Bill Text: IL HB3428 | 2023-2024 | 103rd General Assembly | Chaptered

---

Bill Title: Reinserts the contents of the engrossed bill with the following changes. Provides that if there is a shortage of opioid antagonists, a school district, public school, charter school, or nonpublic school shall make a reasonable effort to maintain a supply of an opioid antagonist. Provides that the requirement that a health care professional prescribe opioid antagonists applies only if the school district or school is not able to obtain opioid antagonists without a prescription. Removes provisions concerning annual training and requiring proof of cardiopulmonary resuscitation and automated external defibrillator certification to administer opioid antagonists.

Spectrum: Moderate Partisan Bill (Democrat 14-3)

Status: (Passed) 2023-07-28 - Public Act . . . . . . . . . 103-0348 [HB3428 Detail]

Download: Illinois-2023-HB3428-Chaptered.html

---

Public Act 103-0348
HB3428 Enrolled LRB103 29807 RJT 56214 b
AN ACT concerning education.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The School Code is amended by changing Section
22-30 as follows:
(105 ILCS 5/22-30)
Sec. 22-30. Self-administration and self-carry of asthma
medication and epinephrine injectors; administration of
undesignated epinephrine injectors; administration of an
opioid antagonist; administration of undesignated asthma
medication; asthma episode emergency response protocol.
(a) For the purpose of this Section only, the following
terms shall have the meanings set forth below:
"Asthma action plan" means a written plan developed with a
pupil's medical provider to help control the pupil's asthma.
The goal of an asthma action plan is to reduce or prevent
flare-ups and emergency department visits through day-to-day
management and to serve as a student-specific document to be
referenced in the event of an asthma episode.
"Asthma episode emergency response protocol" means a
procedure to provide assistance to a pupil experiencing
symptoms of wheezing, coughing, shortness of breath, chest
tightness, or breathing difficulty.

"Epinephrine injector" includes an auto-injector approved
by the United States Food and Drug Administration for the
administration of epinephrine and a pre-filled syringe
approved by the United States Food and Drug Administration and
used for the administration of epinephrine that contains a
pre-measured dose of epinephrine that is equivalent to the
dosages used in an auto-injector.
"Asthma medication" means quick-relief asthma medication,
including albuterol or other short-acting bronchodilators,
that is approved by the United States Food and Drug
Administration for the treatment of respiratory distress.
"Asthma medication" includes medication delivered through a
device, including a metered dose inhaler with a reusable or
disposable spacer or a nebulizer with a mouthpiece or mask.
"Opioid antagonist" means a drug that binds to opioid
receptors and blocks or inhibits the effect of opioids acting
on those receptors, including, but not limited to, naloxone
hydrochloride or any other similarly acting drug approved by
the U.S. Food and Drug Administration.
"Respiratory distress" means the perceived or actual
presence of wheezing, coughing, shortness of breath, chest
tightness, breathing difficulty, or any other symptoms
consistent with asthma. Respiratory distress may be
categorized as "mild-to-moderate" or "severe".
"School nurse" means a registered nurse working in a
school with or without licensure endorsed in school nursing.

"Self-administration" means a pupil's discretionary use of
his or her prescribed asthma medication or epinephrine
injector.
"Self-carry" means a pupil's ability to carry his or her
prescribed asthma medication or epinephrine injector.
"Standing protocol" may be issued by (i) a physician
licensed to practice medicine in all its branches, (ii) a
licensed physician assistant with prescriptive authority, or
(iii) a licensed advanced practice registered nurse with
prescriptive authority.
"Trained personnel" means any school employee or volunteer
personnel authorized in Sections 10-22.34, 10-22.34a, and
10-22.34b of this Code who has completed training under
subsection (g) of this Section to recognize and respond to
anaphylaxis, an opioid overdose, or respiratory distress.
"Undesignated asthma medication" means asthma medication
prescribed in the name of a school district, public school,
charter school, or nonpublic school.
"Undesignated epinephrine injector" means an epinephrine
injector prescribed in the name of a school district, public
school, charter school, or nonpublic school.
(b) A school, whether public, charter, or nonpublic, must
permit the self-administration and self-carry of asthma
medication by a pupil with asthma or the self-administration
and self-carry of an epinephrine injector by a pupil, provided
that:

