Senate Bill No. 1266

Introduced by Senator Huff

February 21, 2014

An act to amend Section 49414 of the Education Code, relating to pupil health.

LEGISLATIVE COUNSEL’S DIGEST

SB 1266, as introduced, Huff. Pupil health: epinephrine auto-injectors.

Existing law authorizes a school district or county office of education to provide emergency epinephrine auto-injectors to trained personnel, and authorizes trained personnel to use those epinephrine auto-injectors to provide emergency medical aid to persons suffering from an anaphylactic reaction. Existing law authorizes each public and private elementary and secondary school in the state to designate one or more school personnel on a voluntary basis to receive initial and annual refresher training regarding the storage and emergency use of an epinephrine auto-injector, as specified. Existing law authorizes a school nurse, or a person who has received the training described above if the school does not have a school nurse, to, among other things, obtain a prescription for epinephrine auto-injectors, as specified.

This bill would require school districts and county offices of education to provide emergency epinephrine auto-injectors to trained personnel and would require trained personnel to use those epinephrine auto-injectors to provide emergency medical aid to persons suffering from an anaphylactic reaction. The bill would require each public elementary and secondary school in the state to designate one or more school personnel on a voluntary basis to receive initial and annual refresher training regarding the storage and emergency use of an epinephrine auto-injector, as specified. The bill would require a school nurse, or a person who has received the training described above if the school does not have a school nurse, to, among other things, obtain the prescription for epinephrine auto-injectors, as specified, and would authorize the prescription for epinephrine auto-injectors to be filled by local or mail order pharmacies. The bill would require an epinephrine auto-injector to be restocked as soon as possible after it is used and before its expiration date. The bill would require epinephrine auto-injectors to be available at each schoolsite and at school-sanctioned events. The bill would provide that the school district, the county office of education, and trained personnel are not liable for any civil damages resulting from the administration of an epinephrine auto-injector to a person reasonably believed to be suffering from an anaphylactic reaction. By requiring school districts and county offices of education to perform additional duties related to epinephrine auto-injectors, the bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.

The people of the State of California do enact as follows:

SECTION 1.  

Section 49414 of the Education Code is amended
to read:

49414.  

(a)  begin delete A school district or end delete begin insert School districts and end insert county
begin delete office end delete begin insert offices end insert of education begin delete may end delete begin insert shall end insert provide emergency
epinephrine auto-injectors to trained personnel, and trained
personnel begin delete may utilize end delete begin insert shall use end insert those epinephrine auto-injectors
to provide emergency medical aid to persons suffering from an
anaphylactic reaction. begin delete Any end delete begin insert A end insert school district or county office of
education begin delete choosing to exercise the authority provided under this
subdivision end delete shall not receive state funds specifically for begin delete the end delete
purposes of this subdivision.

(b) For purposes of this section, the following terms have the
following meaning:

(1) “Anaphylaxis” means a potentially life-threatening
hypersensitivity to a substance.

(A) Symptoms of anaphylaxis may include shortness of breath,
wheezing, difficulty breathing, difficulty talking or swallowing,
hives, itching, swelling, shock, or asthma.

(B) Causes of anaphylaxis may include, but are not limited to,
an insect sting, food allergy, drug reaction, and exercise.

(2) “Epinephrine auto-injector” means a disposable drug delivery
system with a spring-activated concealed needle that is designed
for emergency administration of epinephrine to provide rapid,
convenient first aid for persons suffering a potentially fatal reaction
to anaphylaxis.

(c) Each begin delete public and end delete private elementary and secondary school
in the state may voluntarily determine whether or not to make
emergency epinephrine auto-injectors and trained personnel
available at its school. In making this determination, a school shall
evaluate the emergency medical response time to the school and
determine whether initiating emergency medical services is an
acceptable alternative to epinephrine auto-injectors and trained
personnel. begin delete Any end delete begin insert A private elementary or secondary end insert school choosing
to exercise the authority provided under this subdivision shall not
receive state funds specifically for begin delete the end delete purposes of this subdivision.

