BILL ANALYSIS Ó
SENATE HEALTH
COMMITTEE ANALYSIS
Senator Ed Hernandez, O.D., Chair
BILL NO: SB 161
S
AUTHOR: Huff
B
AMENDED: March 9, 2011
HEARING DATE: April 6, 2011
1
CONSULTANT:
6
Trueworthy
1
SUBJECT
Schools: emergency medical assistance: administration of
epilepsy medication
SUMMARY
This bill would allow non-medical school personnel who
undergo voluntary training to administer the drug Diastat
to a pupil suffering an epileptic seizure.
CHANGES TO EXISTING LAW
Existing federal law:
The Americans with Disabilities Act of 1990 prohibits
discrimination on the basis of disability by employers,
public accommodations, state and local governments, public
and private transportation, and in telecommunications.
The Individuals with Disabilities Education Act (IDEA)
governs Individualized Educational Programs (IEPs) and the
special education process. IDEA guarantees children with
disabilities a "free appropriate public education" (FAPE)
in the least restrictive environment (LRE).
Section 504 of the Rehabilitation Act of 1973 (Section 504)
provides federal financial assistance to state and local
education agencies to guarantee special education and
Continued---
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related services to eligible children with disabilities.
Requires school districts to provide FAPE to each qualified
person with a disability who is in the school district's
jurisdiction, regardless of the nature or severity of the
person's disability, which includes reasonable
accommodations required for the management of chronic
medical conditions.
Existing state law:
Requires the governing board of any school district to give
diligent care to the health and physical development of
students, which may include employing properly certified
persons.
Provides that each student who is required to take
prescribed medication by a physician, may be assisted by
the school nurse or other designated school personnel if
the school district receives a written statement from the
physician detailing the method, amount, and time schedules
by which the medication is to be taken, and a written
statement from the parent or guardian of the student,
indicating the desire that the school district assist the
pupil in the matters set forth in the physician's
statement.
Provides that no school district, officer of any school
district, school principal, physician, or hospital treating
a student shall be held liable for the reasonable treatment
of a child without the consent of a parent or guardian,
when the child is ill or injured during regular school
hours, requires reasonable medical treatment, and the
parent or guardian cannot be reached, unless the parent or
guardian has previously filed with the school district a
written objection to any medical treatment other than first
aid.
Authorizes non-medical school personnel to administer the
following medication to a student in an emergency, after
receiving specified training:
Emergency epinephrine auto-injectors. A
prescription for an auto-injector for a specific
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student is not required; the prescription is for the
school.
Glucagon may be administered to students with
diabetes suffering from severe hypoglycemia in the
absence of a credentialed school nurse or other
licensed nurse onsite at the school.
Authorizes non-medical school personnel to assist or
administer medication to a student on a routine,
non-emergency basis the following:
Assisting in the administration of prescribed
medication, or in the self-administration of
prescription auto-injectable epinephrine.
Assisting in administration of prescribed
medication or in the self-administration of
prescription inhaled asthma medication.
Assisting if the health care provider gives a
written statement with specific information, such as
the medication the pupil is to take, the dosage, and
the period of time during which the medication is to
be taken, and if the parent provides a written
statement initiating a request to have the medication
administered or otherwise assisted in the
administration of the medication.
Sets forth the scope of practice for nursing through the
Nursing Practice Act, which includes the administration of
medication, and prohibits any person from engaging in the
practice of nursing without a license.
This bill:
Makes various legislative findings and declarations,
including the declaration that whenever possible, Diastat
should be administered by a school nurse who has been
trained in its administration.
Authorizes a school district to provide school employees
with voluntary medical training to provide emergency
medical assistance to students suffering from an epileptic
seizure.
Requires a school employee with voluntary emergency medical
training to provide this emergency medical assistance in
accordance with guidelines that the Epilepsy Foundation of
America is encouraged to develop.
