Senate Bill 25-278 Rerevised

A Bill for an Act

• Page 1, Line 101Concerning the administration of emergency-use epinephrine

• Page 1, Line 102in a school setting, and, in connection therewith,

• Page 1, Line 103making an appropriation.

Bill Summary

(Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://leg.colorado.gov.)

For the purpose of encompassing the different ways that epinephrine may be administered to treat anaphylaxis in a school setting, the bill changes the term "epinephrine auto-injector" to "emergency-use epinephrine".

• Page 2, Line 1Be it enacted by the General Assembly of the State of Colorado:

• Page 2, Line 2SECTION 1.  In Colorado Revised Statutes, 22-1-119.5, amend

• Page 2, Line 3(5), (5.5)(a)(I), (5.5)(a)(II), (5.5)(b), (5.5)(c), (5.5)(d), (5.5)(e)

• Page 2, Line 4introductory portion, (5.5)(f), (6), (8)(a), (8)(e), (8)(f), (8)(g) introductory portion, (8)(g)(II), and (8)(g)(III); and add (10) as follows:

• Page 2, Line 522-1-119.5.  Asthma, food allergy, and anaphylaxis health

• Page 2, Line 6management - self-administered medication - staff-administered

• Page 2, Line 7medication - rules - definitions. (5)  Immediately after using an

• Page 2, Line 8emergency-use epinephrine auto-injector during school hours, a student

• Page 2, Line 9shall report to the school nurse, to the designee of the school nurse, or to

• Page 2, Line 10some adult at the school to enable the school nurse, school nurse's

• Page 2, Line 11designee, or other adult to provide the appropriate follow-up care, which shall include making a 911 emergency call.

• Page 2, Line 12(5.5) (a)  As used in this subsection (5.5) and in subsection (6) of this section, unless the context otherwise requires:

• Page 2, Line 13(I)  "Administer" or "administration" means to give a dose of

• Page 2, Line 14medicine to a student who has asthma or a food or other allergy or who

• Page 2, Line 15is experiencing anaphylaxis, including the use of an emergency-use epinephrine, auto-injector, an asthma inhaler, or oral medication.

• Page 2, Line 16(II)  "Designated school personnel" means:

• Page 2, Line 17(A)  An employee in a school who has been trained on the

• Page 2, Line 18administration of emergency-use epinephrine auto-injectors consistent

• Page 2, Line 19with the rules on administration of emergency-use epinephrine

• Page 2, Line 20auto-injectors and to whom a school nurse has delegated the nursing task

• Page 2, Line 21of administering emergency-use epinephrine auto-injectors to students;

• Page 2, Line 22or

• Page 3, Line 1(B)  An employee in a school who has been trained on the

• Page 3, Line 2administration of emergency-use epinephrine auto-injectors consistent

• Page 3, Line 3with the rules on administration of emergency-use epinephrine

• Page 3, Line 4auto-injectors and to whom a school nurse has delegated the nursing

• Page 3, Line 5task of administering emergency-use epinephrine auto-injectors to

• Page 3, Line 6students or who has been trained by a medical professional licensed

• Page 3, Line 7under article 240 of title 12 or part 1 of article 255 of title 12 and to

• Page 3, Line 8whom the licensee has delegated the administration of emergency-use epinephrine auto-injectors under the authority of that person's license.

• Page 3, Line 9(b)  A governing authority of a school may adopt and implement

• Page 3, Line 10a policy whereby schools under its jurisdiction may acquire and maintain a stock supply of emergency-use epinephrine. auto-injectors.

• Page 3, Line 11(c)  A governing authority of a school may adopt a policy for

• Page 3, Line 12schools within its jurisdiction to authorize the school nurse or other

• Page 3, Line 13designated school personnel to administer an emergency-use

• Page 3, Line 14epinephrine auto-injector to any student that the school nurse or

• Page 3, Line 15designated school personnel in good faith believes is experiencing

• Page 3, Line 16anaphylaxis, in accordance with standing orders and protocols from a

• Page 3, Line 17licensed physician, physician assistant, or advanced practice registered

• Page 3, Line 18nurse with prescriptive authority, regardless of whether the student has a prescription for an emergency-use epinephrine. auto-injector.

• Page 3, Line 19(d)  A governing authority of a school may enter into arrangements

• Page 3, Line 20with manufacturers of emergency-use epinephrine auto-injectors or

• Page 3, Line 21third-party suppliers of emergency-use epinephrine auto-injectors to

• Page 3, Line 22obtain emergency-use epinephrine auto-injectors at fair-market or reduced prices or for free.

• Page 3, Line 23(e)  The governing authority of a public school that decides to

• Page 4, Line 1maintain a supply of emergency-use epinephrine auto-injectors as described in this subsection (5.5) shall:

• Page 4, Line 2(f)  To qualify for the protections in subsection (6) of this section,

• Page 4, Line 3the governing authority of a nonpublic school that decides to maintain a

• Page 4, Line 4supply of emergency-use epinephrine auto-injectors as described in this

• Page 4, Line 5subsection (5.5) must implement a plan based on the rules adopted by the state board of education as described in subsection (8) of this section.

