H.F. 771 Section 1. Section 280.16, Code 2021, is amended to read as 1 follows: 2 280.16 Self-administration of respiratory distress, asthma , 3 or other airway constricting disease medication , or epinephrine 4 auto-injectors , or bronchodilator canisters and spacers . 5 1. Definitions. For purposes of this section : 6 a. “Bronchodilator” means a bronchodilator as recommended by 7 the department of public health for treatment of a student’s 8 respiratory distress, asthma, or other airway constricting 9 disease. 10 b. “Bronchodilator canister” means a portable drug 11 delivery device packaged with multiple premeasured doses of a 12 bronchodilator. 13 a. c. “Epinephrine auto-injector” means a device for 14 immediate self-administration or administration by another 15 trained individual of a measured dose of epinephrine to a 16 person at risk of anaphylaxis. 17 b. d. “ Licensed health care professional” means a person 18 licensed under chapter 148 to practice medicine and surgery or 19 osteopathic medicine and surgery, an advanced registered nurse 20 practitioner licensed under chapter 152 or 152E and registered 21 with the board of nursing, or a physician assistant licensed to 22 practice under the supervision of a physician as authorized in 23 chapters 147 and 148C . 24 c. e. “Medication” means a drug that meets the definition 25 provided in section 126.2, subsection 8 , has an individual 26 prescription label, is prescribed by a licensed health care 27 professional for a student, and pertains to the student’s 28 respiratory distress, asthma , or other airway constricting 29 disease , or risk of anaphylaxis , and includes but is not 30 limited to a bronchodilator . 31 d. f. “Self-administration” means a student’s discretionary 32 use of medication prescribed by a licensed health care 33 professional for the student. 34 g. “Spacer” means a holding chamber that is used to optimize 35 -1- HF 771 (3) 89 pf/rh/md 1/ 6

H.F. 771 the delivery of a bronchodilator to a person’s lungs. 1 2. The board of directors of a school district and the 2 authorities in charge of an accredited nonpublic school 3 shall permit the self-administration of medication or the use 4 of a bronchodilator canister and spacer by a student with 5 respiratory distress, asthma , or other airway constricting 6 disease or the use of an epinephrine auto-injector by a student 7 with a risk of anaphylaxis if the following conditions are met: 8 a. The student’s parent or guardian provides to the 9 school written authorization for the self-administration of 10 medication , for the use of a bronchodilator canister and 11 spacer, or for the use of an epinephrine auto-injector. 12 b. The student’s parent or guardian provides to the school 13 a written statement from the student’s licensed health care 14 professional containing the following information: 15 (1) The name and purpose of the medication , bronchodilator 16 canister and spacer, or epinephrine auto-injector. 17 (2) The prescribed dosage. 18 (3) The times at which or the special circumstances under 19 which the medication , bronchodilator canister and spacer, or 20 epinephrine auto-injector is to be administered. 21 c. The parent or guardian and the school meet the 22 requirements of subsection 3 . 23 3. The school district or accredited nonpublic school 24 shall notify the parent or guardian of the student, in 25 writing, that the school district or accredited nonpublic 26 school and its employees are to incur no liability, except 27 for gross negligence, as a result of any injury arising from 28 self-administration of medication , use of a bronchodilator 29 canister and spacer, or use of an epinephrine auto-injector 30 by the student. The parent or guardian of the student shall 31 sign a statement acknowledging that the school district or 32 nonpublic school is to incur no liability, except for gross 33 negligence, as a result of self-administration of medication , 34 use of a bronchodilator canister and spacer, or use of an 35 -2- HF 771 (3) 89 pf/rh/md 2/ 6

H.F. 771 epinephrine auto-injector by the student. A school district or 1 accredited nonpublic school and its employees acting reasonably 2 and in good faith shall incur no liability for any improper 3 use of medication , a bronchodilator canister and spacer, or 4 an epinephrine auto-injector as defined in this section or 5 for supervising, monitoring, or interfering with a student’s 6 self-administration of medication , use of a bronchodilator 7 canister and spacer, or use of an epinephrine auto-injector as 8 defined in this section . 9 4. The permission for self-administration of medication , 10 or for the use of a bronchodilator canister and spacer, or for 11 the use of an epinephrine auto-injector is effective for the 12 school year for which it is granted and shall be renewed each 13 subsequent school year upon fulfillment of the requirements 14 of this section . However, the parent or guardian shall 15 immediately notify the school of any changes in the conditions 16 listed under subsection 2 . 17 5. Provided that the requirements of this section are 18 fulfilled, a student with respiratory distress, asthma , or 19 other airway constricting disease may possess and use the 20 student’s medication and a student with a written statement 21 from a licensed health care professional on file pursuant 22 to subsection 2 , paragraph “a” , may use a bronchodilator 23 canister and spacer or an epinephrine auto-injector while in 24 school, at school-sponsored activities, under the supervision 25 of school personnel, and before or after normal school 26 activities, such as while in before-school or after-school 27 care on school-operated property. If the student misuses this 28 privilege, the privilege may be withdrawn. A school district 29 or nonpublic school shall notify a student’s parent or guardian 30 before withdrawing the privilege to use a bronchodilator 31 canister and spacer or an epinephrine auto-injector. 32 6. Information provided to the school under subsection 2 33 shall be kept on file in the office of the school nurse or, in 34 the absence of a school nurse, the school’s administrator. 35 -3- HF 771 (3) 89 pf/rh/md 3/ 6

