BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      



           ------------------------------------------------------------ 
          |SENATE RULES COMMITTEE            |                   SB 161|
          |Office of Senate Floor Analyses   |                         |
          |1020 N Street, Suite 524          |                         |
          |(916) 651-1520         Fax: (916) |                         |
          |327-4478                          |                         |
           ------------------------------------------------------------ 
           
                                         
                              UNFINISHED BUSINESS


          Bill No:  SB 161
          Author:   Huff (R)
          Amended:  8/26/11
          Vote:     21

           
           SENATE EDUCATION COMMITTEE  :  6-1, 3/16/11
          AYES:  Lowenthal, Runner, Blakeslee, Huff, Liu, Vargas
          NOES:  Hancock
          NO VOTE RECORDED:  Alquist, Price, Simitian, Vacancy

           SENATE HEALTH COMMITTEE  :  7-0, 4/6/11
          AYES:  Hernandez, Strickland, Anderson, Blakeslee, De León, 
            Rubio, Wolk
          NO VOTE RECORDED:  Alquist, DeSaulnier

           SENATE APPROPRIATIONS COMMITTEE  :  8-0, 5/26/11
          AYES:  Kehoe, Walters, Alquist, Lieu, Pavley, Price, 
            Runner, Steinberg
          NO VOTE RECORDED:  Emmerson

           SENATE FLOOR :  32-4, 6/2/11
          AYES:  Alquist, Anderson, Berryhill, Blakeslee, Calderon, 
            Cannella, Correa, De León, Dutton, Emmerson, Evans, 
            Fuller, Gaines, Harman, Hernandez, Huff, Kehoe, La Malfa, 
            Lieu, Liu, Lowenthal, Padilla, Price, Rubio, Simitian, 
            Steinberg, Strickland, Vargas, Walters, Wolk, Wright, 
            Wyland
          NOES:  Corbett, Hancock, Leno, Negrete McLeod
          NO VOTE RECORDED:  DeSaulnier, Pavley, Runner, Yee

           ASSEMBLY FLOOR  :  46-21, 8/30/11 - See last page for vote

                                                           CONTINUED





                                                                SB 161
                                                                Page 
          2


           SUBJECT  :    Emergency medical assistance:  administration 
          of epilepsy
                      medication

           SOURCE  :     Author


           DIGEST  :    This bill allows school districts, county 
          offices of education, or charter schools to participate in 
          a program to train nonmedical school employees who 
          volunteer to administer emergency anti-seizure medication 
          to students with epilepsy.

           Assembly Amendments  change provisions of the bill to allow 
          a school district, county office of education or charter 
          school to participate in a program to provide nonmedical 
          school personnel with voluntary emergency medical training 
          rather than allowing them to provide the voluntary 
          emergency medical training, add county offices of education 
          and charter schools within the scope of the bill, and make 
          technical changes.

           ANALYSIS  :    

           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" in the 
          least restrictive environment.

          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 
          related services to eligible children with disabilities.

          Requires school districts to provide a free appropriate 

                                                           CONTINUED





                                                                SB 161
                                                                Page 
          3

          public education 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

           1.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.

          2.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.

          3.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 objections to any medical 
            treatment other than first aid.

          4.Authorizes non-medical school personnel to administer the 
            following medication to a student in an emergency, after 
            receiving specified training:

             A.    Emergency epinephrine auto-injectors.  A 
                prescription or an auto-injector for a specific 
                student is not required; the prescription is for the 
                school.


                                                           CONTINUED





                                                                SB 161
                                                                Page 
          4

             B.    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.

          5.Authorizes non-medical school personnel to assist or 
            administer medication to a student on a routine, 
            non-emergency basis the following:

             A.    Assisting in the administration of prescribed 
                medication, or in the self-administration of 
                prescription auto-injectable epinephrine.

             B.    Assisting in administration of prescribed 
                medication or in the self-administration of 
                prescription inhaled asthma medication.

             C.    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.

          6.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 allows school districts, county offices of 
          education, or charter schools to participate in a program 
          to train nonmedical school employees who volunteer to 
          administer emergency anti-seizure medication to students 
          with epilepsy.  Specifically, this bill:

           1.Provides that, in the absence of a credentialed school 
             nurse or other licensed nurse onsite at the school or 
             charter school, a school district, COE or charter school 
             may elect to participate in a program to allow 
             nonmedical employees to volunteer to provide medical 
             assistance to students with epilepsy suffering from 
             seizures, upon request by a parent or guardian.  If the 

                                                           CONTINUED





                                                                SB 161
                                                                Page 
          5

             school district, COE or charter school elects to 
             participate in such a program, the school, COE or 
             charter school shall provide school employees who 
             volunteer with voluntary emergency medical training that 
             is consistent with training guidelines established by 
             this bill.