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The guidelines may be developed in coordination
with the State Department of Education, the California
Nurses Organization, the California Medical
Association, and the American Academy of Pediatrics.
Prohibits a school employee, who does not volunteer or who
has not been trained, from being required to provide
emergency medical assistance.
Authorizes a parent or guardian of a pupil with epilepsy
who has been prescribed Diastat to request the school have
one or more of its employees receive training in the
administration of Diastat.
Requires, upon receipt of the parent's or guardian's
request, the school to notify the parent or guardian that
his or her child may qualify for services or
accommodations, pursuant to Section 504. Requires the
school to assist in the exploration of that option.
Authorizes a school to ask the parent or guardian to sign a
notice verifying they were given information about Section
504 and they understand it is their right to request a
Section 504 plan at any time.
Authorizes a school to create an individualized health
plan, seizure action plan, or other appropriate health plan
designed to acknowledge and prepare for the child's health
care needs in school if the parent chooses to not have the
pupil assessed for a Section 504 plan. The plan may include
the involvement of trained volunteer school employees.
Authorizes a school that decides to train voluntary school
employees to distribute an electronic notice to all staff
that states all of the following:
1. The notice is a request for volunteers to
administer Diastat to a pupil experiencing a severe
epileptic seizure, in the absence of a school nurse.
2. Diastat is an FDA-approved, pre-dosed,
rectally-administered gel that reduces the severity of
epileptic seizures.
3. A volunteer will receive training from a licensed
health professional regarding the administration of
Diastat.
4. Any agreement by an employee to administer Diastat
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is voluntary, and no employee of the school or
district shall directly or indirectly use or attempt
to use his or her authority or influence for the
purpose of intimidating, threatening, coercing, or
attempting to intimidate, threaten, or coerce, any
staff member who does not choose to volunteer.
Requires a school to re-notify the pupil's parent or
guardian of the Section 504 options if there are no
volunteers.
Encourages the Epilepsy Foundation to develop guidelines
for training and supervision.
Requires a school that chooses to train school employees to
have in place a school plan that includes:
1. Identification of existing licensed staff within
the district or region who could be trained in the
administration of Diastat and could be available to
respond to an emergency need to administer Diastat.
2. Identification of pupils who may require the
administration of Diastat.
3. Written authorization from the parent or guardian
for a non-medical school employee to administer
Diastat.
4. A requirement that the parent or guardian notify
the school if the pupil has had Diastat administered
within the past four hours on a school day.
5. Notification to the parent or guardian that Diastat
has been administered.
6. A written statement from the pupil's health care
practitioner that shall include all of the following:
a) The pupil's name.
b) The name and purpose of the medication.
c) The prescribed dosage.
d) Detailed seizure symptoms, including
frequency, type, or length of seizures that
identify when the administration of Diastat
becomes necessary.
e) The method of administration.
f) The frequency with which the medication
may be administered.
g) The circumstances under which the
medication may be administered.
h) Any potential adverse responses by the
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pupil and recommended actions, including when to
call emergency services.
i) A protocol for observing the pupil after
a seizure.
Requires a school to compensate a volunteer when the
administration of Diastat and subsequent monitoring of a
pupil requires the person to work beyond his or her
normally scheduled hours.
Requires the training to include the following:
1. Recognition and treatment of different types of
seizures.
2. Administration of Diastat.
3. Basic emergency follow-up procedures including,
calling 911 and contacting the pupil's parent or
guardian.
4. Techniques and procedures to ensure pupil privacy.
Requires training to be conducted by one or more of the
following:
1. A physician and surgeon.
2. A physician and surgeon's assistant.
3. A credentialed school nurse.
4. A registered nurse.
5. A certificated public health nurse.
Deems training provided in accordance with the
manufacturer's instructions, the pupil's health care
provider's instructions and guidelines as adequate
training.
Requires a school employee to notify the credentialed
school nurse assigned to the school district if Diastat is
administered. If a credentialed school nurse is not
assigned to the school district, the school employee shall
notify the superintendent of the school district, or his or
her designee.