H.F. 771 7. The Iowa braille and sight saving school, the Iowa school 1 for the deaf, and the institutions under the control of the 2 department of human services as provided in section 218.1 are 3 exempt from the provisions of this section . 4 Sec. 2. Section 280.16A, Code 2021, is amended to read as 5 follows: 6 280.16A Epinephrine auto-injector or bronchodilator canister 7 and spacer supply. 8 1. For purposes of this section , unless the context 9 otherwise requires: 10 a. “Bronchodilator” means the same as defined in section 11 280.16. 12 b. “Bronchodilator canister” means the same as defined in 13 section 280.16. 14 a. c. “Epinephrine auto-injector” means the same as 15 provided in section 280.16 . 16 b. d. “Licensed health care professional” means the same as 17 provided in section 280.16 . 18 c. e. “Personnel authorized to administer epinephrine or 19 a bronchodilator ” means a school nurse or other employee of 20 a school district or accredited nonpublic school trained and 21 authorized to administer an epinephrine auto-injector or a 22 broncholdilator canister and spacer . 23 f. “School nurse” means a registered nurse holding current 24 licensure recognized by the board of nursing who practices in 25 the school setting to promote and protect the health of the 26 school population by using knowledge from the nursing, social, 27 and public health sciences. 28 g. “Spacer” means the same as defined in section 280.16. 29 2. Notwithstanding any other provision of law to the 30 contrary, a licensed health care professional may prescribe 31 epinephrine auto-injectors and bronchodilator canisters 32 and spacers in the name of a school district or accredited 33 nonpublic school to be maintained for use as provided in this 34 section . 35 -4- HF 771 (3) 89 pf/rh/md 4/ 6

H.F. 771 3. The board of directors in charge of each school district 1 and the authorities in charge of each accredited nonpublic 2 school may obtain a prescription for epinephrine auto-injectors 3 and bronchodilator canisters and spacers and maintain a supply 4 of such epinephrine auto-injectors and bronchodilator canisters 5 and spacers in a secure location at each school for use as 6 provided in this section . The board and the authorities shall 7 replace epinephrine auto-injectors and bronchodilator canisters 8 and spacers in the supply upon use or expiration. Personnel 9 authorized to administer epinephrine or a bronchodilator 10 may possess and administer epinephrine auto-injectors or 11 bronchodilator canisters and spacers, as applicable, from the 12 supply as provided in this section . 13 4. Personnel authorized to administer epinephrine or 14 a bronchodilator may provide or administer an epinephrine 15 auto-injector or a bronchodilator canister and spacer, 16 as applicable, from the school’s supply to a student or 17 other individual if such personnel reasonably and in good 18 faith believe the student or other individual is having an 19 anaphylactic reaction or requires treatment for respiratory 20 distress, asthma, or other airway constricting disease . 21 5. The following persons, provided they have acted 22 reasonably and in good faith, shall not be liable for 23 any injury arising from the provision, administration, 24 or assistance in the administration of an epinephrine 25 auto-injector or a bronchodilator canister and spacer as 26 provided in this section : 27 a. Any personnel authorized to administer epinephrine or 28 a bronchodilator who , as applicable, provide, administer, or 29 assist in the administration of an epinephrine auto-injector to 30 a student or other individual present at the school who such 31 personnel believe to be having an anaphylactic reaction or in 32 the administration of a bronchodilator canister and spacer 33 to a student or other individual present at the school who 34 such personnel believe to require treatment for respiratory 35 -5- HF 771 (3) 89 pf/rh/md 5/ 6

H.F. 771 distress, asthma, or other airway constricting disease . 1 b. A school district or accredited nonpublic school 2 employing the personnel. 3 c. The board of directors in charge of the school district 4 or authorities in charge of the accredited nonpublic school. 5 d. The prescriber of the epinephrine auto-injector or 6 bronchodilator canister and spacer . 7 6. The department of education, the board of medicine, 8 the board of nursing, and the board of pharmacy shall, in 9 consultation with an organization representing school nurses, 10 adopt rules pursuant to chapter 17A to implement and administer 11 this section , including but not limited to standards and 12 procedures for the prescription, distribution, storage, 13 disposal, replacement, and administration of epinephrine 14 auto-injectors and bronchodilator canisters and spacers , and 15 for training and authorization to be required for personnel 16 authorized to administer epinephrine or a bronchodilator . 17 -6- HF 771 (3) 89 pf/rh/md 6/ 6