Colorado Code § 22-1-119.5

Asthma, food allergy, and anaphylaxis health management - self- administered medication - staff-administered medication - rules - definitions
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(1) This
section shall be known and may be cited as the "Colorado Schoolchildren's Asthma, Food
Allergy, and Anaphylaxis Health Management Act".
(2) (a) A student with asthma, a food allergy, other severe allergies, or a related, life-
threatening condition may possess and self-administer medication to treat the student's asthma,
food or other allergy, anaphylaxis, or other related, life-threatening condition if the student has a
treatment plan approved pursuant to this subsection (2) or the student's school district board of
education has adopted a policy for student possession and administration of prescription
medication pursuant to section 22-1-119.3.
(b) A public school shall, and a nonpublic school is encouraged to, approve a treatment
plan for a student enrolled in the school to possess and self-administer medication for asthma, a
food allergy, or anaphylaxis if all of the following conditions are met:
(I) A health-care practitioner has prescribed medication for use by the student during
school hours, at school-sponsored activities, and while in transit to or from school or school-
sponsored activities and has instructed the student in the correct and responsible use of the
medication.
(II) The student demonstrates to the health-care practitioner or the health-care
practitioner's designee and the school nurse or a school administrator the skill level necessary to
use the medication and any device that is necessary to administer the medication as prescribed.
(III) The school nurse or a school administrator collaborates with the student's health-
care practitioner to formulate a written treatment plan for managing asthma, food allergy, or
anaphylaxis episodes of the student and for medication use by the student during school hours, at
school-sponsored activities, and while in transit to or from school or school-sponsored activities.
(IV) The student's parent or legal guardian completes and submits to the public or
nonpublic school the documentation required by rule of the state board of education, including
but not limited to:
(A) A written medical authorization that includes the signature of the health-care
practitioner for the medication prescribed; the name, purpose, prescribed dosage, frequency, and
length of time between dosages of the medications to be self-administered; and confirmation
from the health-care practitioner that the student has been instructed and is capable of self-
administration of the prescribed medications;
(B) A written statement from the student's parent or legal guardian releasing the school,
school district, any associated entity, and employees and volunteers of the school, school district,
and associated entity from liability, except in cases of willful or wanton conduct or disregard of
the criteria of the treatment plan; and
(C) A written contract between the school nurse or a school administrator, the student,
and the student's parent or legal guardian assigning levels of responsibility to the parent or legal
guardian, student, and school employees.
(c) A treatment plan shall be effective only for the school year in which it is approved.
The public school shall approve a new treatment plan for each school year so long as the plan
meets the conditions specified in paragraph (b) of this subsection (2). The parent or legal
guardian shall submit a new treatment plan annually or more often if changes occur to the
student's health or prescribed treatment.
(3) A student with a treatment plan approved pursuant to subsection (2) of this section or
whose school district board of education has adopted a policy for student possession and
administration of prescription medication pursuant to section 22-1-119.3 may possess and self-
administer his or her medication while in school, while at school-sponsored activities, and while
in transit to or from school or school-sponsored activities.
(4) With the approval of the parent or legal guardian of a student with a treatment plan
approved pursuant to subsection (2) of this section, a school may maintain additional asthma,
food or other allergy, or anaphylaxis medication to be kept at the school in a location to which
the student has immediate access in the event of an asthma, food or other allergy, or anaphylaxis
emergency.
(5) Immediately after using an epinephrine auto-injector during school hours, a student
shall report to the school nurse, to the designee of the school nurse, or to some adult at the school
to enable the school nurse, nurse's designee, or other adult to provide the appropriate follow-up
care, which shall include making a 911 emergency call.
(5.5) (a) As used in this subsection (5.5) and in subsection (6) of this section, unless the
context otherwise requires:
(I) "Administer" or "administration" means to give a dose of medicine to a student who
has asthma or a food or other allergy or who is experiencing anaphylaxis, including the use of an
epinephrine auto-injector, an asthma inhaler, or oral medication.
(II) "Designated school personnel" means:
(A) An employee in a school who has been trained on the administration of epinephrine
auto-injectors consistent with the rules on administration of epinephrine auto-injectors and to
whom a school nurse has delegated the nursing task of administering epinephrine auto-injectors
to students; or
(B) An employee in a school who has been trained on the administration of epinephrine
auto-injectors consistent with the rules on administration of epinephrine auto-injectors and to
whom a nurse has delegated the nursing task of administering epinephrine auto-injectors to
students or has been trained by a medical professional licensed under article 240 of title 12 or
part 1 of article 255 of title 12 and to whom the licensee has delegated the administration of
epinephrine auto-injectors under the authority of that person's license.
(III) "Governing authority of a school" means a school district board of education of a
public school, the state charter school institute for an institute charter school, or the governing
board of a nonpublic school.