Requires a school to retain all records relating to the
administration of Diastat.
Requires the pupil's parent or guardian to provide all
materials necessary to administer Diastat.
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Defines "Diastat" as a diazepam rectal gel, marketed as
Diastat AcuDial, approved by the federal Food and Drug
Administration for patients with epilepsy for the
management of seizures.
Sunsets the provisions of this bill on January 1, 2017,
FISCAL IMPACT
This bill has not been analyzed by a fiscal committee.
BACKGROUND AND DISCUSSION
According to the author, uncontrolled seizures can damage a
child's developing brain and can impact academic
performance, memory, learning, and result in
social-emotional challenges. Some children with epilepsy
are susceptible to prolonged seizures and require access to
a life-saving emergency medication. Diastat Acudial, a
pre-dosed preparation of diazepam gel, is the standard
out-of-hospital treatment for prolonged seizures. Diastat
is a FDA-approved emergency medication and is a safe and
effective treatment, specifically designed to be
administered by people without medical training.
The author states that for over 10 years it was common in
California schools to have nurses, or where unavailable,
trained non-medical personnel to administer the
doctor-prescribed Diastat in an emergency situation to a
student when suffering a severe, possibly life-threatening
seizure. In October 2009, however, a nursing education
consultant to the Board of Registered Nursing (BRN) advised
that there is no provision in the Nursing Practice Act for
unlicensed school personnel to administer Diastat. The BRN
has further stated that absent an authorizing statute,
school nurses cannot train or supervise unlicensed
personnel to administer Diastat. As a consequence, nurses
are refusing to train school personnel, and schools are
reluctant to have staff, even those already trained,
administer Diastat. Some schools are telling parents they
must be available to come to the school to administer
Diastat or are calling 911 in an emergency. The author
contends that either of these solutions results in delays
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in treatment that places the child in danger of serious
injury, or worse. SB 161 will allow schools to provide the
fastest, safest and most effective way of protecting the
health and safety of children with epilepsy in schools.
Epilepsy background and statistics
Epilepsy is defined as a chronic neurological condition in
which the individual is susceptible to several seizures. A
seizure is a sudden, temporary interruption of the normal
electrical/chemical activity in the brain, resulting in a
change in sensation, awareness or behavior. A seizure can
range from a brief disruption of senses, muscle spasms, or
odd sensations to short periods of unconsciousness and
convulsions. Currently there is no known cure for epilepsy.
Epilepsy is a complex condition and there are many types of
seizures associated with epilepsy. The type of seizure a
person has depends on a variety of things, such as the part
of the brain affected and the underlying cause of the
seizure. The type of medicine individuals with epilepsy
take depends on the type of seizures.
Almost 3 million people in the U.S. have some form of
epilepsy. About 200,000 new cases of seizure disorders and
epilepsy are diagnosed each year. According to the
Epilepsy Foundation, as many as 325,000 school-age
children, ages 5-14, have epilepsy. Epilepsy affects over
90,000 children across California.
Diastat
Diastat --diazepam rectal gel and its trademark
administration system-- was first approved for use by the
FDA in the United States in 1997 as a treatment for
breakthrough seizures in adults and children 2 years old
and over. This is the only FDA-approved, at-home
medication for the treatment of cluster seizures. Diastat
was specifically developed to be administered by people
without medical training and is considered the fastest,
safest and most effective way to address epileptic
seizures. It is often prescribed for people who have
experienced acute repetitive seizures, or "cluster"
seizures. Dosages are determined on an individual basis,
depending upon the condition to be treated, the severity of
symptoms, the body weight of the patient, and any
comorbidity conditions the patient may have.
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Diastat is intended to be kept handy so that a caregiver
can attempt to stop the seizures by administering the drug
relatively quickly. Diastat is a gel formulation of
Diazepam (valium) that is administered rectally. The
delivery system includes a plastic applicator with a
flexible, molded tip and is provided in fixed unit-doses of
5, 10, 15 and 20 mg. A pharmacist simply dials the syringe
to the physician's prescribed dosage before it is dispensed
to the patient.