(1) the parents or guardians of the pupil provide to
the school (i) written authorization from the parents or
guardians for (A) the self-administration and self-carry
of asthma medication or (B) the self-carry of asthma
medication or (ii) for (A) the self-administration and
self-carry of an epinephrine injector or (B) the
self-carry of an epinephrine injector, written
authorization from the pupil's physician, physician
assistant, or advanced practice registered nurse; and
(2) the parents or guardians of the pupil provide to
the school (i) the prescription label, which must contain
the name of the asthma medication, the prescribed dosage,
and the time at which or circumstances under which the
asthma medication is to be administered, or (ii) for the
self-administration or self-carry of an epinephrine
injector, a written statement from the pupil's physician,
physician assistant, or advanced practice registered nurse
containing the following information:
(A) the name and purpose of the epinephrine
injector;
(B) the prescribed dosage; and
(C) the time or times at which or the special
circumstances under which the epinephrine injector is
to be administered.
The information provided shall be kept on file in the office of
the school nurse or, in the absence of a school nurse, the

school's administrator.
(b-5) A school district, public school, charter school, or
nonpublic school may authorize the provision of a
student-specific or undesignated epinephrine injector to a
student or any personnel authorized under a student's
Individual Health Care Action Plan, Illinois Food Allergy
Emergency Action Plan and Treatment Authorization Form, or
plan pursuant to Section 504 of the federal Rehabilitation Act
of 1973 to administer an epinephrine injector to the student,
that meets the student's prescription on file.
(b-10) The school district, public school, charter school,
or nonpublic school may authorize a school nurse or trained
personnel to do the following: (i) provide an undesignated
epinephrine injector to a student for self-administration only
or any personnel authorized under a student's Individual
Health Care Action Plan, Illinois Food Allergy Emergency
Action Plan and Treatment Authorization Form, plan pursuant to
Section 504 of the federal Rehabilitation Act of 1973, or
individualized education program plan to administer to the
student that meets the student's prescription on file; (ii)
administer an undesignated epinephrine injector that meets the
prescription on file to any student who has an Individual
Health Care Action Plan, Illinois Food Allergy Emergency
Action Plan and Treatment Authorization Form, plan pursuant to
Section 504 of the federal Rehabilitation Act of 1973, or
individualized education program plan that authorizes the use

of an epinephrine injector; (iii) administer an undesignated
epinephrine injector to any person that the school nurse or
trained personnel in good faith believes is having an
anaphylactic reaction; (iv) administer an opioid antagonist to
any person that the school nurse or trained personnel in good
faith believes is having an opioid overdose; (v) provide
undesignated asthma medication to a student for
self-administration only or to any personnel authorized under
a student's Individual Health Care Action Plan or asthma
action plan, plan pursuant to Section 504 of the federal
Rehabilitation Act of 1973, or individualized education
program plan to administer to the student that meets the
student's prescription on file; (vi) administer undesignated
asthma medication that meets the prescription on file to any
student who has an Individual Health Care Action Plan or
asthma action plan, plan pursuant to Section 504 of the
federal Rehabilitation Act of 1973, or individualized
education program plan that authorizes the use of asthma
medication; and (vii) administer undesignated asthma
medication to any person that the school nurse or trained
personnel believes in good faith is having respiratory
distress.
(c) The school district, public school, charter school, or
nonpublic school must inform the parents or guardians of the
pupil, in writing, that the school district, public school,
charter school, or nonpublic school and its employees and