(IV) "Prescription" means any order issued in writing, dated and signed by a physician
licensed pursuant to article 240 of title 12, a physician assistant licensed in accordance with
section 12-240-113, or an advanced practice registered nurse with prescriptive authority in
accordance with section 12-255-112.
(V) "School" means any public or nonpublic school.
(b) A governing authority of a school may adopt and implement a policy whereby
schools under its jurisdiction may acquire and maintain a stock supply of epinephrine auto-
injectors.
(c) A governing authority of a school may adopt a policy for schools within its
jurisdiction to authorize the school nurse or other designated school personnel to administer an
epinephrine auto-injector to any student that the school nurse or designated school personnel in
good faith believes is experiencing anaphylaxis, in accordance with standing orders and
protocols from a licensed physician, physician assistant, or advanced practice registered nurse
with prescriptive authority, regardless of whether the student has a prescription for an
epinephrine auto-injector.
(d) A governing authority of a school may enter into arrangements with manufacturers
of epinephrine auto-injectors or third-party suppliers of epinephrine auto-injectors to obtain
epinephrine auto-injectors at fair-market or reduced prices or for free.
(e) The governing authority of a public school that decides to maintain a supply of
epinephrine auto-injectors as described in this subsection (5.5) shall:
(I) Implement a plan based on the rules developed pursuant to subsection (8) of this
section for the management of students with life-threatening allergies enrolled in schools under
its jurisdiction; and
(II) Make such plan available on such governing authority's website or the website of
each school under the governing authority's jurisdiction, or if such websites do not exist, make
such plan available to parents and other interested persons through other practical means as
determined by such governing authority.
(f) To qualify for the protections in subsection (6) of this section, the governing
authority of a nonpublic school that decides to maintain a supply of epinephrine auto-injectors as
described in this subsection (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.
(g) The department of education shall develop and publish an annual report compiling,
summarizing, and analyzing all incident reports submitted to the department pursuant to
paragraph (e) of subsection (8) of this section.
(6) Unless the damages were caused by willful or wanton conduct or disregard of the
criteria of an approved treatment plan, if the provisions of this section are met, a school, school
district, school district director, or school or school district employee not otherwise provided for
under section 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:
(a) A student's own use of the student's epinephrine auto-injector or any other
medication contained in an approved treatment plan; or
(b) The good-faith administration of an epinephrine auto-injector in accordance with a
policy and standing orders and protocols on the administration of epinephrine auto-injectors as
described in paragraph (c) of subsection (5.5) of this section and pursuant to a plan adopted
pursuant to paragraph (e) or (f) of subsection (5.5) of this section.
(7) Nothing in this section shall be interpreted to create a cause of action or increase or
diminish the liability of any person.
(8) The state board of education, with assistance from the department of public health
and environment, shall promulgate and revise, as necessary, rules for treatment plans for the
management of students with life-threatening allergies pursuant to this section. The state board
of education shall adopt rules on or before December 31, 2013, to include, but not be limited to:
(a) Education and training for school nurses and designated school personnel on the
management of students with life-threatening allergies, including training related to the
administration of an epinephrine auto-injector. In developing the rules on education and training,
the state board shall solicit input from an organization that represents school nurses.
(b) Procedures for responding to life-threatening allergic reactions;
(c) A process for the development of individualized health-care and allergy action plans
for every student with a known life-threatening allergy, including the self-administration of
medications pursuant to subsection (2) of this section;
(d) Protocols to prevent exposure to allergens;
(e) Requirements for each school to submit, on a form developed by the department of
education, a report of each incident at the school or a related-school event involving a severe
allergic reaction or the administration of an epinephrine auto-injector or both;
(f) Requirements for school nurses in schools that have adopted a policy allowing for the
administration of epinephrine auto-injectors pursuant to subsection (5.5) of this section to report
to the department whether the school nurse has trained and designated any school personnel to
administer epinephrine auto-injectors and, if so, the number of employees in the school or school
district that have been trained and designated to administer epinephrine auto-injectors;
(g) Detailed standards for training programs that must be completed by school nurses
and designated school personnel in order to administer an epinephrine auto-injector in
accordance with subsection (5.5) of this section. Training may be conducted online and, at a
minimum, shall cover:
(I) Techniques on how to recognize symptoms of severe allergic reactions, including
anaphylaxis;
(II) Standards and procedures for the storage and administration of an epinephrine auto-
injector; and
(III) Emergency follow-up procedures after administering an epinephrine auto-injector.
(9) The department of public health and environment is authorized to audit school
records for the determination of asthma and severe allergy rates within the schools and to
determine the proportion of those students with asthma and severe allergies in the schools that
have treatment plans allowing for self-administration of asthma and severe allergy medications.
The audit shall define the extent of asthma and severe allergies among students and determine
the effect of this section on the well-being of children with asthma and severe allergies in
schools. The audit shall be conducted in conformance with the requirements of the "Family
Educational Rights and Privacy Act of 1974", 20 U.S.C. sec. 1232g.

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