           2.Requires a school employee with the training specified 
             above to provide emergency medical assistance using 
             guidelines approved on the California Department of 
             Education's (CDE) Internet Web site, as specified, and 
             performance instructions set forth by the student's 
             licensed health care provider.  A school employee who 
             does not volunteer or who has not been trained pursuant 
             to this bill's provisions shall not be required to 
             provide emergency medical assistance pursuant to this 
             bill.

           3.Allows the parent or guardian of a student with 
             epilepsy, who has been prescribed an emergency 
             anti-seizure medication by his or her health care 
             provider, to request that a school have one or more of 
             its employees receive training pursuant to this bill in 
             the administration of an emergency anti-seizure 
             medication in the event that the student suffers a 
             seizure when a nurse is not available.  Upon such a 
             request, the school or charter school must: 

             A.    Notify the parent or guardian that his or her 
                child may qualify for services or accommodations 
                under a Section 504 plan or an individualized 
                education program (IEP), pursuant to Section 504 of 
                the federal Rehabilitation Act of 1973 (Section 504) 
                and the federal Individuals with Disabilities 
                Education Act (IDEA).

             B.    Assist the parent or guardian with the exploration 
                of that option.

             C.    Encourage the parent or guardian to adopt that 
                option if it is determined that the child is 
                eligible.

           4.Allows a school or charter school to ask the parent or 

                                                           CONTINUED





                                                                SB 161
                                                                Page 
          6

             guardian to sign a notice verifying that the parent or 
             guardian was given information about Section 504 and 
             IDEA, and that the parent or guardian understands that 
             it is his or her right to request a Section 504 plan or 
             an IEP at any time.

           5.Allows a school or charter 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 or guardian does not choose to have the 
             student assessed for a Section 504 plan or an IEP.  The 
             plan may include the involvement of trained volunteer 
             school employees or a licensed vocational nurse.

           6.Requires a school district, COE or charter school that 
             trains employees pursuant to this bill to ensure that:

             A.    A volunteer receives training from a licensed 
                health care professional regarding the administration 
                of an emergency anti-seizure medication.  A staff 
                member who has completed training shall, if he or she 
                has not administered an emergency anti-seizure 
                medication within the prior two years and there is a 
                student enrolled in the school who may need the 
                administration of an anti-seizure medication, attend 
                a new training program to retain the ability to 
                administer an emergency anti-seizure medication.

             B.    Any agreement by an employee to administer an 
                emergency anti-seizure medication is voluntary, and 
                an employee of the school or charter school or an 
                employee of the school district or COE or charter 
                school administrator shall not 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, including, but not limited to, 
                direct contact with the employee.

             C.    Any employee who volunteers pursuant to this 
                section may rescind his or her offer to administer an 
                emergency anti-seizure medication up to three days 

                                                           CONTINUED





                                                                SB 161
                                                                Page 
          7

                after the completion of the training. After that 
                time, a volunteer may rescind his or her offer to 
                administer an emergency anti-seizure medication with 
                a two-week notice, or until a new individual health 
                plan or Section 504 plan has been developed for an 
                affected student, whichever is less.

           7.Requires a school or charter school that trains 
             employees pursuant to this bill to solicit volunteers 
             exclusively via an electronic notice no more than twice 
             per school year per child to all staff that states the 
             following information in bold print:

             A.    A description of the volunteer request, stating 
                that the request is for volunteers to administer an 
                emergency anti-seizure medication to a student 
                experiencing a severe epileptic seizure, in the 
                absence of a school nurse, and that this emergency 
                anti-seizure medication is a Food and Drug 
                Administration (FDA)-approved, pre-dosed, rectally 
                administered gel that reduces the severity of 
                epileptic seizures.

             B.    A description of the training the that volunteer 
                will receive, as specified.

             C.    A description of the voluntary nature of the 
                voluntary program, as specified.

             D.    The volunteer rescission timelines, as specified.

           8.Specifies that an employee who volunteers pursuant to 
             this bill shall not be required to administer an 
             emergency anti-seizure medication until completion of 
             the training program adopted by the school district, COE 
             or charter school and documentation of completion is 
             recorded in his or her personnel file.

