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<section article="ged" article_name="Education" number="7-426.6" title_number="7" title_name="Public Schools" subtitle_number="4" subtitle_name="Health and Safety of Students">
  <level label="a">
    <level label="1">
      <text>In this section the following words have the meanings indicated.</text>
    </level>
    <level label="2">
      <text>“Asthma” means a chronic lung disease that inflames and narrows air passages, causing recurring periods of wheezing, chest tightness, shortness of breath, and coughing.</text>
    </level>
    <level label="3">
      <text>“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.</text>
    </level>
    <level label="4">
      <level label="i">
        <text>“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.</text>
      </level>
      <level label="ii">
        <text>“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.</text>
      </level>
    </level>
  </level>
  <level label="b">
    <level label="1">
      <text>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:</text>
      <level label="i">
        <text>Has been diagnosed with asthma or reactive airway disease; or</text>
      </level>
      <level label="ii">
        <text>Has been prescribed a bronchodilator by an authorized licensed health care practitioner under the Health Occupations Article.</text>
      </level>
    </level>
    <level label="2">
      <text>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.</text>
    </level>
  </level>
  <level label="c">
    <level label="1">
      <text>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:</text>
      <level label="i">
        <text>Identify the symptoms of asthma and respiratory distress;</text>
      </level>
      <level label="ii">
        <text>Identify the symptoms of anaphylaxis; and</text>
      </level>
      <level label="iii">
        <text>Distinguish between anaphylaxis and asthma or respiratory distress.</text>
      </level>
    </level>
    <level label="2">
      <text>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.</text>
    </level>
    <level label="3">
      <text>The training provided under this subsection shall be a paid professional development training.</text>
    </level>
  </level>
  <level label="d">
    <text>The policy established under subsection (b) of this section shall include:</text>
    <level label="1">
      <text>The training required under subsection (c) of this section;</text>
    </level>
    <level label="2">
      <text>Procedures for the emergency administration of a bronchodilator by a school nurse or designated school personnel;</text>
    </level>
    <level label="3">
      <text>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;</text>
    </level>
    <level label="4">
      <text>The proper follow–up emergency procedures;</text>
    </level>
    <level label="5">
      <text>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;</text>
    </level>
    <level label="6">
      <text>A provision authorizing a county board to obtain a standing order for the administration of bronchodilators; and</text>
    </level>
    <level label="7">
      <text>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.</text>
    </level>
  </level>
  <level label="e">
    <level label="1">
      <text>An authorized licensed health care practitioner may provide bronchodilators to a school nurse or designated school personnel for use in accordance with this section.</text>
    </level>
    <level label="2">
      <text>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.</text>
    </level>
    <level label="3">
      <text>A county board or public school may accept donated bronchodilators and modes of administration, including inhalers with spacers, from a licensed pharmacy or manufacturer.</text>
    </level>
    <level label="4">
      <text>A county board may apply for grants to obtain funding for the purchase of bronchodilators and modes of administration, including inhalers with spacers.</text>
    </level>
  </level>
  <level label="f">
    <level label="1">
      <text>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.</text>
    </level>
    <level label="2">
      <text>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.</text>
    </level>
  </level>
  <level label="g">
    <level label="1">
      <level label="i">
        <text>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:</text>
        <level label="1">
          <text>Notify the student’s parent or legal guardian of the incident; and</text>
        </level>
        <level label="2">
          <text>Make a record of the incident, on the form that the Department requires, and file the form in the student’s school medical record.</text>
        </level>
      </level>
      <level label="ii">
        <text>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.</text>
      </level>
    </level>
    <level label="2">
      <text>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.</text>
    </level>
  </level>
</section>