agents, including a physician, physician assistant, or
advanced practice registered nurse providing standing protocol
and a prescription for school epinephrine injectors, an opioid
antagonist, or undesignated asthma medication, are to incur no
liability or professional discipline, except for willful and
wanton conduct, as a result of any injury arising from the
administration of asthma medication, an epinephrine injector,
or an opioid antagonist regardless of whether authorization
was given by the pupil's parents or guardians or by the pupil's
physician, physician assistant, or advanced practice
registered nurse. The parents or guardians of the pupil must
sign a statement acknowledging that the school district,
public school, charter school, or nonpublic school and its
employees and agents are to incur no liability, except for
willful and wanton conduct, as a result of any injury arising
from the administration of asthma medication, an epinephrine
injector, or an opioid antagonist regardless of whether
authorization was given by the pupil's parents or guardians or
by the pupil's physician, physician assistant, or advanced
practice registered nurse and that the parents or guardians
must indemnify and hold harmless the school district, public
school, charter school, or nonpublic school and its employees
and agents against any claims, except a claim based on willful
and wanton conduct, arising out of the administration of
asthma medication, an epinephrine injector, or an opioid
antagonist regardless of whether authorization was given by

the pupil's parents or guardians or by the pupil's physician,
physician assistant, or advanced practice registered nurse.
(c-5) When a school nurse or trained personnel administers
an undesignated epinephrine injector to a person whom the
school nurse or trained personnel in good faith believes is
having an anaphylactic reaction, administers an opioid
antagonist to a person whom the school nurse or trained
personnel in good faith believes is having an opioid overdose,
or administers undesignated asthma medication to a person whom
the school nurse or trained personnel in good faith believes
is having respiratory distress, notwithstanding the lack of
notice to the parents or guardians of the pupil or the absence
of the parents or guardians signed statement acknowledging no
liability, except for willful and wanton conduct, the school
district, public school, charter school, or nonpublic school
and its employees and agents, and a physician, a physician
assistant, or an advanced practice registered nurse providing
standing protocol and a prescription for undesignated
epinephrine injectors, an opioid antagonist, or undesignated
asthma medication, are to incur no liability or professional
discipline, except for willful and wanton conduct, as a result
of any injury arising from the use of an undesignated
epinephrine injector, the use of an opioid antagonist, or the
use of undesignated asthma medication, regardless of whether
authorization was given by the pupil's parents or guardians or
by the pupil's physician, physician assistant, or advanced

practice registered nurse.
(d) The permission for self-administration and self-carry
of asthma medication or the self-administration and self-carry
of an epinephrine injector is effective for the school year
for which it is granted and shall be renewed each subsequent
school year upon fulfillment of the requirements of this
Section.
(e) Provided that the requirements of this Section are
fulfilled, a pupil with asthma may self-administer and
self-carry his or her asthma medication or a pupil may
self-administer and self-carry an epinephrine injector (i)
while in school, (ii) while at a school-sponsored activity,
(iii) while under the supervision of school personnel, or (iv)
before or after normal school activities, such as while in
before-school or after-school care on school-operated property
or while being transported on a school bus.
(e-5) Provided that the requirements of this Section are
fulfilled, a school nurse or trained personnel may administer
an undesignated epinephrine injector to any person whom the
school nurse or trained personnel in good faith believes to be
having an anaphylactic reaction (i) while in school, (ii)
while at a school-sponsored activity, (iii) while under the
supervision of school personnel, or (iv) before or after
normal school activities, such as while in before-school or
after-school care on school-operated property or while being
transported on a school bus. A school nurse or trained

personnel may carry undesignated epinephrine injectors on his
or her person while in school or at a school-sponsored
activity.
(e-10) Provided that the requirements of this Section are
fulfilled, a school nurse or trained personnel may administer
an opioid antagonist to any person whom the school nurse or
trained personnel in good faith believes to be having an
opioid overdose (i) while in school, (ii) while at a
school-sponsored activity, (iii) while under the supervision
of school personnel, or (iv) before or after normal school
activities, such as while in before-school or after-school
care on school-operated property. A school nurse or trained
personnel may carry an opioid antagonist on his or her person
while in school or at a school-sponsored activity.
(e-15) If the requirements of this Section are met, a
school nurse or trained personnel may administer undesignated
asthma medication to any person whom the school nurse or
trained personnel in good faith believes to be experiencing
respiratory distress (i) while in school, (ii) while at a
school-sponsored activity, (iii) while under the supervision
of school personnel, or (iv) before or after normal school
activities, including before-school or after-school care on
school-operated property. A school nurse or trained personnel
may carry undesignated asthma medication on his or her person
while in school or at a school-sponsored activity.
(f) The school district, public school, charter school, or

