1. (1) Definitions.

   1. (a) Anaphylaxis. Anaphylaxis is a medical term for the life-threatening allergic reactions that may occur when allergic individuals are exposed to specific allergens. Anaphylaxis is a collection of symptoms affecting multiple systems in the body.
   2. (b) Epinephrine Auto-injector. Epinephrine auto-injector is a prescription medication (epinephrine) in a specific dose-for-weight device that is packaged for self-delivery in the event of a life-threatening allergic reaction.
   3. (c) Emergency Action Plan. Emergency action plan (EAP) is a child-specific action plan, distributed to appropriate school and contracted personnel, to facilitate an appropriate response for an anticipated health emergency. The EAP is a component of the Individualized Healthcare Plan developed in accordance with Section 1006.062, F.S., and Rule 64F-6.004, F.A.C.
   4. (d) Individualized Healthcare Plan (IHP). An IHP is a written plan of care developed at the local level to outline the provision of student healthcare services intended to achieve specific student outcomes. The IHP is developed by a registered nurse (RN) in collaboration with the family, student, student’s healthcare providers, and school personnel for the management of severe allergic reactions while in school, participating in school-sponsored activities, and in transit to or from school or school-sponsored activities. The IHP is child-specific and includes a written format for nursing assessment (health status, risks, concerns, and strengths), nursing diagnoses, interventions, delegation, training, expected outcomes, and goals to meet the healthcare needs of a student at risk for anaphylaxis.
   5. (e) Self-Administration. Self-administration shall mean that the student is able to utilize the epinephrine auto-injector in the manner directed by the licensed healthcare provider without additional assistance or direction.

2. (2) Use of Epinephrine Auto-Injectors and Individualized Healthcare Plan (IHP)

   1. (a) A written authorization is required from the physician and parent/guardians for a student to carry an epinephrine auto-injector and self-administer epinephrine by auto-injector in accordance with Section 1002.20, F.S.
   2. (b) In accordance with subsection 64F-6.004(4), F.A.C., the school nurse shall develop an annual IHP that includes an EAP, in cooperation with the student, parent/guardians, healthcare provider, and school personnel for the student with life-threatening allergies.
3. (3) The IHP shall include provisions for child-specific training in accordance with Section 1006.062(4), F.S., to ensure personnel are prepared to support a student’s unique needs, respond appropriately, and protect the safety of all students from the misuse or abuse of auto-injectors. The EAP component shall specify that the emergency number (911) will be called immediately for an anaphylaxis event and describe a plan of action if the student is unable to perform self-administration of the epinephrine auto-injector.

4. (4) Training

   1. (a) Each district school board and charter school governing board must require that each school serving students in kindergarten through grade 8 provide training to an adequate number of school personnel and contracted personnel on the prevention and response to allergic reactions, including anaphylaxis. This training or other training which meets the requirements of s. 1002.20(3)(q), F.S., may be used by school boards or charter school governing boards as part of the training required under paragraph (4)(c) of this rule.

   2. (b) In determining what constitutes an adequate number of school personnel and contracted personnel identified for training, school and governing boards must consider the following:

      1. The number of students with an IHP at the school;

      2. The number of students who have experienced or are at risk of experiencing an allergic reaction, including anaphylaxis;

      3. The accessibility of healthcare personnel at the school; and

      4. The number of trained persons needed to ensure coverage of areas where there is a higher probability of student exposure to allergens, such as the cafeteria and playgrounds.

   3. (c) Training Content. The training must include at a minimum:

      1. Recognition of the signs and symptoms of an anaphylactic reaction; and

      2. Administration of a United States Food and Drug Administration-approved epinephrine delivery device that contains a pre-measured, appropriate weight-based dose in accordance with s. 1006.062, F.S.

   4. (d) Florida Department of Education identified approved training is posted on the Student Support Services website at https://www.fldoe.org/schools/k-12-public-schools/sss/sch-health-serv.stml.

5. (5) Each school board and charter school governing board must develop or amend its policies or procedures to ensure that:

   1. (a) A student’s EAP is in effect and accessible at all times when the student is on school grounds during the school day or participating in school-sponsored activities, including before and after school programs at the school;
   2. (b) Personnel designated to implement a student’s EAP receive training in order to implement the plan; and
   3. (c) The policies or procedures apply, at a minimum, to students in kindergarten through grade 8.

Rulemaking Authority 1002.20(3)(i), (q) FS. Law Implemented 1002.20(3)(i), (q), 1006.062 FS. History–New 3-24-08, Amended 10-28-25.