Amended in Senate March 24, 2014

Senate BillNo. 1266


Introduced by Senator Huff

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(Coauthor: Senator Hill)

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February 21, 2014


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

LEGISLATIVE COUNSEL’S DIGEST

SB 1266, as amended, 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 personnelbegin insert, to the extent feasible,end insert 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 abegin delete personend deletebegin insert school administrator or his or her designeeend insert who has received the training described above if the school does not have a school nursebegin insert or the school nurse is not onsite or availableend insert, 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 pharmaciesbegin insert or epinephrine auto-injector manufacturersend insert. The bill would require an epinephrine auto-injector to be restocked as soon as possible after it is used and before its expiration date.begin delete 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. Byend delete

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The bill would require the school nurse or designated employee to report any incident of epinephrine auto-injector use to the Superintendent of Public Instruction on a form developed by the Superintendent within 30 days after the last day of each school year. The bill would require the Superintendent to annually post the result of those forms on its Internet Web site, as specified. The bill would authorize a public school to accept gifts, grants, and donations from any source for the support of the public school carrying out these provisions.

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begin insertByend insert 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:

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SECTION 1.  

Section 49414 of the Education Code is amended
2to read:

3

49414.  

(a) School districts and county offices of education
4shall provide emergency epinephrine auto-injectors to trained
5personnel, and trained personnel shallbegin insert, to the extent feasible,end insert use
6those epinephrine auto-injectors to provide emergency medical
7aid to persons suffering from an anaphylactic reaction.begin delete A school
8district or county office of education shall not receive state funds
9specifically for purposes of this subdivision.end delete

10(b) For purposes of this section, the following terms have the
11 followingbegin delete meaning:end deletebegin insert meanings:end insert

12(1) “Anaphylaxis” means a potentially life-threatening
13hypersensitivity to a substance.

14(A) Symptoms of anaphylaxis may include shortness of breath,
15wheezing, difficulty breathing, difficulty talking or swallowing,
16hives, itching, swelling, shock, or asthma.

17(B) Causes of anaphylaxis may include, but are not limited to,
18an insect sting, food allergy, drug reaction, and exercise.

19(2) “Epinephrine auto-injector” means a disposable drug delivery
20system with a spring-activatedbegin delete concealedend delete needle that is designed
21for emergency administration of epinephrine to provide rapid,
22convenient first aid for persons suffering a potentially fatal reaction
23to anaphylaxis.

24(c) Each private elementary and secondary school in the state
25may voluntarily determine whether or not to make emergency
26epinephrine auto-injectors and trained personnel available at its
27school. In making this determination, a school shall evaluate the
28emergency medical response time to the school and determine
29whether initiating emergency medical services is an acceptable
30alternative to epinephrine auto-injectors and trained personnel. A
31private elementary or secondary school choosing to exercise the
32authority provided under this subdivision shall not receive state
33funds specifically for purposes of this subdivision.

34(d) Each public elementary and secondary school in the state
35shall, and each private elementary and secondary school in the
36state may, designate one or more school personnel on a voluntary
37basis to receive initial and annual refresher training, based on the
38standards developed pursuant to subdivision (e), regarding the
P4    1storage and emergency use of an epinephrine auto-injector from
2the school nurse or other qualified person designated by the school
3district physician, the medical director of the local health
4department, or the local emergency medical services director.begin delete A
5school shall not receive state funds specifically for purposes of
6this subdivision.end delete

7(e) (1) begin deleteThe end deletebegin insertEvery five years, or sooner as deemed necessary
8by the Superintendent, the end insert
Superintendent shallbegin delete establishend deletebegin insert reviewend insert
9 minimum standards of training for the administration of
10epinephrine auto-injectors that satisfy the requirementsbegin delete inend deletebegin insert ofend insert
11 paragraph (2). For purposes of this subdivision, the Superintendent
12shall consult with organizations and providers with expertise in
13administering epinephrine auto-injectors and administering
14medication in a school environment, including, but not limited to,
15the State Department of Health Care Services, the Emergency
16Medical Services Authority, the American Academy of Allergy,
17Asthma, and Immunology, the California School Nurses
18Organization, the California Medical Association, the American
19 Academy of Pediatrics,begin insert Food Allergy Research and Education,
20the California Society of Allergy, Asthma and Immunology, the
21American College of Allergy, Asthma and Immunology,end insert
and others.

