                                 CODE OF VIRGINIA

POSSESSION AND ADMINISTRATION OF INHALED ASTHMA MEDICATIONS, EPINEPHRINE,
GLUCAGON, AND SEIZURE RESCUE MEDICATIONS BY CERTAIN STUDENTS OR SCHOOL BOARD
EMPLOYEES (§ 22.1-274.2)

A. Local school boards shall develop and implement policies permitting a student
with a diagnosis of asthma or anaphylaxis, or both, to possess and
self-administer inhaled asthma medications or auto-injectable epinephrine, or
both, as the case may be, during the school day, at school-sponsored activities,
or while on a school bus or other school property. Such policies shall include,
but not be limited to, provisions for:

   1. Written consent of the parent, as defined in &#xA7; 22.1-1, of a student
   with a diagnosis of asthma or anaphylaxis, or both, that the student may
   self-administer inhaled asthma medications or auto-injectable epinephrine, or
   both, as the case may be.

   2. Written notice from the student&#8217;s primary care provider or medical
   specialist, or a licensed physician or licensed advanced practice registered
   nurse, that (i) identifies the student; (ii) states that the student has a
   diagnosis of asthma or anaphylaxis, or both, and has approval to
   self-administer inhaled asthma medications or auto-injectable epinephrine, or
   both, as the case may be, that have been prescribed or authorized for the
   student; (iii) specifies the name and dosage of the medication, the frequency
   in which it is to be administered and certain circumstances which may warrant
   the use of inhaled asthma medications or auto-injectable epinephrine, such as
   before exercising or engaging in physical activity to prevent the onset of
   asthma symptoms or to alleviate asthma symptoms after the onset of an asthma
   episode; and (iv) attests to the student&#8217;s demonstrated ability to
   safely and effectively self-administer inhaled asthma medications or
   auto-injectable epinephrine, or both, as the case may be.

   3. Development of an individualized health care plan, including emergency
   procedures for any life-threatening conditions.

   4. Consultation with the student&#8217;s parent before any limitations or
   restrictions are imposed upon a student&#8217;s possession and
   self-administration of inhaled asthma medications and auto-injectable
   epinephrine, and before the permission to possess and self-administer inhaled
   asthma medications and auto-injectable epinephrine at any point during the
   school year is revoked.

   5. Self-administration of inhaled asthma medications and auto-injectable
   epinephrine to be consistent with the purposes of the Virginia School Health
   Guidelines and the Guidelines for Specialized Health Care Procedure Manuals,
   which are jointly issued by the Department of Education and the Department of
   Health.

   6. Disclosure or dissemination of information pertaining to the health
   condition of a student to school board employees to comply with &#xA7;&#xA7;
   22.1-287 and 22.1-289 and the federal Family Education Rights and Privacy Act
   of 1974, as amended, 20 U.S.C. &#xA7; 1232g, which govern the disclosure and
   dissemination of information contained in student scholastic records.

B. The permission granted a student with a diagnosis of asthma or anaphylaxis,
or both, to possess and self-administer inhaled asthma medications or
auto-injectable epinephrine, or both, shall be effective for one school year.
Permission to possess and self-administer such medications shall be renewed
annually. For the purposes of this section, &#8220;one school year&#8221; means
365 calendar days.

C. Local school boards shall adopt and implement policies for the possession and
administration of epinephrine in every school, to be administered by any school
nurse, employee of the school board, employee of a local governing body, or
employee of a local health department who is authorized by a prescriber and
trained in the administration of epinephrine to any student believed to be
having an anaphylactic reaction. Such policies shall require that at least one
school nurse, employee of the school board, employee of a local governing body,
or employee of a local health department who is authorized by a prescriber and
trained in the administration of epinephrine has the means to access at all
times during regular school hours any such epinephrine that is stored in a
locked or otherwise generally inaccessible container or area.

D. Each local school board shall adopt and implement policies for the possession
and administration of undesignated stock albuterol inhalers and valved holding
chambers in every public school in the local school division, to be administered
by any school nurse, licensed athletic trainer under contract with a local
school division, employee of the school board, employee of a local governing
body, or employee of a local health department who is authorized by the local
health director and trained in the administration of albuterol inhalers and
valved holding chambers for any student believed in good faith to be in need of
such medication.

E. Any local school board may adopt and implement policies for the possession
and administration of undesignated nasal or injectable glucagon in each public
elementary or secondary school in the local school division, provided that such
policies are consistent with the guidance outlined in the most recent revision
of the Diabetes Management In School: Manual for Unlicensed Personnel published
by the Department and include guidance outlining the following:

   1. One or more locations in each public elementary or secondary school in the
   local school division in which doses of such undesignated glucagon shall be
   stored;

   2. The conditions under which doses of such undesignated glucagon shall be
   stored, replaced, and disposed;

   3. The individuals who are authorized to access and administer doses of such
   undesignated glucagon in an emergency and training requirements for such
   individuals; and

   4. A process for requesting emergency medical services and notifying
   appropriate personnel immediately after a dose of such undesignated glucagon
   is administered.

F. Any public elementary or secondary school may maintain a supply of nasal or
injectable glucagon in any secure location that is immediately accessible to any
school nurse or other employee trained in the administration of nasal and
injectable glucagon prescribed to the school by a prescriber, as defined in
&#xA7; 54.1-3401. Any such school shall ensure that such a supply consists of at
least two doses. Any school nurse or other authorized employee who is trained in
the administration of nasal and injectable glucagon consistent with the guidance
outlined in the most recent revision of the Diabetes Management In School:
Manual for Unlicensed Personnel published by the Department may administer nasal
or injectable glucagon from undesignated inventory with parental consent and if
the student&#8217;s prescribed glucagon is not available on school grounds or
has expired.

G. Any school board may accept donations of nasal or injectable glucagon from a
wholesale distributor of glucagon or donations of money from any individual to
purchase nasal or injectable glucagon for the purpose of maintenance and
administration in a public school in the local school division as permitted
pursuant to subsection F.

H. Any school board may adopt and implement policies:

   1. Permitting any student enrolled in any secondary school in the local school
   division who has a diagnosis of a condition causing seizures to possess
   seizure rescue medications during the school day, at school-sponsored
   activities, or while on a school bus or other school property if (i) the
   student&#8217;s parent has submitted a seizure management and action plan in
   accordance with &#xA7; 22.1-274.6 that includes written consent of the parent
   and written approval of the student&#8217;s primary care provider for such
   self-possession and (ii) the school nurse has been notified of such
   self-possession; or

   2. For the administration of seizure rescue medications to any student
   enrolled in any elementary or secondary school in the local school division
   who has a diagnosis of a condition causing seizures, consistent with the
   provisions of subsection BB of &#xA7; 54.1-3408.

HISTORY: 2000, c. 871; 2005, c. 785; 2012, cc. 787, 833; 2013, cc. 336, 617;
2020, c. 476; 2021, Sp. Sess. I, c. 508; 2023, cc. 183, 569; 2024, c. 466; 2025,
cc. 59, 65.