BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                            



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                                    THIRD READING


          Bill No:  SB 1266
          Author:   Huff (R), et al.
          Amended:  5/27/14
          Vote:     21

           
           SENATE EDUCATION COMMITTEE  :  7-0, 4/2/14
          AYES:  Liu, Wyland, Correa, Galgiani, Hueso, Huff, Monning
          NO VOTE RECORDED:  Block, Hancock

           SENATE HEALTH COMMITTEE  :  9-0, 4/24/14
          AYES:  Hernandez, Morrell, Beall, De León, DeSaulnier, Evans,  
            Monning, Nielsen, Wolk

           SENATE JUDICIARY COMMITTEE  :  7-0, 4/29/14
          AYES:  Jackson, Anderson, Corbett, Lara, Leno, Monning, Vidak

           SENATE APPROPRIATIONS COMMITTEE  :  7-0, 5/23/14
          AYES:  De León, Walters, Gaines, Hill, Lara, Padilla, Steinberg


           SUBJECT  :    Epinephrine auto-injectors

           SOURCE  :     Food Allergy Research and Education


           DIGEST  :    This bill requires school districts, charter schools  
          and county offices of education (COEs) to provide emergency  
          epinephrine auto-injectors (EAIs) to trained personnel who has  
          volunteered to provide emergency medical aid to a person  
          suffering from an anaphylactic reaction.  This bill requires  
          local educational agencies (LEAs) to have a trained volunteer to  
          administer EAIs in emergencies and requires that each employee  
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          who volunteers is provided defense and indemnification by the  
          LEA for any and all civil liability, as specified.   
          Additionally, this bill requires certain reporting by the school  
          nurse or designated employee, and by the LEA, and specifies that  
          the Superintendent of Public Instruction (SPI) must review the  
          minimum training standards for the administration of EAIs at  
          least every five years, as specified.

           ANALYSIS  :    

          Existing law:

          1. Authorizes a school district or COE to provide emergency  
             epinephrine auto-injectors to trained personnel, and  
             authorizes trained personnel to use an epinephrine  
             auto-injector to provide emergency medical aid to a person  
             suffering from an anaphylactic reaction.

          2. Authorizes public schools to designate at least one school  
             personnel on a voluntary basis to receive initial and annual  
             training, based on specific standards, regarding the storage  
             and emergency use of an epinephrine auto-injector.

          3. Authorizes a school nurse, or if the school does not have a  
             nurse, a person who has received training, to:

             A.    Obtain a prescription for epinephrine auto-injectors  
                from the school district physician, medical director of  
                the local health department, or local emergency medical  
                services director.

             B.    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.

          4. Requires a school district or COE electing to use epinephrine  
             auto-injectors for emergency medical aid to create a plan to  
             address all of the following issues:

             A.    Designation of the person(s) who will provide the  
                training.

             B.    Designation of the school district physician, medical  

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                director of the local health department or local  
                emergency medical services director who will be  
                consulted for the prescription for epinephrine  
                auto-injectors.

             C.    Documentation as to who will obtain the prescription  
                and the medication.

             D.    Documentation regarding where the epinephrine  
                auto-injector is stored and how the epinephrine  
                auto-injector will be made readily available in case of  
                an emergency.

          5. Requires the SPI to develop minimum standards of training,  
             and requires the training to 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 911  
                and contacting, if possible, the student's parents and  
                physician.

             D.    Instruction and certification in cardiopulmonary  
                resuscitation.

             E.    Written materials covering the information described  
                above.

          6. Authorizes, in the absence of a credentialed school nurse or  
             other licensed nurse onsite at the school, non-medical school  
             personnel to administer medication to a pupil in an  
             emergency, after receiving specified training:

             A.    Glucagon may be administered to students with  
                diabetes suffering from severe hypoglycemia.  

             B.    Emergency anti-seizure medication may be administered  
                to students with epilepsy suffering from seizures.  

          This bill requires school districts, charter schools and COEs to  
          provide emergency EAIs to trained personnel to provide emergency  

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          medical aid to a person suffering from an anaphylactic reaction.  
           This bill requires LEAs to have a trained volunteer to  
          administer EAIs in emergencies and requires that each employee  
          who volunteers is provided defense and indemnification by the  
          LEA for any and all civil liability, as specified.   
          Additionally, this bill requires certain reporting by the school  
          nurse or designated employee, and by the LEA, and specifies that  
          the SPI must review the minimum training standards for the  
          administration of EAIs at least every five years, as specified.

          This bill requires the school nurse or voluntarily designated  
          employee to report any incident of EAI use to the school  
          district, COE, or chartering authority on a form developed by  
          the California Department of Education (CDE) within 30 days  
          after the last day of each school year and require the CDE to  
          annually post the result of those forms on its Internet Web  
          site.

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


          According to the Senate Appropriations Committee:


           Mandate:  Potentially substantial reimbursable state mandate  
            on LEAs to provide and maintain EAIs, train volunteers, and  
            adhere to reporting requirements.  Annual costs will be in the  
            millions of dollars (General Fund); the cost of purchasing  
            EAIs for the more than 10,000 district schools alone will  
            exceed $2 million.

           Standards:  Costs to the CDE to review and update minimum  
            training standards would be minor and absorbable.

           SUPPORT  :   (Verified  5/27/14)

          Food Allergy Research and Education (source)
          Allergy & Asthma Associates of Southern California
          Allergy & Asthma Medical Group & Research Center
          Allergy and Asthma Associates of Northern California
          American Academy of Allergy Asthma and Immunology 
          American College of Emergency Physicians
          American Red Cross

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          Asthma and Allergy Foundation of America
          Bay Area Allergy Advisory Board
          Bay Area Food Allergy 5k Walk/Run in Memory of BJ HOM
          California Academy of Family Physicians 
          California Academy of Physician Assistants 
          California Advocates for People with Food Allergies 
          California Allergy Support & Anaphylaxis Prevention
          California American College of Emergency Physicians
          California Pharmacists Association
          California Physicians United for SB 1266
          California School Nurses Organization 
          California Society of Allergy Asthma and Immunology 
          California Society of Health-System Pharmacists 
          California State PTA
          Capital Allergy & Respiratory Disease Center
          Children's Hospital Los Angeles
          Food Allergy and Anaphylaxis Connection Team 
          Food Allergy Research & Education
          Food Allergy Support of Sacramento 
          Kids with Food Allergies 
          Lucille Packard Children's Hospital
          Mercy Medical Group
          Mylan
          Natalie Giorgi Sunshine Foundation
          Northern California Allergy & Asthma Advocates 
          Nut Free Wok
          Orange County Tax Payers Association
          San Clemente Food Allergy Support Group
          San Diego Food Allergy
          San Diego Food Allergy Support Group
          Sanofi
          San Francisco Bay Area Food Allergy Network
          South Orange County Food Allergy Network
          Stanford Food Allergy & Food Sensitivity Center Community  
          Council
          Sutter Medical Group
          The Allergy Station

           OPPOSITION  :    (Verified  5/27/14)

          California Federation of Teachers


          PQ:d  5/27/14   Senate Floor Analyses 

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                           SUPPORT/OPPOSITION:  SEE ABOVE

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