nonpublic school may maintain a supply of undesignated
epinephrine injectors in any secure location that is
accessible before, during, and after school where an allergic
person is most at risk, including, but not limited to,
classrooms and lunchrooms. A physician, a physician assistant
who has prescriptive authority in accordance with Section 7.5
of the Physician Assistant Practice Act of 1987, or an
advanced practice registered nurse who has prescriptive
authority in accordance with Section 65-40 of the Nurse
Practice Act may prescribe undesignated epinephrine injectors
in the name of the school district, public school, charter
school, or nonpublic school to be maintained for use when
necessary. Any supply of epinephrine injectors shall be
maintained in accordance with the manufacturer's instructions.
The school district, public school, charter school, or
nonpublic school shall may maintain a supply of an opioid
antagonist in any secure location where an individual may have
an opioid overdose, unless there is a shortage of opioid
antagonists, in which case the school district, public school,
charter school, or nonpublic school shall make a reasonable
effort to maintain a supply of an opioid antagonist. Unless
the school district, public school, charter school, or
nonpublic school is able to obtain opioid antagonists without
a prescription, a A health care professional who has been
delegated prescriptive authority for opioid antagonists in
accordance with Section 5-23 of the Substance Use Disorder Act

shall may prescribe opioid antagonists in the name of the
school district, public school, charter school, or nonpublic
school, to be maintained for use when necessary. Any supply of
opioid antagonists shall be maintained in accordance with the
manufacturer's instructions.
The school district, public school, charter school, or
nonpublic school may maintain a supply of asthma medication in
any secure location that is accessible before, during, or
after school where a person is most at risk, including, but not
limited to, a classroom or the nurse's office. A physician, a
physician assistant who has prescriptive authority under
Section 7.5 of the Physician Assistant Practice Act of 1987,
or an advanced practice registered nurse who has prescriptive
authority under Section 65-40 of the Nurse Practice Act may
prescribe undesignated asthma medication in the name of the
school district, public school, charter school, or nonpublic
school to be maintained for use when necessary. Any supply of
undesignated asthma medication must be maintained in
accordance with the manufacturer's instructions.
(f-3) Whichever entity initiates the process of obtaining
undesignated epinephrine injectors and providing training to
personnel for carrying and administering undesignated
epinephrine injectors shall pay for the costs of the
undesignated epinephrine injectors.
(f-5) Upon any administration of an epinephrine injector,
a school district, public school, charter school, or nonpublic

school must immediately activate the EMS system and notify the
student's parent, guardian, or emergency contact, if known.
Upon any administration of an opioid antagonist, a school
district, public school, charter school, or nonpublic school
must immediately activate the EMS system and notify the
student's parent, guardian, or emergency contact, if known.
(f-10) Within 24 hours of the administration of an
undesignated epinephrine injector, a school district, public
school, charter school, or nonpublic school must notify the
physician, physician assistant, or advanced practice
registered nurse who provided the standing protocol and a
prescription for the undesignated epinephrine injector of its
use.
Within 24 hours after the administration of an opioid
antagonist, a school district, public school, charter school,
or nonpublic school must notify the health care professional
who provided the prescription for the opioid antagonist of its
use.
Within 24 hours after the administration of undesignated
asthma medication, a school district, public school, charter
school, or nonpublic school must notify the student's parent
or guardian or emergency contact, if known, and the physician,
physician assistant, or advanced practice registered nurse who
provided the standing protocol and a prescription for the
undesignated asthma medication of its use. The district or
school must follow up with the school nurse, if available, and

may, with the consent of the child's parent or guardian,
notify the child's health care provider of record, as
determined under this Section, of its use.
(g) Prior to the administration of an undesignated
epinephrine injector, trained personnel must submit to the
school's administration proof of completion of a training
curriculum to recognize and respond to anaphylaxis that meets
the requirements of subsection (h) of this Section. Training
must be completed annually. The school district, public
school, charter school, or nonpublic school must maintain
records related to the training curriculum and trained
personnel.
Prior to the administration of an opioid antagonist,
trained personnel must submit to the school's administration
proof of completion of a training curriculum to recognize and
respond to an opioid overdose, which curriculum must meet the
requirements of subsection (h-5) of this Section. Training
must be completed annually. Trained personnel must also submit
to the school's administration proof of cardiopulmonary
resuscitation and automated external defibrillator
certification. The school district, public school, charter
school, or nonpublic school must maintain records relating to
the training curriculum and the trained personnel.
Prior to the administration of undesignated asthma
medication, trained personnel must submit to the school's
administration proof of completion of a training curriculum to

