BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1937
                                                                  Page  1


          ASSEMBLY THIRD READING
          AB 1937 (Fletcher)
          As Amended April 28, 2010
          Majority vote 

           BUSINESS & PROFESSIONS    11-0                                  
           
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          |Ayes:|Hayashi, Emmerson,        |     |                          |
          |     |Conway, Eng, Hernandez,   |     |                          |
          |     |Hill, Ma, Nava, Niello,   |     |                          |
          |     |Ruskin, Smyth             |     |                          |
          |     |                          |     |                          |
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           SUMMARY  :  Expands the individuals who are authorized to  
          administer school immunizations, as specified.  Specifically,  
           this bill  :  

          1)Authorizes the governing board (board) of a school district to  
            allow the following individuals, acting under the direction of  
            a supervising physician and surgeon (SPS), to administer  
            certain immunizations to a pupil whose parent or guardian has  
            consented in writing:

             a)   A physician assistant (PA);

             b)   A nurse practitioner (NP);

             c)   A registered nurse (RN);

             d)   A licensed nurse (LN); or, 

             e)   A student nurse (SN) acting under the supervision of a  
               registered nurse as authorized under current law.

          2)Permits the authorized individuals to perform immunizations as  
            part of a school immunization program if:

             a)   The administration of an immunizing agent is upon the  
               standing orders of a SPS and in accordance with any written  
               regulations adopted by the State Department of Public  
               Health; and,

             b)   The school nurse is notified and he or she maintains  








                                                                  AB 1937
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               control, as specified.

          3)Requires the SPS to require the PA, NP, RN, LN, or SN to:

             a)   Satisfactorily demonstrate competence in the  
               administration of the immunizing agent,  including  
               knowledge of all indications and contraindications for the  
               administration of the agent, and the recognition and  
               treatment of emergency reactions to the agent that   
               constitute a danger to the health or life of the person  
               receiving the immunization; and, 

             b)   Possess the medications and equipment that are required,  
               in the medical judgment of the SPS, to treat any emergency  
               conditions or reactions caused by the immunizing agents  
               that constitute a danger to the health or life of the  
               person receiving the immunization, and to demonstrate the  
               ability to administer the medications and use the equipment  
               as necessary.

          4)Authorizes the PA, NP, RN, LN, or SN to administer, as  
            specified, an immunization agent that controls the following:

             a)   Annual seasonal influenza;

             b)   Influenza pandemic episodes; and,

             c)   Other diseases that represent a current or potential  
               outbreak, as declared by a local, state, or federal public  
               health officer.  

          5)Declares legislative intent.

          6)Defines "SPS" as the physician and surgeon of the local health  
            department or school district that is directing the school  
            immunization program.

           FISCAL EFFECT  :  Unknown.  This bill is keyed non-fiscal by the  
          Legislative Counsel.

           COMMENTS  :  According to the author's office, "This proposed  
          legislation would allow school districts to 'voluntarily' add  
          additional medical personnel, currently permitted to administer  
          vaccinations, in order to implement a school based immunization  








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          program.  Further, this would supplement the work of a school  
          nurse by permitting more licensed medical personnel to assist  
          with the administering of vaccines during a school based  
          immunization program.  As a result, there is the potential for  
          more children to be immunized or allow multiple programs to be  
          held on a single day with increased qualified healthcare staff."

          Current law requires a board to cooperate with the local health  
          officer to help prevent and control communicable diseases in  
          school age children.  California Education Code permits only a  
          licensed physician and surgeon or a licensed RN acting under the  
          direction of a SPS to administer immunizations to pupils.   
          However, California Business and Professions Code authorizes a  
          greater number of individuals to administer vaccinations  
          according to their scopes of practice, in addition to a  
          physician and surgeon and a RN.  Under varying circumstances,  
          the following individuals may administer immunizations:   
          physicians and surgeons, NPs, PAs, RNs, LVNs, MAs, pharmacists,  
          and paramedics.  This bill would more closely reconcile the two  
          codes relating to health professionals' practice scopes.  

          The California School Immunization Law (CSIL) requires that  
          children receive a series of immunizations before entry to  
          schools, child care centers, or family child care homes.  In  
          addition, CSIL requires schools, child care centers, and family  
          child care homes to enforce immunization requirements, to  
          maintain immunization records of all children enrolled, and to  
          submit reports to the health department.
           

          Analysis Prepared by  :    Sarah Weaver / B., P. & C. P. / (916)  
          319-3301 

                                                                FN: 0004142