Maryland Code § ED-7-426.6

Section ED-7-426.6
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(a) (1) In this section the following words have the meanings indicated.
(2) "Asthma" means a chronic lung disease that inflames and
narrows air passages, causing recurring periods of wheezing, chest tightness,
shortness of breath, and coughing.
(3) "Bronchodilator" means medication that relaxes bronchial
muscles, resulting in the expansion of bronchial air passages to provide fast
treatment of asthma-related symptoms and symptoms of respiratory distress.
(4) (i) "School personnel" means individuals who are employed by
a public school, or, in the case of some school health staff, by a local health
department.
(ii) "School personnel" includes part-time employees,
teachers, substitute teachers employed by the school for at least 7 days each school
year, registered nurse case managers, delegating nurses, and administrative staff.
(b) (1) Except as provided in paragraph (2) of this subsection, the
Maryland Department of Health, in consultation with county boards, shall establish
a policy for public schools to authorize the school nurse and designated school
personnel to administer a bronchodilator to a student who is determined by an
individual who has undergone the training provided under subsection (c) of this
section to be, or is perceived to be, experiencing asthma-related symptoms or is
perceived to be in respiratory distress, regardless of whether the student:
(i) Has been diagnosed with asthma or reactive airway
disease; or
(ii) Has been prescribed a bronchodilator by an authorized
licensed health care practitioner under the Health Occupations Article.

(2) Neither a school nurse nor any other designated school personnel
may administer a bronchodilator to a prekindergarten student unless the student has
been diagnosed with asthma or a reactive airway disease and has a prescription for
a bronchodilator as prescribed by the student's health care practitioner.
(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 develop training to:
(i) Identify the symptoms of asthma and respiratory distress;
(ii) Identify the symptoms of anaphylaxis; and
(iii) Distinguish between anaphylaxis and asthma or
respiratory distress.
(2) The training identified or developed under paragraph (1) of this
subsection shall be provided to school nurses and voluntary 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 subsection shall be a paid
professional development training.
(d) The policy established under subsection (b) of this section shall include:
(1) The training required under subsection (c) of this section;
(2) Procedures for the emergency administration of a bronchodilator
by a school nurse or designated school personnel;
(3) Procedures for recognizing the need to administer a
bronchodilator and for administering a bronchodilator based on the severity of the
symptoms being experienced by a student;
(4) The proper follow-up emergency procedures;
(5) A provision requiring that bronchodilators and modes of delivery,
including inhalers with spacers, be stored in public schools to be used in an emergency
situation;
(6) A provision authorizing a county board to obtain a standing order
for the administration of bronchodilators; and

(7) 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 licensed health care practitioner may provide
bronchodilators to a school nurse or designated school personnel for use in accordance
with this section.
(2) Bronchodilators and modes of administration, including inhalers
with spacers, used by a school nurse or designated school personnel must be from a
licensed pharmacy or manufacturer.
(3) A county board or public school may accept donated
bronchodilators and modes of administration, including inhalers with spacers, from
a licensed pharmacy or manufacturer.
(4) A county board may apply for grants to obtain funding for the
purchase of bronchodilators and modes of administration, including inhalers with
spacers.
(f) (1) Except for any willful or grossly negligent act, a school nurse or
any other school personnel who respond in good faith to the asthma attack or
respiratory distress 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 child in
distress.
(2) Except for any willful or grossly negligent act, a health care
provider who prescribes or dispenses a bronchodilator used to treat a child in
accordance with paragraph (1) of this subsection may not be held personally liable for
any act or omission that occurs in the course of responding to the child in distress.
(g) (1) (i) For each incident at the school or at a related school event
that requires the use of a stock bronchodilator in accordance with this section, each
public school shall:
1. Notify the student's parent or legal guardian of the
incident; 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 shall submit to the Department a
report, on the form and schedule required by the Department, on the number of

incidents at the school or at a related school event that required the use of a stock
bronchodilator in accordance with this section.
(2) The Department shall develop and disseminate standard forms to
record each incident and report incidents requiring the use of a bronchodilator at a
public school.

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