           9.Requires a school district, COE or charter school that 
             elects to participate pursuant to this bill to ensure 
             that each employee who volunteers will be provided 
             defense and indemnification by the school district, COE 
             or charter school for any and all civil liability, in 
             accordance with, but not limited to, current law 

                                                           CONTINUED





                                                                SB 161
                                                                Page 
          8

             governing claims and actions against public employees.  
             This information shall be reduced to writing, provided 
             to the volunteer, and retained in the volunteer's 
             personnel file.

          10.Requires a school or charter school, if there are no 
             volunteers, to re-notify a student's parent or guardian 
             of the option to be assessed for services and 
             accommodations guaranteed under Section 504 and IDEA.

          11.Requires a school district, COE or charter school that 
             elects to participate pursuant to this bill to have a 
             school district, COE or charter school plan in place 
             that includes all of the following:

             A.    Identification of existing licensed staff within 
                the district or region who could be trained in the 
                administration of an emergency anti-seizure 
                medication and could be available to respond to an 
                emergency need to administer an emergency 
                anti-seizure medication.  The school district or 
                charter school shall consult with the COE to obtain 
                this information.

             B.    Identification of students who may require the 
                administration of an emergency anti-seizure 
                medication.

             C.    Written authorization from the parent or guardian 
                for a nonmedical school employee to administer an 
                emergency anti-seizure medication.

             D.    The requirement that the parent or guardian notify 
                the school or charter school if the student has had 
                an emergency anti-seizure medication administered 
                within the past four hours on a school day.

             E.    Notification of the parent or guardian by the 
                school or charter school administrator or, if the 
                administrator is not available, by another school 
                staff member that an emergency anti-seizure 
                medication has been administered.

             F.    A written statement from the student's health care 

                                                           CONTINUED





                                                                SB 161
                                                                Page 
          9

                practitioner that includes specified information, 
                including (among other things) dosage, seizure 
                symptoms, when to administer medication, adverse 
                reactions, a protocol for observing the student after 
                a seizure, and a requirement that the student's 
                parent or guardian and the school nurse must be 
                contacted by the school or charter school 
                administrator or, if the administrator is not 
                available, by another staff member following a 
                seizure to continue the observation protocol.

          12.Requires a school district, COE or charter school that 
             elects to allow volunteers to administer an emergency 
             anti-seizure medication to compensate a volunteer, in 
             accordance with that employee volunteer's pay scale 
             pursuant to current law governing overtime pay for 
             classified employees, when the administration of an 
             emergency anti-seizure medication and subsequent 
             monitoring of the student requires a volunteer to work 
             beyond his or her normally scheduled hours.

          13.Requires CDE, in consultation with the Department of 
             Public Health (DPH), to develop guidelines for the 
             training and supervision of school and charter school 
             employees in providing emergency medical assistance to 
             students with epilepsy suffering from seizures and to 
             post this information on CDE's Internet Web site by July 
             1, 2012., as specified.

          14.Requires CDE to include on its Internet Web site a 
             clearinghouse for best practices in training nonmedical 
             personnel to administer an emergency anti-seizure 
             mediation to students, as specified.  Training must 
             include specified components and must be conducted by a 
             physician and surgeon, a physician assistant, a 
             credentialed school nurse, a registered nurse, and/or a 
             certificated public health nurse.

          15.Requires notification to the credentialed school nurse 
             assigned to the school district, COE or charter school 
             if an employee at the school site administers an 
             emergency anti-seizure medication pursuant to this bill. 
              If a credentialed school nurse is not assigned, 
             notification must be provided to the superintendent of 

                                                           CONTINUED





                                                                SB 161
                                                                Page 
          10

             the school district, the county superintendent of 
             schools, or the charter school administrator, as 
             specified.

          16.Requires a school or charter school to retain all 
             records relating to the administration of an emergency 
             anti-seizure medication while a student is under the 
             supervision of school staff.

          17.Requires the student's parent or guardian to provide all 
             materials necessary to administer an emergency 
             anti-seizure medication, including the statement from 
             the student's health practitioner, as specified.  A 
             school or charter school shall not be responsible for 
             providing any of the necessary materials.

          18.Provides the following definitions:

             A.    An "emergency anti-seizure medication" means 
                diazepam rectal gel and emergency medications 
                approved by the FDA for patients with epilepsy for 
                the management of seizures by persons without the 
                medical credentials listed in #14 above.

             B.    "Emergency medical assistance" means the 
                administration of an emergency anti-seizure 
                medication to a student suffering from an epileptic 
                seizure.

