221119.5-R-1.00 Statement of Basis and Purpose The statutory basis for the enactment of the Rules, adopted by the State Board of Education on December 8, 2005 and re-adopted on April 6, 2006 is found in 22-1-119.5 (2)(b)(IV) & (8), C.R.S. The Colorado Schoolchildren’s Asthma and Anaphylaxis Act requires the State Board of Education to promulgate rules on determining students’ qualifications, contract requirements and treatment plan requirements.

221119.5-R-2.00 Determining student qualifications 2.01 In order to determine whether a student is eligible to administer their own medication the professional school nurse, in collaboration with the parent or guardian and health care provider shall make an assessment of the student’s knowledge of their condition and their ability to self- administer medication. The skill level assessment shall include, but not be limited to, the following areas: ability to identify the correct medication, a demonstration of the correct administration technique, knowledge of the dose required, the frequency of use, and the ability to recognize when to take the medication.

221119.5-R-3.00 Contract Requirements 3.01 The contract shall clearly define the responsibilities of the student, the parent/guardian and the school nurse. The contract shall include, but not be limited to: a plan on the part of the student to keep the rescue inhaler with them at school rather than the health office, an agreement to use the inhaler in a manner consistent with physician’s orders, an agreement to notify the school health office if the condition is presenting unusual difficulty, and an agreement not to allow any other individual to use the inhaler. Such agreement shall be signed by the student.

3.02 The contract shall clearly define the responsibilities of the parent/guardian and shall include, but not be limited to, the following: An assurance that the student carries medication as prescribed, that a back-up rescue inhaler will be provided to the Health Office for emergencies, and to review the plan on a regular basis with the student.

3.03 The contract shall clearly define the responsibilities of the school nurse to include, but not be limited to: Assuring the student can demonstrate the correct technique for inhaler use, understands the physician order for time and dosages, and that school staff is aware of the student’s condition and the need for the student to carry the medication.

221119.5-R-4.00 Treatment Plan Requirements 4.01 The treatment plan shall be called a health care plan. Such plan shall direct school staff in the management of the students with asthma and/or severe allergies. A written contact between the school nurse, the student, and the student’s parents or legal guardian shall be established assigning levels of responsibility for each individual. This contract shall accompany orders for the medication from a healthcare provider. There must be agreement by all parties that noncompliance with the contract may result in withdrawal of the privilege.

4.02 The contract for the student shall include, but not be limited to: the ability to demonstrate competency in taking his/her medication, the ability to demonstrate asthma management and self-care skills, notify school health office when having more difficulty than usual with their condition, and not allow another person to use the medication.

4.03 The contract for the Parent/Guardian shall include, but not be limited to: the provision of a written order by the health care professional, provision of a written authorization by the parent/guardian, the assurance that the container is appropriately labeled by a pharmacist or health care provider, that the medication device has the medication in it, that the medication has not expired, and that the status is reviewed of the student’s asthma/allergy with the student on a regular basis.

4.04 The contract for the School Nurse shall include but not be limited to: the review with the student of the correct technique for use of the medication device(s), an understanding of the order for time and dosages, and an understanding of the appropriate use of the medication, review the status of the student’s asthma/allergy with the student on a regular basis identified in the treatment plan, notify school staff that needs to know that the student has asthma and has permission to carry and self-administer the medication, and assign a designee to make a 911 emergency call if the student has an exposure that results in the need to use epinephrine (Epi-pen).