• Page 4, Line 6(6)  Unless the damages were caused by willful or wanton conduct

• Page 4, Line 7or disregard of the criteria of an approved treatment plan, if the provisions

• Page 4, Line 8of this section are met, a school, school district, school district director,

• Page 4, Line 9or school or school district employee not otherwise provided for under

• Page 4, Line 10section 13-21-108 C.R.S., shall not be liable in a suit for damages as a result of an act or omission related to:

• Page 4, Line 11(a)  A student's own use of the student's emergency-use

• Page 4, Line 12epinephrine auto-injector or any other medication contained in an approved treatment plan; or

• Page 4, Line 13(b)  The good faith administration of an emergency-use

• Page 4, Line 14epinephrine auto-injector in accordance with a policy and standing orders

• Page 4, Line 15and protocols on the administration of emergency-use epinephrine

• Page 4, Line 16auto-injectors as described in paragraph (c) of subsection (5.5) of this

• Page 4, Line 17section subsection (5.5)(c) of this section and pursuant to a plan

• Page 4, Line 18adopted pursuant to paragraph (e) or (f) of subsection (5.5) of this section subsection (5.5)(e) or (5.5)(f) of this section.

• Page 4, Line 19(8)  The state board of education, with assistance from the

• Page 4, Line 20department of public health and environment, shall promulgate and

• Page 4, Line 21revise, as necessary, rules for treatment plans for the management of

• Page 4, Line 22students with life-threatening allergies pursuant to this section. The state

• Page 5, Line 1board of education shall adopt rules on or before December 31, 2013, to include but not be limited to:

• Page 5, Line 2(a)  Education and training for school nurses and designated school

• Page 5, Line 3personnel on the management of students with life-threatening allergies,

• Page 5, Line 4including training related to the administration of an emergency-use

• Page 5, Line 5epinephrine. auto-injector. In developing the rules on education and

• Page 5, Line 6training, the state board shall solicit input from an organization that represents school nurses.

• Page 5, Line 7(e)  Requirements for each school to submit, on a form developed

• Page 5, Line 8by the department of education, a report of each incident at the school or

• Page 5, Line 9a related-school event involving a severe allergic reaction or the administration of an emergency-use epinephrine auto-injector or both;

• Page 5, Line 10(f)  Requirements for school nurses in schools that have adopted

• Page 5, Line 11a policy allowing for the administration of emergency-use epinephrine

• Page 5, Line 12auto-injectors pursuant to subsection (5.5) of this section to report to the

• Page 5, Line 13department of education whether the school nurse has trained and

• Page 5, Line 14designated any school personnel to administer emergency-use

• Page 5, Line 15epinephrine auto-injectors and, if so, the number of employees in the

• Page 5, Line 16school or school district that have been trained and designated to administer emergency-use epinephrine; auto-injectors;

• Page 5, Line 17(g)  Detailed standards for training programs that must be

• Page 5, Line 18completed by school nurses and designated school personnel in order to

• Page 5, Line 19administer an emergency-use epinephrine auto-injector in accordance

• Page 5, Line 20with subsection (5.5) of this section. Training may be conducted online and, at a minimum, shall cover:

• Page 5, Line 21(II)  Standards and procedures for the storage and administration

• Page 5, Line 22of an emergency-use epinephrine; auto-injector; and

• Page 6, Line 1(III)  Emergency follow-up procedures after administering an emergency-use epinephrine. auto-injector.

• Page 6, Line 2(10)  As used in this section, "emergency-use epinephrine"

• Page 6, Line 3means a portable, disposable drug delivery device or product

• Page 6, Line 4approved by the federal food and drug administration that

• Page 6, Line 5contains a premeasured, single dose of epinephrine that is used to treat anaphylaxis in an emergency situation.

• Page 6, Line 6SECTION 2.  In Colorado Revised Statutes, 22-2-135, amend (3)(a) introductory portion, (3)(a)(III), and (3)(a)(IV) as follows:

• Page 6, Line 722-2-135.  Food allergy and anaphylaxis management - rules.

• Page 6, Line 8(3) (a)  On or before January 1, 2010, the state board of education, in

• Page 6, Line 9consultation with the department of public health and environment, shall

• Page 6, Line 10promulgate rules for the management of food allergies and anaphylaxis

• Page 6, Line 11among students enrolled in the public schools of the state. The rules shall must include, but need not be limited to, the following:

• Page 6, Line 12(III)  The provision of emergency anaphylaxis treatment training

• Page 6, Line 13for appropriate staff to prepare them to respond appropriately in the event

• Page 6, Line 14that a student suffers anaphylaxis as a result of an allergic reaction to

• Page 6, Line 15food, which training shall must include but need not be limited to training in the administration of self-injectable epinephrine; and

• Page 6, Line 16(IV)  Procedures to ensure the availability of a student's

• Page 6, Line 17self-injectable epinephrine to faculty and administrative staff of the

• Page 6, Line 18school in the event that a student suffers anaphylaxis and requires emergency medical treatment.

• Page 6, Line 19SECTION 3.  Appropriation. For the 2025-26 state fiscal year,

• Page 6, Line 20$9,379 is appropriated to the department of education for use by student

• Page 6, Line 21pathways. This appropriation is from the general fund and is based on an

• Page 7, Line 1assumption that the division will require an additional 0.1 FTE. To

• Page 7, Line 2implement this act, the division may use this appropriation for epinephrine administration.

• Page 7, Line 3SECTION 4.  Safety clause. The general assembly finds,

• Page 7, Line 4determines, and declares that this act is necessary for the immediate

• Page 7, Line 5preservation of the public peace, health, or safety or for appropriations for

• Page 7, Line 6the support and maintenance of the departments of the state and state institutions.