The most common side effect is sleepiness. Other less
frequent side effects include skin rash, dizziness, pain,
headache, stuffy nose, abdominal pain, nervousness,
diarrhea, feeling unsteady or clumsy, and wheezing.
Most seizure patients, no matter how well-managed through
maintenance medication, will likely experience breakthrough
seizures throughout their lifetime. Possibly as many as 35
percent of patients on anti-seizure medications may not be
adequately controlled. Between 50,000 and 200,000
generalized convulsive status epilepticus seizures occur
every year in the United States, with an overall mortality
rate of 20 percent. Additional statistics show that status
seizures lasting more than one hour have a mortality rate
of 32 percent, compared with 2.7 percent for seizures of
shorter duration.
Health care needs in schools
In classrooms throughout California, there are numerous
children with special medical needs, including gastronomy
feeding tubes, oxygen administration, tracheal suctioning
and monitoring for seizures. California's nurse-to-pupil
ratio is approximately 1:2,200. According to the
California Basic Educational Data System (CBEDS), about
one-half of school districts do not have a school nurse.
Federal laws and 504 plans
Two federal anti-discrimination statutes, Section 504 of
the Rehabilitation Act of 1973 (Section 504) and Title II
of the Americans with Disabilities Act of 1990 (ADA),
together establish rights for eligible students in
California's public schools. They serve to protect students
from discrimination based upon their disability. In
general, a student will be determined to have a disability
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under Section 504 if he/she has a mental or physical
impairment that substantially limits one or more major life
activities, such as eating, breathing, caring for oneself,
performing manual tasks, hearing, speaking, walking, and
learning.
Section 504 requires school districts to provide FAPE to
each qualified pupil, regardless of the nature or severity
of the disability. An appropriate education may comprise of
education in regular classes, education in regular classes
with the use of related aids and services, or special
education and related services in separate classrooms for
all or portions of the school day.
A "504 plan" differs from an individualized education
program (IEP) in that an IEP provides for specialized
instruction while a 504 plan provides for accommodation due
to a physical or mental impairment that does not require
specialized instruction.
The Nursing Practice Act and the Bureau of Registered
Nursing (BRN)
The Nursing Practice Act (NPA) specifies that medication
administration is a nursing function that may not be
performed by unlicensed personnel unless expressly
authorized by statute.
The BRN has issued a legal opinion stating the NPA does not
permit unlicensed school personnel to administer Diastat
and the administration of Diastat constitutes the practice
of nursing. The legal opinion further states that the NPA
does not permit a nurse to train unlicensed school
personnel knowing that the purpose for the training is to
enable the administration of Diastat.
Exceptions to the Nursing Practices Act
Current law authorizes non-medical school personnel to
administer emergency epinephrine auto-injectors in an
emergency after receiving specified training. Current law
also allows Glucagon to be administered to students with
diabetes suffering from severe hypoglycemia in the absence
of a credentialed school nurse or other licensed nurse
onsite at the school.
The NPA does not prohibit nursing services in the case of
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an emergency.
Lawsuit specific to the administration of insulin.
In 2005, the American Diabetes Association (ADA) sued the
State of California (K.C., et al. vs. Jack O'Connell, et
al) asking the court to compel public school officials to
comply with federal law by providing the assistance that
California students with diabetes require to manage their
diabetes during the school day. The California Department
of Education (CDE) entered into a settlement with them and,
as a part of the settlement, CDE issued a legal advisory
that declared unlicensed but adequately trained school
employees may administer insulin under the treating
physician's orders and in accordance with the student's
Section 504 Plan or IEP, in the absence of available
licensed health care professionals.