          19.Sunsets January 1, 2017.

           Comments
            
          More than 90,000 children in California have epilepsy, a 
          common symptom of which is seizures.  Diastat is a 
          trademark administration system of diazepam (valium) and is 
          the only FDA-approved, at-home medication for the treatment 
          of acute repetitive seizures, or "cluster" seizures.  
          Diastat, a rectally-administered gel, was specifically 
          developed to be administered by people without medical 
          training and is considered the fastest, safest and most 
          effective way to treat epileptic seizures.  

          Many seizure patients, despite maintenance medication, 

                                                           CONTINUED





                                                                SB 161
                                                                Page 
          11

          experience breakthrough seizures.  Up to 35% of patients on 
          anti-seizure medications may not be adequately controlled.  
          Between 50,000 and 200,000 generalized convulsive status 
          epileptic seizures occur every year in the United States, 
          with an overall mortality rate of 20%.  Status seizures 
          lasting more than one hour have a mortality rate of 32%, 
          compared with 2.7% for seizures of shorter duration. 

          Two federal anti-discrimination statutes, Section 504 and 
          Title II of the ADA, establish rights for eligible students 
          with disabilities in California's public schools.  In 
          general, a student will be determined to have a disability 
          under Section 504 if he/she has a mental or physical 
          impairment that substantially limits one or more major life 
          activities.  Section 504 requires school districts to 
          provide a free appropriate public education to each 
          qualified student, regardless of the nature or severity of 
          the disability. 

          A 504 plan differs from an IEP.  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 (NPA) specifies that medication 
                                                  administration is a nursing function that cannot be 
          performed by unlicensed (non-medical) personnel unless 
          expressly authorized by statute.  However, current law 
          authorizes non-medical school personnel to administer 
          emergency epinephrine auto-injectors in an emergency after 
          receiving specified training (Education Code, Section 
          49414).  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 
          (Education Code, Section 49414.5).

          The Board of Registered Nursing issued a legal opinion in 
          March 2010 on the administration of Diastat to students by 
          unlicensed school personnel, stating, "The NPA does not 
          permit unlicensed school personnel to administer Diastat to 
          a student undergoing an epileptic seizure.  Diastat is a 
          medication and its administration constitutes the practice 
          of nursing.  A school district's use of unlicensed school 

                                                           CONTINUED





                                                                SB 161
                                                                Page 
          12

          personnel to administer Diastat to fulfill its duty to 
          provide medical services to students undergoing seizure is 
          not exempt from the NPA.

          "The NPA does not permit a nurse to train unlicensed school 
          personnel knowing that the purpose for the training is to 
          enable the trainees to administer Diastat to a student, and 
          the unlicensed person actually administers Diastat in 
          violation of the NPA.  Such conduct may subject the nurse 
          to discipline for aiding and abetting the unlicensed 
          practice of nursing.

          "The NPA does not permit a nurse to establish and supervise 
          a program where unlicensed school personnel administer 
          Diastat to students during the school day.  Such conduct 
          may subject the nurse to discipline for being a departure 
          from the standards of competent performance established in 
          (the California Code of Regulations) in that he or she 
          would be delegating a health care task to a person who is 
          not legally able to perform that task."

          California's nurse-to-student ratio is approximately 
          1:2,200.  According to the California Basic Educational 
          Data System, about one-half of school districts do not have 
          a school nurse.  

           Related/Prior Legislation

           SB 65 (Strickland), 2011-12 Session, authorizes 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.  (In Senate Education 
          Committee)

          SB 1051 (Huff), 2009-10 Session, was very similar to this 
          bill.  (Held on Senate Appropriations Committee's Suspense 
          File)

          AB 1802 (Hall), 2009-10 Session, would have authorized a 
          parent or guardian of a pupil with diabetes to designate 

                                                           CONTINUED





                                                                SB 161
                                                                Page 
          13

          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), 2009-10 Session, 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 
          Assembly Appropriations Committee)

          AB 2454 (Torlakson), 2009-10 Session, 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 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), 2009-10 Session, 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 the Assembly Business, 
          Professions, and Consumer Protection Committee)

          AB 426 (Hall), 2009-10 Session, would have required the 
          CDE, 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. 
           (Died in Assembly Education Committee)

          AB 942 (Leno), Chapter 444, Statutes of 2003, authorizes 
          each school district to provide voluntary emergency medical 
          training to school personnel, as defined, to administer 
          emergency medical assistance to pupils with diabetes 

                                                           CONTINUED





                                                                SB 161
                                                                Page 
          14

          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 
          Department of Health Services,' Diabetes Control Program, 
          in the absence of a credentialed school nurse or other 
          licensed nurse.  Passed the Senate with a vote of 38-0 on 
          September 3, 2003.

