Amended in Senate April 21, 2014

Amended in Senate March 24, 2014

Senate Bill No. 1266

Introduced by Senator Huff

(Coauthor: Senator Hill)

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 begin delete districts and end delete begin insert districts, end insert county offices of education begin insert , and charter schools end insert to provide emergency epinephrine auto-injectors to trained personnel and would begin delete require end delete begin insert authorize end insert trained personnel begin delete , to the extent feasible, end delete 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 school administrator or his or her designee who has received the training described above if the school does not have a school nurse or the school nurse is not onsite or available, to begin delete , among other things, end delete 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 or epinephrine auto-injector manufacturers. 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 the school nurse or designated employee to report any incident of epinephrine auto-injector use to the begin delete Superintendent of Public Instruction end delete begin insert school district, county office of education, or chartering authority end insert on a form developed by the begin delete Superintendent end delete begin insert State Department of Education end insert within 30 days after the last day of each school year. The bill would require the begin delete Superintendent end delete begin insert school district, county office of education, or chartering authority to report any incident of epinephrine auto-injector use to the department on those forms and would require the department end insert to annually post the result of those forms on its Internet Web site begin delete , as specified end delete . begin insert The bill would require a school district, county office of education, or charter school to ensure that each employee who volunteers is provided defense and indemnification by the school district, county office of education, or charter school for any and all civil liability, as specified. end insert 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.

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) School begin delete districts and end delete begin insert districts, end insert county offices of
education begin insert , and charter schools end insert shall provide emergency
epinephrine auto-injectors to trained personnel, and trained
personnel begin delete shall, to the extent feasible, end delete begin insert may end insert use those epinephrine
auto-injectors to provide emergency medical aid to persons
suffering from an anaphylactic reaction.

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

(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 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 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. A
private elementary or secondary school choosing to exercise the
authority provided under this subdivision shall not receive state
funds specifically for purposes of this subdivision.

(d) Each public elementary and secondary school in the state
shall, and each private elementary and secondary school in the
state may, 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 begin delete school
district end delete begin insert local educational agency end insert physician, the medical director
of the local health department, or the local emergency medical
services director. begin insert However, each public school shall designate and
have trained at least one person for the purposes listed in
subdivisions (f), (g), and (h). end insert

(e) (1) Every five years, or sooner as deemed necessary by the
Superintendent, the Superintendent shall review minimum
standards of training for the administration of epinephrine
auto-injectors that satisfy the requirements of paragraph (2). For
purposes of this subdivision, the Superintendent 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 Care 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, Food Allergy Research and Education, the California
Society of Allergy, Asthma and Immunology, the American
College of Allergy, Asthma and Immunology, 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.

begin insert

(E) Instruction on how to determine whether to use an adult
epinephrine auto-injector or a junior epinephrine auto-injector.

end insert begin delete

(E)

end delete

begin insert (F) end insert  Written materials covering the information required under
this subdivision.

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

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

(f) A school nurse, or if the school does not have a school nurse
or the school nurse is not onsite or available, a school begin delete district end delete
administrator or his or her designee who has received training
pursuant to subdivision (d), shall begin delete do the following: end delete begin insert obtain from
the local educational agency physician, a physician contracting
with the local educational agency, the medical director of the local
health department, or the local emergency medical services
director a prescription for epinephrine auto-injectors that, at a
minimum, includes one adult epinephrine auto-injector and one
junior epinephrine auto-injector. The prescription may be filled
by local or mail order pharmacies or epinephrine auto-injector
manufacturers. end insert

begin delete

(1) Obtain from the school district physician, a physician
contracting with the school district, the medical director of the
local health department, or the local emergency medical services
director a prescription for epinephrine auto-injectors that, at a
minimum, includes one adult epinephrine auto-injector and one
junior epinephrine auto-injector. The prescription may be filled
by local or mail order pharmacies or epinephrine auto-injector
manufacturers.

(2) Immediately

end delete

begin insert (g) end insert begin insert   end insert begin insert A school nurse, or if the school does not have a school nurse
or the school nurse is not onsite or available, a school
administrator or his or her designee who has received training
pursuant to subdivision (d) may end insert 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. If the epinephrine
auto-injector is used it shall be restocked as soon as reasonably
possible. begin delete Expired epinephrine end delete begin insert Epinephrine end insert auto-injectors shall be
restocked before their expiration date.

begin delete

(g)

end delete

begin insert (h) end insert  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 begin delete (3) end delete begin insert (4) end insert of subdivision (e).

begin delete

(h)

end delete

begin insert (i) end insert  No later than 30 days after the last day of each school year,
the school nurse or designated employee shall report any incident
of epinephrine auto-injector use to the begin delete Superintendent end delete begin insert school
district, county office of education, or chartering authority end insert on a
form developed by the begin delete Superintendent. In compliance with federal
and state privacy laws, the Superintendent end delete begin insert department. The school
district, county office of education, or chartering authority shall
report any incident of epinephrine auto-injector use to the
department on the form developed by the department. Without
violating federal and state privacy laws, the department end insert shall
annually publish the results of the submitted forms on begin delete his or her end delete
begin insert its end insert Internet Web site.

begin delete

(i)

end delete

begin insert (j) end insert  A school begin delete district or end delete begin insert district, end insert county office of education begin insert , or
charter school end insert using 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 begin delete school district end delete begin insert local educational agency end insert
physician, the medical director of the local health department, or
the local emergency medical services director that the school
begin delete district or end delete begin insert district, end insert county office of education begin insert , or charter school end insert
will consult for the prescription for epinephrine auto-injectors
pursuant to begin delete paragraph (1) of end delete subdivision (f).

(3) Documentation as to which individual, the school nurse or
other trained person pursuant to subdivision (f), in the school
begin delete district or end delete begin insert district, end insert county office of education begin insert , or charter school end insert
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

(k) A school district, county office of education, or charter
school shall ensure that each employee who volunteers under this
section will be provided defense and indemnification by the school
district, county office of education, or charter school for any and
all civil liability, in accordance with, but not limited to, that
provided in Division 3.6 (commencing with Section 810) of Title
1 of the Government Code. This information shall be reduced to
writing, provided to the volunteer, and retained in the volunteer’s
personnel file.

end insert begin delete

(j)

end delete

begin insert (l) end insert  A public school may accept gifts, grants, and donations from
any source for the support of the public school carrying out the
provisions of this section, including, but not limited to, the
acceptance of epinephrine auto-injectors from a manufacturer or
wholesaler.

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.