Several nursing groups sued to overturn this portion of the
legal advisory (American Nurses Assoc. v. Jack O'Connell),
and in November 2008, a trial court judge ruled in their
favor. Following the court ruling, ADA and CDE filed an
appeal of the court ruling, and in April 2009, a California
Court of Appeals ruled that the lower court's ruling is
"stayed" during the appeal. While this is not a decision on
the merits of the case, it does mean that the lower court's
ruling has no effect until the appeal is decided.
Therefore, the CDE may continue to advise districts that
non-medical school personnel are authorized to administer
insulin.
Related bills
SB 65 (Strickland) would authorize any pupil who has been
diagnosed with cystic fibrosis and is required to take,
during the regular school day, medication prescribed for
him or her by a physician or surgeon, to be assisted by the
school nurse or other designated school personnel, or may
carry and self-administer prescription pancreatic enzymes
if the school district receives specified written
statements. SB 65 is pending before the Senate Education
Committee.
Prior legislation
SB 1051 (Huff) of 2010 was very similar to this bill. SB
1051 was held on the Senate Appropriations Committee's
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suspense file.
AB 1802 (Hall) of 2010 would authorize a parent or guardian
of a pupil with diabetes
to designate one or more school employees as
parent-designated school employees for the purpose of
administering insulin to the pupil as necessary during the
regular school day when a credentialed school nurse or
other health care professional is not immediately available
onsite at the school. Failed passage in Assembly Business,
Professions, and Consumer Protection Committee.
SB 1200 (Leno) of 2010 would have required the Department
of Managed Health Care and the Insurance Commissioner to
develop regulations to ensure timeliness of care for school
age children who must receive medically necessary services
during school hours. Failed passage in the Assembly
Appropriations Committee.
AB 2454 (Torlakson) of 2010 would have required the
governing board of a school district to employ at least one
school nurse, registered nurse, or licensed vocational
nurse for every 750 pupils on and after July 1, 2020. The
bill would have required registered nurses and licensed
vocational nurses to provide health care services to pupils
under the supervision of a school nurse. Failed passage in
Assembly Appropriations Committee.
AB 1430 (Swanson) of 2009 would have required, with certain
exceptions, that any medication that is administered to a
pupil who is required to take, during the regular school
day, medication prescribed for him or her by a physician or
surgeon be administered by a health care professional
operating within the scope of his or her
practice. Failed passage in Assembly Business and
Professions Committee.
AB 426 (Hall) of 2009 would have required the Department of
Education, in consultation with specified entities, to
recommend to the Legislature ways to address specific
health-related needs of pupils on school campuses,
including but not limited to, diabetes, asthma and
obesity-related diseases. AB 426 was never heard.
AB 942 (Leno) Chapter 684, Statutes of 2003, authorizes
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each school district to provide voluntary emergency medical
training to school personnel, as defined, to administer
emergency medical assistance to pupils with diabetes
suffering from severe hypoglycemia, if certain performance
standards for training and supervision are developed by the
American Diabetes Association in cooperation with several
other entities for approval and distribution by the State
Department of Health Services' Diabetes Control Program, in
the absence of a credentialed school nurse or other
licensed nurse.
AB 559 (Wiggins), Chapter 458, Statutes of 2001, authorizes
a school district or county office of education to provide
emergency epinephrine auto-injectors to trained personnel,
and authorizes the trained personnel to utilize those
epinephrine auto-injectors to provide emergency medical aid
to persons suffering from an anaphylactic reaction.
Arguments in support
Supporters write that Diastat is a safe and effective drug
and allowing trained school personnel to administer Diastat
could save an epileptic child from very serious injury.
The Health Officers Association of California (HOAC) writes
that without SB 161, school personnel would have to wait
for the child's parent or an ambulance to arrive in order
for the drug to be administered. Epilepsy California
writes a student suffering from prolonged seizures that is
prescribed and yet denied access to Diastat risks permanent
brain damage or death. After five minutes, seizures are
life threatening. The California Association of Suburban
School Districts writes that Diastat is the first and only
FDA-approved, acute layperson-administered medication and
is the best option for providing a safe educational
environment for students.
