H 209

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2025
No. 53. An act relating to intranasal epinephrine in schools.
                                   (H.209)
It is hereby enacted by the General Assembly of the State of Vermont:
Sec. 1. 16 V.S.A. § 1388 is amended to read:
§ 1388. STOCK SUPPLY AND EMERGENCY ADMINISTRATION OF
         EPINEPHRINE AUTO-INJECTORS
   (a) As used in this section:
      (1) “Designated personnel” means a school employee, agent, or
volunteer who has completed training required by State Board policy and who
has been authorized by the school administrator or delegated by the school
nurse to provide and administer epinephrine auto-injectors under in accordance
with a provider’s standing order or protocol pursuant to this section and who
has completed the training required by State Board policy.
      (2) “Epinephrine auto-injector” means a U.S. Food and Drug
Administration-approved single-use device that delivers a epinephrine delivery
system containing a premeasured single dose of epinephrine.
      (3) “Health care professional” means a physician licensed pursuant to 26
V.S.A. chapter 23 or 33, an advanced practice registered nurse licensed to
prescribe drugs and medical devices pursuant to 26 V.S.A. chapter 28, or a
physician assistant licensed to prescribe drugs and medical devices pursuant to
26 V.S.A. chapter 31.
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      (4) “School” means a public or approved independent school and
extends to school grounds, school-sponsored activities, school-provided
transportation, and school-related programs.
      (5) “School administrator” means a school’s principal or headmaster.
      (6) “School nurse” means a school nurse or associate school nurse
endorsed by the Agency of Education pursuant to the Licensing of Educators
and the Preparation of Educational Professionals rule (CVR 22-000-010) or
registered nurses certified through the Office of Professional Regulation and
contracted to perform the duties of a school nurse.
   (b)(1) A health care professional may prescribe an epinephrine auto-
injector in a school’s name, which may be maintained by the school for use as
described in subsection (d) of this section. The health care professional shall
issue to the school a standing order for the use of an epinephrine auto-injector
prescribed under this section, including protocols for:
         (A) assessing recognizing whether an individual is experiencing a
potentially life-threatening allergic reaction;
         (B) administering an epinephrine auto-injector to an individual
experiencing a potentially life-threatening allergic reaction;
         (C) caring for an individual after administering an epinephrine auto-
injector to him or her, including contacting emergency services personnel and
documenting the incident; and
         (D) disposing of used or expired epinephrine auto-injectors.
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      (2) A pharmacist licensed pursuant to 26 V.S.A. chapter 36 or a health
care professional may dispense epinephrine auto-injectors prescribed to a
school.
   (c) A school may maintain a stock supply of epinephrine auto-injectors. A
school may enter into arrangements with epinephrine auto-injector
manufacturers or suppliers to acquire epinephrine auto-injectors these products
for free or at reduced or fair market prices.
   (d) The school administrator may authorize a school nurse or appropriately
trained designated personnel, or both, to:
      (1) provide an epinephrine auto-injector to a student for self-
administration according to a plan of action for managing the student’s life-
threatening allergy maintained in the student’s school health records pursuant
to section 1387 of this title;
      (2) administer a prescribed epinephrine auto-injector to a student
according to a plan of action maintained in the student’s school health records;
and
      (3) administer an epinephrine auto-injector, in accordance with the
protocol issued under subsection (b) of this section, to a student or other
individual at a school if the school nurse or designated personnel believe in
good faith that the student or individual is experiencing anaphylaxis, regardless
of whether the student or individual has a prescription for an epinephrine auto-
injector.
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   (e) Designated personnel, a school, a school nurse, and a health care
professional prescribing an epinephrine auto-injector to a school shall be
immune from any civil or criminal liability arising from the administration or
self-administration of an epinephrine auto-injector under this section, unless
the person’s conduct constituted intentional misconduct. Providing or
administering an epinephrine auto-injector under this section does not
constitute the practice of medicine.
   (f) On or before January 1, 2014, the The State Board, in consultation with
the Department of Health, shall adopt policies for managing students with life-
threatening allergies and other individuals with life-threatening allergies who
may be present at a school. The policies shall:
      (1) establish protocols to prevent exposure to allergens in schools;
      (2) establish procedures for responding to life-threatening allergic
reactions in schools, including postemergency procedures;
      (3) implement a process for schools and the parents or guardians of
students with a life-threatening allergy to jointly develop a written
individualized allergy management plan of action that:
         (A) incorporates instructions from a student’s physician health care
professional regarding the student’s life-threatening allergy and prescribed
treatment;
         (B) includes the requirements of section 1387 of this title, if a student
is authorized to possess and self-administer emergency medication at school;
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         (C) becomes part of the student’s health records maintained by the
school; and
         (D) is updated each school year;
      (4) require education and training for school nurses and designated
personnel, including training related to storing and administering an
epinephrine auto-injector and recognizing and responding to a life-threatening
allergic reaction; and
      (5) require each school to make publicly available protocols and
procedures developed in accordance with the policies adopted by the State
Board under this section.
Sec. 2. EFFECTIVE DATE
   This act shall take effect on July 1, 2025.
Date Governor signed bill: June 11, 2025
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