recognize and respond to respiratory distress, which must meet
the requirements of subsection (h-10) of this Section.
Training must be completed annually, and the school district,
public school, charter school, or nonpublic school must
maintain records relating to the training curriculum and the
trained personnel.
(h) A training curriculum to recognize and respond to
anaphylaxis, including the administration of an undesignated
epinephrine injector, may be conducted online or in person.
Training shall include, but is not limited to:
(1) how to recognize signs and symptoms of an allergic
reaction, including anaphylaxis;
(2) how to administer an epinephrine injector; and
(3) a test demonstrating competency of the knowledge
required to recognize anaphylaxis and administer an
epinephrine injector.
Training may also include, but is not limited to:
(A) a review of high-risk areas within a school and
its related facilities;
(B) steps to take to prevent exposure to allergens;
(C) emergency follow-up procedures, including the
importance of calling 9-1-1 or, if 9-1-1 is not available,
other local emergency medical services;
(D) how to respond to a student with a known allergy,
as well as a student with a previously unknown allergy;
(E) other criteria as determined in rules adopted

pursuant to this Section; and
(F) any policy developed by the State Board of
Education under Section 2-3.190.
In consultation with statewide professional organizations
representing physicians licensed to practice medicine in all
of its branches, registered nurses, and school nurses, the
State Board of Education shall make available resource
materials consistent with criteria in this subsection (h) for
educating trained personnel to recognize and respond to
anaphylaxis. The State Board may take into consideration the
curriculum on this subject developed by other states, as well
as any other curricular materials suggested by medical experts
and other groups that work on life-threatening allergy issues.
The State Board is not required to create new resource
materials. The State Board shall make these resource materials
available on its Internet website.
(h-5) A training curriculum to recognize and respond to an
opioid overdose, including the administration of an opioid
antagonist, may be conducted online or in person. The training
must comply with any training requirements under Section 5-23
of the Substance Use Disorder Act and the corresponding rules.
It must include, but is not limited to:
(1) how to recognize symptoms of an opioid overdose;
(2) information on drug overdose prevention and
recognition;
(3) how to perform rescue breathing and resuscitation;

(4) how to respond to an emergency involving an opioid
overdose;
(5) opioid antagonist dosage and administration;
(6) the importance of calling 9-1-1 or, if 9-1-1 is
not available, other local emergency medical services;
(7) care for the overdose victim after administration
of the overdose antagonist;
(8) a test demonstrating competency of the knowledge
required to recognize an opioid overdose and administer a
dose of an opioid antagonist; and
(9) other criteria as determined in rules adopted
pursuant to this Section.
(h-10) A training curriculum to recognize and respond to
respiratory distress, including the administration of
undesignated asthma medication, may be conducted online or in
person. The training must include, but is not limited to:
(1) how to recognize symptoms of respiratory distress
and how to distinguish respiratory distress from
anaphylaxis;
(2) how to respond to an emergency involving
respiratory distress;
(3) asthma medication dosage and administration;
(4) the importance of calling 9-1-1 or, if 9-1-1 is
not available, other local emergency medical services;
(5) a test demonstrating competency of the knowledge
required to recognize respiratory distress and administer