Disability Rights of California (DRC) contends SB 161 is an
important step to providing children with epilepsy with a
free appropriate education. DRC writes access to
medication is important for children with disabilities who
need it to be able to receive an education in the least
restrictive environment with their peers. Riverside
Unified School District writes SB 161 is a critical
component of the overall medical and welfare care the
district provides to special needs students.
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The Riverside County School Superintendents' Association
writes that it is the unfortunate fiscal reality that we
will not have nurses in our schools and we must adapt to
that fiscal reality in a manner that provides the most
health protection to the students.
Supporters state that it has been common practice for over
10 years for trained non-medical personnel to have the
authority to administer doctor-prescribed Diastat to a
student suffering a severe and possibly life threatening
seizure. Supporters further contend that SB 161 is
patterned after two existing laws which allow non-medical
school personnel to administer drugs, Epinephrine and
Glucagon. Supporters argue these medications must also be
given in a specified and extremely short amount of time
from the onset of the episode. Supporters argue Diastat,
like Epinephrine and Glucagon, is a life-saving measure.
If Diastat is administered incorrectly, the medication is
not life-threating, but a significant delay in receiving
treatment can be.
Support if amended
The California Association of Joint Powers Authorities
(CAJPA) writes that SB 161 does not contain needed "Good
Samaritan" liability immunity for the school employee or
the school who agrees to participate in the volunteer
program to help epileptic students in need. In these
litigious times, CAJPA believes that adding this important
liability protection is critical to the ultimate success of
the proposed program. Otherwise, volunteers and schools
will be very reluctant to agree to take on such important
duties and responsibilities as proposed in SB 161.
Arguments in opposition
A coalition of union groups including, the California
Teachers Association, California School Employees
Association, American Nurses Association-California,
California Nurses Association, California Labor Federation,
Service Employees International Union - Nurses Alliance of
California, and the California Federation of Teachers are
opposed to SB 161 writing that Diastat is a dangerous
medication that must be administered rectally to control
seizures. The coalition writes that because a seizure is
unpredictable, providing for any level of privacy is nearly
impossible. The coalition further argues that school
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employees face legal liability if something goes wrong as
school districts generally do not cover punitive damages.
Opponents also argue that SB 161 does not require 911 to be
called and in medical emergencies, a 911 call must be
required.
The coalition supports having licensed, appropriately
trained health care personnel provide the high quality care
that is required to assure that not only children with
disabilities but all school children have access to a free,
fair and appropriate education.
The United Nurses Association of California-Union of Health
Care Professionals writes in opposition to SB 161, arguing
the bill will "deskill the role of school nurses" at a risk
to children.
Opponents further argue that if an employee is named in a
lawsuit, they will have to go to court to defend themselves
and there are no protections against punitive damages or
criminal prosecution.
The California School Employees Association (CSEA) argues
that training will be inadequate if provided at all, as the
bill does not provide funding for any training. CSEA
writes that if a Registered Nurse is not available to
perform this duty, Licensed Vocational Nurses (LVNs) can
and should be used as they are appropriately licensed and
have the skills and ability to help epileptic students.
COMMENTS
1)Amendments in Education Committee. The following
amendments were agreed to in the Senate Education
committee to be taken in the Senate Health Committee:
a) Clarification that a school is required to provide
information about the possibility of eligibility for a
504 plan to a parent once the parent requests the
school to have an employee receive training in the
administration of Diastat.
b) Delete reference to "a physician and surgeon's
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assistant" and only reference "physician assistant" as
those who may provide training to school employees.
There is no such position as a surgeon's assistant.
2)Coercion issue. Concern has been raised that employees
will face coercion and possible retaliation under SB 161.
