BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 161|
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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
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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
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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.
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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
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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
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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
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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
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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
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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
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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,
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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
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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
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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
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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
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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
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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
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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
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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
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