(d) Each public begin insert elementary and secondary school in the state
shall, end insert and begin insert each end insert private elementary and secondary school in the
state may begin insert , end insert designate one or more school personnel on a voluntary
basis to receive initial and annual refresher training, based on the
standards developed pursuant to subdivision (e), regarding the
storage and emergency use of an epinephrine auto-injector from
the school nurse or other qualified person designated by the school
district physician, the medical director of the local health
department, or the local emergency medical services director. begin delete Any end delete
begin insert A end insert school begin delete choosing to exercise the authority provided under this
subdivision end delete shall not receive state funds specifically for begin delete the end delete
purposes of this subdivision.

(e) (1) The Superintendent begin delete of Public Instruction end delete shall establish
minimum standards of training for the administration of
epinephrine auto-injectors that satisfy the requirements in
paragraph (2). For purposes of this subdivision, the Superintendent
begin delete of Public Instruction end delete shall consult with organizations and providers
with expertise in administering epinephrine auto-injectors and
administering medication in a school environment, including, but
not limited to, the State Department of Health begin insert Care end insert Services, the
Emergency Medical Services Authority, the American Academy
of Allergy, Asthma, and Immunology, the California School Nurses
Organization, the California Medical Association, the American
Academy of Pediatrics, and others.

(2) Training established pursuant to this subdivision shall include
all of the following:

(A) Techniques for recognizing symptoms of anaphylaxis.

(B) Standards and procedures for the storage and emergency
use of epinephrine auto-injectors.

(C) Emergency follow-up procedures, including calling the
emergency 911 phone number and contacting, if possible, the
pupil’s parent and physician.

(D) Instruction and certification in cardiopulmonary
resuscitation.

(E) Written materials covering the information required under
this subdivision.

(3) A school shall retain for reference the written materials
prepared under subparagraph (E) of paragraph (2).

(f) A school nurse, or if the school does not have a school nurse,
a person who has received training pursuant to subdivision (d),
begin delete may end delete begin insert shall end insert do the following:

(1) Obtain from the school district physician, the medical
director of the local health department, or the local emergency
medical services director a prescription for epinephrine
auto-injectors. begin insert The prescription may be filled by local or mail
order pharmacies. end insert

(2) Immediately administer an epinephrine auto-injector to a
person exhibiting potentially life-threatening symptoms of
anaphylaxis at school or a school activity when a physician is not
immediately available. begin insert If the epinephrine auto-injector is used it
shall be restocked as soon as reasonably possible. Expired
epinephrine auto-injectors shall be restocked before their
expiration date. end insert

(g) A person who has received training as set forth in subdivision
(d) or a school nurse shall initiate emergency medical services or
other appropriate medical follow up in accordance with the training
materials retained pursuant to paragraph (3) of subdivision (e).

(h)  begin delete Any end delete begin insert A end insert school district or county office of education begin delete electing
to utilize end delete begin insert using end insert epinephrine auto-injectors for emergency medical
aid shall create a plan to address all of the following issues:

(1) Designation of the individual or individuals who will provide
the training pursuant to subdivision (d).

(2) Designation of the school district physician, the medical
director of the local health department, or the local emergency
medical services director that the school district or county office
of education will consult for the prescription for epinephrine
auto-injectors pursuant to paragraph (1) of subdivision (f).

(3) Documentation as to which individual, the school nurse or
other trained person pursuant to subdivision (f), in the school
district or county office of education will obtain the prescription
from the physician and the medication from a pharmacist.

(4) Documentation as to where the medication is stored and
how the medication will be made readily available in case of an
emergency.

begin insert

(i) An epinephrine auto-injector shall be available at each
schoolsite and at school-sanctioned events including, but not
limited to, field trips and off-campus events.

end insert begin insert

(j) The school district, the county office of education, and trained
personnel shall not be liable for any civil damages resulting from
the administration of an epinephrine auto-injector to a person
reasonably believed to be suffering from an anaphylactic reaction.

end insert

SEC. 2.  

If the Commission on State Mandates determines that
this act contains costs mandated by the state, reimbursement to
local agencies and school districts for those costs shall be made
pursuant to Part 7 (commencing with Section 17500) of Division
4 of Title 2 of the Government Code.