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DEPARTMENT OF EDUCATION
Colorado State Board of Education
ADMINISTRATION OF COLORADO SCHOOL CHILDREN'S ASTHMA, FOOD ALLERGY, AND ANAPHYLAXIS HEALTH MANAGEMENT ACT AND COLORADO SCHOOL CHILDREN’S FOOD ALLERGY AND ANAPHYLAXIS MANAGEMENT ACT
1 CCR 301-68
[Editor’s Notes follow the text of the rules at the end of this CCR Document.]
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. 
222135-R-1.00 Statement of Basis and Purpose 
The statutory basis for the enactment of these Rules is found in SB09-226, Section 22-2-135(3)(a), C.R.S. The Colorado School Children’s Food Allergy and Anaphylaxis Management Act  requires the State Board of Education to promulgate rules for the management of food allergies and anaphylaxis among students enrolled in public schools of the state. 
222135-R-1.00 Definitions
222135-R-1.01	“Health Care Plan” hereinafter referred to as the “Plan” is a plan for a specific client for a specific student that addresses the administration of medications and/or treatments for the student, including emergency treatment, that is developed by a professional nurse employed or contracted by the client’s school in conjunction with the client and parent or legal guardian and is based on the client’s student’s Health Care Practitioner’s orders for the administration of medications and/or treatments for the clientstudent. 
1.01	222135-R-1.02 “Appropriate Staff” means employees of the school whom the principal or equivalent executive in consultation with the school nurse of the school determines to be appropriate recipients of emergency anaphylaxis treatment training, which employees shall include, but need not be limited to, employees who are directly involved during the school day with a student who has a known food allergy.
1.02	222135-R-1.03 “Policy” means the Policy developed on or before July 1, 2010, by the local each school district board of education and the state charter school institute on or before July 1, 2010 which shall, at a minimum, contain the requirements set forth in statute.
1.03	222135-R-1.04 “Contract” means the written contract between the student,  the student’s parents or legal guardian, and the school nurse or the school administrator in consultation with the school nurse, the student, and the student’s parents or legal guardian, which clearly defines responsibility for the student to self-carry their his or her emergency medication.
1.04	222135-R-1.05  “Healthcare Provider Practitioner” means a physician, nurse practitioner, or physician’s assistant who has prescriptive authority and is licensed to practice in the State of Colorado.
222135-R-2.00	Management of Food Allergy and Anaphylaxis in the School 
222135-R-2.01	The management of food allergies and anaphylaxis in the school setting shall be collaboration between the school district, parents, Healthcare Provider, Practitioner and student as appropriate.  The School Guidelines for Managing Students with Food Allergies posted on the Food Allergy and Anaphylaxis website, http;//www.foodallergy.org will be considered best practice in caring for the student with life-threatening allergies.   
222135-R-2.02	The school nurse or school administrator, in consultation with the school nurse, is responsible for the development and implementation of the Plan for each student with the diagnosis of a potential life-threatening food allergy allergic condition after reviewing the health information provided by the student’s parent or legal guardian and Healthcare Provider, Practitioner on the allergy and anaphylaxis standard form developed by the Colorado Department of Public Health and Environment pursuant to section 25-1.5-109 C.R.S. and referenced in  22-2-135 C.R.S., including dissemination of information and training for the student with life-threatening allergies to the appropriate staff as outlined below in Rule 222135-R-3.  If a student qualifies as a student with a disability in accordance with federal law, including but not limited to Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act, or the Individuals with Disabilities Education Act, the development of a Health Care Plan and/or other plan as appropriate, in accordance with such federal laws, shall be deemed to meet the requirements of these rules.
222135-R -2.03	The school shall have a plan in place for communication between the school and emergency medical services, including instructions for emergency medical responders.
222135-R- 2.04	Reasonable accommodations shall be made to reduce the student’s exposure to allergenic foods agents that may cause anaphylaxis within the school environment as set  forth in Section 22-2-103 135(3)(a)(II) C.R.S. In developing accommodations, The school nurse, school personnel, Healthcare Provider, Practitioner and the student’s parent or legal guardian, and student as appropriate, shall work in partnership to develop strategies reasonable accommodations for avoiding an allergic reaction while allowing the student to participate fully in all activities. to reduce the risk of the student’s exposure to agents that cause anaphylaxis. If a student qualifies as a student with a disability in accordance with federal law, including but not limited to Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act, or the Individuals with Disabilities Education Act, the development of a Health Care Plan and/or other plan as appropriate, in accordance with such federal laws, shall be deemed to meet the requirements of these rules. 
222135-R- 2.05	Training shall be done for appropriate staff as outlined below in Rule 222135-R-63.
