCLUDING INHALERS W ITH SPACERS. 
 
 (E) (1) EXCEPT FOR ANY WILLFU L OR GROSSLY NEGLIGE NT ACT, A 
SCHOOL NURSE OR ANY OTHER SCHOOL PERSONN EL WHO RESPOND IN GOO D FAITH 
TO THE ASTHMA ATTACK OR RESPIRATORY DISTR ESS OF A CHILD IN AC CORDANCE 
WITH THIS SECTION MA Y NOT BE HELD PERSON ALLY LIABLE FOR ANY ACT OR 
OMISSION IN THE COUR SE OF RESPONDING TO THE CHILD IN DISTRES S. 
 
 (2) EXCEPT FOR ANY WILLFU L OR GROSSLY NEGLIGE NT ACT, A 
HEALTH CARE PROVIDER WHO PRESCRIBES OR DI SPENSES A BRONCHODIL ATOR 
USED TO TREAT A CHIL D IN ACCORDANCE WITH PARAGRAPH (1) OF THIS 
SUBSECTION MAY NOT B E HELD PERSONALLY LI ABLE FOR ANY ACT OR OMISSION 
THAT OCCURS IN THE C OURSE OF RESPONDING TO THE CH ILD IN DISTRESS.  
 
 SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 
1, 2024.  Ch. 280 	2024 LAWS OF MARYLAND  
 
– 12 – 
 
Approved by the Governor, April 25, 2024.