asthma medication; and
(6) other criteria as determined in rules adopted
under this Section.
(i) Within 3 days after the administration of an
undesignated epinephrine injector by a school nurse, trained
personnel, or a student at a school or school-sponsored
activity, the school must report to the State Board of
Education in a form and manner prescribed by the State Board
the following information:
(1) age and type of person receiving epinephrine
(student, staff, visitor);
(2) any previously known diagnosis of a severe
allergy;
(3) trigger that precipitated allergic episode;
(4) location where symptoms developed;
(5) number of doses administered;
(6) type of person administering epinephrine (school
nurse, trained personnel, student); and
(7) any other information required by the State Board.
If a school district, public school, charter school, or
nonpublic school maintains or has an independent contractor
providing transportation to students who maintains a supply of
undesignated epinephrine injectors, then the school district,
public school, charter school, or nonpublic school must report
that information to the State Board of Education upon adoption
or change of the policy of the school district, public school,

charter school, nonpublic school, or independent contractor,
in a manner as prescribed by the State Board. The report must
include the number of undesignated epinephrine injectors in
supply.
(i-5) Within 3 days after the administration of an opioid
antagonist by a school nurse or trained personnel, the school
must report to the State Board of Education, in a form and
manner prescribed by the State Board, the following
information:
(1) the age and type of person receiving the opioid
antagonist (student, staff, or visitor);
(2) the location where symptoms developed;
(3) the type of person administering the opioid
antagonist (school nurse or trained personnel); and
(4) any other information required by the State Board.
(i-10) Within 3 days after the administration of
undesignated asthma medication by a school nurse, trained
personnel, or a student at a school or school-sponsored
activity, the school must report to the State Board of
Education, on a form and in a manner prescribed by the State
Board of Education, the following information:
(1) the age and type of person receiving the asthma
medication (student, staff, or visitor);
(2) any previously known diagnosis of asthma for the
person;
(3) the trigger that precipitated respiratory

distress, if identifiable;
(4) the location of where the symptoms developed;
(5) the number of doses administered;
(6) the type of person administering the asthma
medication (school nurse, trained personnel, or student);
(7) the outcome of the asthma medication
administration; and
(8) any other information required by the State Board.
(j) By October 1, 2015 and every year thereafter, the
State Board of Education shall submit a report to the General
Assembly identifying the frequency and circumstances of
undesignated epinephrine and undesignated asthma medication
administration during the preceding academic year. Beginning
with the 2017 report, the report shall also contain
information on which school districts, public schools, charter
schools, and nonpublic schools maintain or have independent
contractors providing transportation to students who maintain
a supply of undesignated epinephrine injectors. This report
shall be published on the State Board's Internet website on
the date the report is delivered to the General Assembly.
(j-5) Annually, each school district, public school,
charter school, or nonpublic school shall request an asthma
action plan from the parents or guardians of a pupil with
asthma. If provided, the asthma action plan must be kept on
file in the office of the school nurse or, in the absence of a
school nurse, the school administrator. Copies of the asthma

action plan may be distributed to appropriate school staff who
interact with the pupil on a regular basis, and, if
applicable, may be attached to the pupil's federal Section 504
plan or individualized education program plan.
(j-10) To assist schools with emergency response
procedures for asthma, the State Board of Education, in
consultation with statewide professional organizations with
expertise in asthma management and a statewide organization
representing school administrators, shall develop a model
asthma episode emergency response protocol before September 1,
2016. Each school district, charter school, and nonpublic
school shall adopt an asthma episode emergency response
protocol before January 1, 2017 that includes all of the
components of the State Board's model protocol.
(j-15) Every 2 years, school personnel who work with
pupils shall complete an in-person or online training program
on the management of asthma, the prevention of asthma
symptoms, and emergency response in the school setting. In
consultation with statewide professional organizations with
expertise in asthma management, the State Board of Education
shall make available resource materials for educating school
personnel about asthma and emergency response in the school
setting.
(j-20) On or before October 1, 2016 and every year
thereafter, the State Board of Education shall submit a report
to the General Assembly and the Department of Public Health

identifying the frequency and circumstances of opioid
antagonist administration during the preceding academic year.
This report shall be published on the State Board's Internet
website on the date the report is delivered to the General
Assembly.
(k) The State Board of Education may adopt rules necessary
to implement this Section.
(l) Nothing in this Section shall limit the amount of
epinephrine injectors that any type of school or student may
carry or maintain a supply of.
(Source: P.A. 101-81, eff. 7-12-19; 102-413, eff. 8-20-21;
102-813, eff. 5-13-22.)