          AB 559 (Wiggins), Chapter 458, Statues of 2001, authorized 
          a school district or county office of education to provide 
          emergency epinephrine auto-injectors to trained personnel, 
          and authorized the trained personnel to utilize those 
          epinephrine auto-injectors to provide emergency medical aid 
          to persons suffering from an anaphylactic reaction.  Passed 
          the Senate with a vote of 40-0 on August 27, 2001.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  No

          According to the Senate Appropriations Committee:

                          Fiscal Impact (in thousands)

           Major Provisions             2011-12             2012-13         
              2013-14             Fund

           CDE consultation/       Potentially significant costs to 
          participate       General
          approval 

          CDE Web site                         -- Minor and 
          absorbable --                   General
          information 

           SUPPORT  :   (Verified  8/30/11)

          American Academy of Pediatrics
          Association of Regional Center Agencies
          Association of Suburban School Districts
          California Association of Joint Powers Authorities (if 
          amended)
          California Association of School Business Officials
          California Association of Suburban School Districts

                                                           CONTINUED





                                                                SB 161
                                                                Page 
          15

          California County Superintendents Educational Services 
          Association
          California Disability Services Association
          California Medical Association
          California School Boards Association
          Children's Specialty Care Coalition
          Coalition for Adequate Funding for Special Education
          County of Los Angeles
          Democrats for Education Reform
          Developmental Disabilities Area Board 10
          Disability Rights California
          Epilepsy Foundation of California
          Epilepsy Foundation of California
          Epilepsy Foundation of Greater Los Angeles
          Epilepsy Foundation of Northern 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
          Orange Unified School District
          Riverside County School Superintendents' Association
          Riverside Unified School District
          Saddleback Valley Unified School District
          San Bernardino County District Advocates for Better Schools
          San Francisco Unified School District
          Small School Districts' Association
          Special Education Local Plan Area Administrators
          State Council on Developmental Disabilities
          The Arc and United Cerebral Policy in California

           OPPOSITION  :    (Verified  8/30/11)

          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
          Laborers International Union of North America, Local 777

                                                           CONTINUED





                                                                SB 161
                                                                Page 
          16

          Service Employees International Union-Nurses Alliance of 
          California
          United Nurses Associations of CA-Union of Health Care 
          Professionals
          United Teachers Los Angeles

           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.

          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 this bill is 

                                                           CONTINUED





                                                                SB 161
                                                                Page 
          17

          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.

           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 this 
          bill 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 employees face 
          legal liability if something goes wrong as school districts 
          generally do not cover punitive damages.  Opponents also 
          argue that this bill 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 

                                                           CONTINUED





                                                                SB 161
                                                                Page 
          18

          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 can and 
          should be used as they are appropriately licensed and have 
          the skills and ability to help epileptic students.  
           

           ASSEMBLY FLOOR :  46-21, 8/30/11
          AYES: Achadjian, Allen, Atkins, Bill Berryhill, Brownley, 
            Buchanan, Charles Calderon, Cedillo, Conway, Cook, 
            Donnelly, Feuer, Fletcher, Fuentes, Beth Gaines, 
            Galgiani, Garrick, Gatto, Gordon, Grove, Hagman, 
            Halderman, Hall, Harkey, Hill, Huber, Hueso, Jeffries, 
            Jones, Knight, Logue, Bonnie Lowenthal, Ma, Mansoor, 
            Mitchell, Morrell, Nestande, Nielsen, Norby, Olsen, 
            Perea, Portantino, Silva, Smyth, Valadao, Wagner
          NOES: Alejo, Ammiano, Block, Bonilla, Campos, Dickinson, 
            Eng, Furutani, Hayashi, Huffman, Lara, Mendoza, Monning, 
            Pan, Skinner, Solorio, Swanson, Torres, Wieckowski, 
            Yamada, John A. Pérez
          NO VOTE RECORDED: Beall, Blumenfield, Bradford, Butler, 
            Carter, Chesbro, Davis, Fong, Gorell, Roger Hernández, 
            Miller, V. Manuel Pérez, Williams


          CPM:cm  8/30/11   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

                                ****  END  ****














                                                           CONTINUED