222135-R- 2.06	Emergency medications shall be kept in a secure location easily accessible for designated staff. Students may carry their own epinephrine if age appropriate after an assessment from the school nurse and in collaboration with the school administrator, the parent or legal guardian and the Healthcare Provider,
222135-R -2.07	 The parent or legal guardian shall be responsible, whenever possible, to supply to the school in a timely fashion the medication needed for treatment of food allergies or anaphylaxis unless the student is authorized to self-carry.
222135-R -2.08 	Prior to the beginning of each school year, each school district shall provide notice to the parent or legal guardian of each student enrolled in a public school of the policy adopted by the school district pursuant to Section 22-32-139 C.R.S. The notice shall direct the parent or legal guardian how to access the state-approved Plan. the standard form referred to in 22-2-135(3)(b) C.R.S. and developed by the Colorado Department of Public Health and Environment pursuant to section 25-1.5-109 C.R.S. The Plan shall be available on the CDE School Heath Services website: http://www.cde.state.co.us/cdesped/RSS-Nurse.asp. On an annual basis, the Plan shall be reviewed and approved in writing with the parent or legal guardian the Healthcare Provider and the student, when appropriate.
222135-R-3.00 Appropriate Staff Training 
222135-R -3.01  	The principal or an equivalent school administrator, in consultation with the school nurse, shall determine the appropriate recipients of school emergency anaphylaxis treatment  training, including Appropriate Staff  all staff members who are directly involved with who has a student with a known food allergy.  during the school day with a student who has a known food allergy. 
222135-R -3.02 Training shall, at a minimum, prepare Appropriate Staffschool staff to have a basic understanding of food allergies and the importance of reasonable avoidance of allergens, agents that may cause anaphylaxis, the ability to recognize symptoms of anaphylaxis, and the ability to respond appropriately in the event of the student suffering an anaphylactic reaction.  The training shall include the administration of self-injectable epinephrine.
222135-R -3.03	Staff training and delegation of emergency medications by the school nurse shall be done in accordance with the State of Colorado Guide for Medication Administration: An Instructional Program for Training Unlicensed Persons to Give Medications in Out of Home Childcare, School and Camp Settings, (Qualistar Pub, Revised 2008) and the Colorado Nurse Practice Act, Section 12-38-103(10) C.R.S.
222135-R-4.00 School Allergy and Anaphylaxis Policy Required
222135-R -4.01	On or before July 1, 2010, each school district board of education, including the Charter School Institute, shall adopt and implement a Policy for the management of food allergies and anaphylaxis among students enrolled in the public schools of the school district. The Policy shall include, at a minimum, measures that satisfy the Rules set forth herein, pursuant to Section 22-2-135 C.R.S.

221119.5-R-1.00	Determining Student Qualifications to Self-Carry aAsthma/Anaphylaxis Medication 
221119.5-R-1.01	In order to determine whether a student is eligible to administer his/her own medication, the professional school nurse or administrator in consultation with the school nurse and in collaboration with the parent or legal guardian and Healthcare Provider Practitioner shall make an assessment of the student’s knowledge of  his/her condition and his/her 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.
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221119.5-R-2.00	Requirements for to Self-Carry of Asthma/Anaphylaxis Medication
221119.5-R-2.01	A written contract between the school nurse or school administrator in consultation with 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 Provide. Pracitioner.There must be agreement by all parties that noncompliance with the Contract may result in withdrawal of the privilege.
221119.5-R-2.02	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/allergy management and self-care skills, notify school staff if emergency medication has been administered or when having more difficulty than usual with his/her condition, and the express prohibition againstallowing another person to use his/her medication.
221119.5-R-2.03	The Contract for the parent or legal guardian shall include, but not be limited to: the provision of a written order by the HealthCareProvider;  Practitioner, the provision of a written authorization by the parent or legal guardian; the assurance that the container is appropriately labeled by a pharmacist or HealthCare Provider Practitioner  that the medication device contains the medication;, that the medication has not expired, that backup medication will be provided to the Health Office for emergencies, and that, on a regular basis, the status of the student’s asthma/allergy is reviewed with the student.  Consideration should be given to supplying the school with back-up medication for the health office.
221119.5-R-2.04	The Contract for the school nurse or the school administrator, in consultation with 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; a review of the status of the student’s asthma/allergy with the student on a regular basis ; a requirement to notify school staff that needs to know who whether the student has asthma or a life-threatening allergeyallergy and has permission to carry and self-administer the medication, and the assignment of a designee to make a 911 emergency call if the student has an exposure that results in the need to use epinephrine.
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Editor’s Notes
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