While Section 49414.7 (b) of the bill states that a
school employee who does not volunteer or who has not
been trained shall not be required to provide emergency
medical assistance, staff recommends the following
amendments to clarify this issue:
i) Prohibit a face-to-face request for volunteers
or face-to-face follow-up requesting volunteers.
ii) State that no response to the notice is
required from school employees unless they are
affirmatively volunteering.
iii) Add language to allow a school employee who has
volunteered to opt-out by submitting written
notification.
3)Volunteers. Staff recommends adding language in
subsection (f) of the bill to encourage schools to first
utilize LVNs prior to asking school employees to
volunteer for training.
4)Definitions.
a) Concern has been raised about who the bill applies
to. Staff recommends adding language to clarify the
term "school employee" to mean any one or more
employees of a school district who volunteer to be
trained to administer emergency medical assistance to
a pupil suffering an epileptic seizure.
b) Staff recommends defining "emergency medical
assistance" to mean the administration of Diastat to a
pupil suffering from an epileptic seizure.
c) Concern has been raised about using a brand name
drug in legislation. Staff recommends using a broader
definition and not the brand name drug.
5)Liability Concerns. Concern has been raised that
employees will not be afforded the same protections they
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currently have because the employee is volunteering.
While Section 49414.7(j) of the bill states that a school
that chooses to allow volunteers to administer Diastat
shall compensate a volunteer when the administration of
Diastat and subsequent monitoring of a pupil requires a
volunteer to work beyond his or her normally scheduled
hours, staff recommends adding language to clarify that
any actions undertaken as part of this section is
considered to be within the current scope of their
employment.
6)School Plan. Section 49414.7(i) outlines the requirements
a school plan must include for school's choosing to
participate. Staff recommends adding language to require
a 911 call in the school plan. Training requirements
outlined in (k)(2)(C) of the bill already include calling
911 as basic emergency follow-up procedures.
7) Training.
a) Section 49414.7 (k)(2) describes what the training
shall include. Staff recommends adding language to
require written materials covering the information
described in this subsection to also be included and
to require a school to retain the written materials.
b) Section 49414.7 (k) in subsections (1), (2), (3),
and (4) outline the training components. Staff
recommends adding language to require documentation of
a completed training by a school employee be
maintained by both the school and school district.
c) Section 49414.7 (k)(1) only encourages the Epilepsy
Foundation of America to develop guidelines for
training and supervision. The language is silent on
what will occur in the absence of such development.
i) Staff recommends adding language to clarify
that until such training guidelines are established
and approved, the bill shall not take effect.
ii) Staff also recommends adding language to
require the Department of Education to approve any
guidelines used for training.
d) Staff recommends adding language to require school
employees who have volunteered for training to be
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required to receive updated training on an annual
basis.
e) Staff recommends adding language to clarify that a
volunteer must receive training prior to administering
Diastat in Section 49414.7(g)(3) of the bill.
POSITIONS
Support: Association of Regional Center Agencies
The California Association of Joint Powers
Authorities (If Amended)
California Association of School Business
Officials
California Association of Suburban School
Districts
California School Boards Association
Democrats for Education Reform
Disability Rights California
Epilepsy Foundation, California
Health Officers Association of California
Humboldt County Office of Education
Kern County Superintendent of Schools
Los Angeles County Office of Education
Los Angeles Unified School district
Orange County Department of Education
Riverside County School Superintendents'
Association
Riverside Unified School District
Saddleback Valley Unified School District
San Bernardino County District Advocates for
Better Schools
Small School Districts' Association
35 individuals
Oppose: American Nurses Association-California,
California Labor Federation
The California Federation of Teachers
California Association for Nurse Practitioners
California Nurses Association
California School Employees Association
California School Nurses Organization
California School Employees Association
California Teachers Association
STAFF ANALYSIS OF SENATE BILL 161 (Huff) Page
19
Laborers International Union of North America,
Local 777
Service Employees International Union-Nurses
Alliance of California
United Nurses Associations of CA-Union of Health
Care Professionals
United Teachers Los Angeles
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