22(2) Training established pursuant to this subdivision shall include
23all of the following:

24(A) Techniques for recognizing symptoms of anaphylaxis.

25(B) Standards and procedures for the storage and emergency
26use of epinephrine auto-injectors.

27(C) Emergency follow-up procedures, including calling the
28emergency 911 phone number and contacting, if possible, the
29pupil’s parent and physician.

30(D) Instruction and certification in cardiopulmonary
31resuscitation.

32(E) Written materials covering the information required under
33this subdivision.

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34(3) Training established pursuant to this subdivision shall be
35consistent with the most recent Voluntary Guidelines for Managing
36Food Allergies In Schools and Early Care and Education Programs
37published by the federal Centers for Disease Control and
38Prevention and the most recent guidelines for medication
39administration issued by the department.

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19 40(3)

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P5    1begin insert(4)end insert A school shall retain for reference the written materials
2prepared under subparagraph (E) of paragraph (2).

3(f) A school nurse, or if the school does not have a school nursebegin delete,
4a personend delete
begin insert or the school nurse is not onsite or available, a school
5district administrator or his or her designeeend insert
who has received
6training pursuant to subdivision (d), shall do the following:

7(1) Obtain from the school district physician,begin insert a physician
8contracting with the school district,end insert
the medical director of the
9local health department, or the local emergency medical services
10director a prescription for epinephrine auto-injectorsbegin insert that, at a
11minimum, includes one adult epinephrine auto-injector and one
12junior epinephrine auto-injectorend insert
. The prescription may be filled
13by local or mail order pharmaciesbegin insert or epinephrine auto-injector
14manufacturersend insert
.

15(2) Immediately administer an epinephrine auto-injector to a
16person exhibiting potentially life-threatening symptoms of
17anaphylaxis at school or a school activity when a physician is not
18immediately available. If the epinephrine auto-injector is used it
19shall be restocked as soon as reasonably possible. Expired
20epinephrine auto-injectors shall be restocked before their expiration
21date.

22(g) A person who has received training as set forth in subdivision
23(d) or a school nurse shall initiate emergency medical services or
24other appropriate medical follow up in accordance with the training
25materials retained pursuant to paragraph (3) of subdivision (e).

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26(h) No later than 30 days after the last day of each school year,
27the school nurse or designated employee shall report any incident
28of epinephrine auto-injector use to the Superintendent on a form
29developed by the Superintendent. In compliance with federal and
30state privacy laws, the Superintendent shall annually publish the
31results of the submitted forms on his or her Internet Web site.

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P5   1 32(h)

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33begin insert(i)end insert A school district or county office of education using
34epinephrine auto-injectors for emergency medical aid shall create
35a plan to address all of the following issues:

36(1) Designation of the individual or individuals who will provide
37the training pursuant to subdivision (d).

38(2) Designation of the school district physician, the medical
39director of the local health department, or the local emergency
40medical services director that the school district or county office
P6    1of education will consult for the prescription for epinephrine
2auto-injectors pursuant to paragraph (1) of subdivision (f).

3(3) Documentation as to which individual, the school nurse or
4other trained person pursuant to subdivision (f), in the school
5district or county office of education will obtain the prescription
6from the physician and the medication from a pharmacist.

7(4) Documentation as to where the medication is stored and
8how the medication will be made readily available in case of an
9emergency.

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10(i) An epinephrine auto-injector shall be available at each
11schoolsite and at school-sanctioned events including, but not
12limited to, field trips and off-campus events.

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13(j) The school district, the county office of education, and trained
14personnel shall not be liable for any civil damages resulting from
15the administration of an epinephrine auto-injector to a person
16reasonably believed to be suffering from an anaphylactic reaction.

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17(j) A public school may accept gifts, grants, and donations from
18any source for the support of the public school carrying out the
19provisions of this section, including, but not limited to, the
20acceptance of epinephrine auto-injectors from a manufacturer or
21wholesaler.

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22

SEC. 2.  

If the Commission on State Mandates determines that
23this act contains costs mandated by the state, reimbursement to
24local agencies and school districts for those costs shall be made
25pursuant to Part 7 (commencing with Section 17500) of Division
264 of Title 2 of the Government Code.



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