BILL ANALYSIS Ó
SB 1266
Page 1
SENATE THIRD READING
SB 1266 (Huff)
As Amended August 18, 2014
Majority vote
SENATE VOTE :37-0
JUDICIARY 10-0 EDUCATION 7-0
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|Ayes:|Wieckowski, Wagner, |Ayes:|Buchanan, Olsen, Chávez, |
| |Alejo, Chau, Dickinson, | |Gonzalez, Nazarian, |
| |Garcia, Gorell, | |Weber, Williams |
| |Maienschein, Muratsuchi, | | |
| |Stone | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
| | | | |
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APPROPRIATIONS 17-0
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|Ayes:|Gatto, Bigelow, | | |
| |Bocanegra, Bradford, Ian | | |
| |Calderon, Campos, | | |
| |Donnelly, Eggman, Gomez, | | |
| |Holden, Jones, Linder, | | |
| |Pan, Quirk, | | |
| |Ridley-Thomas, Wagner, | | |
| |Weber | | |
|-----+--------------------------+-----+--------------------------|
| | | | |
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SUMMARY : Requires school districts, county offices of
education (COE), and charter schools to provide emergency
epinephrine auto-injectors to school nurses or trained personnel
who have volunteered, and school nurses or trained personnel may
use epinephrine auto-injectors to provide emergency medical aid
to persons suffering, or reasonably believed to be suffering,
from an anaphylactic reaction. Specifically, this bill :
1)Authorizes a pharmacy to furnish epinephrine auto-injectors to
a charter school (in addition to a school district or COE) if
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all of the following are met:
a) The epinephrine auto-injectors are furnished exclusively
for use at a charter school.
b) A physician and surgeon provides a written order that
specifies the quantity of epinephrine auto-injectors to be
furnished.
2)Specifies that records regarding the acquisition and
disposition of epinephrine auto-injectors furnished shall be
maintained by the school district, COE or charter school for a
period of three years from the date the records were created.
The school district, COE or charter school shall be
responsible for monitoring the supply of epinephrine
auto-injectors and ensuring the destruction of expired
epinephrine auto-injectors.
3)Defines the following:
a) "Anaphylaxis" means a potentially life-threatening
hypersensitivity to a substance. Symptoms of anaphylaxis
may include shortness of breath, wheezing, difficulty
breathing, difficulty talking or swallowing, hives,
itching, swelling, shock, or asthma. Causes of anaphylaxis
may include, but are not limited to, an insect sting, food
allergy, drug reaction, and exercise.
b) "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) "Volunteer" or "Trained personnel" means an employee who
has volunteered to administer epinephrine auto-injectors to
a person if the person is suffering, or reasonably believed
to be suffering, from anaphylaxis, and has been designated
by a school and has received training.
d) "Authorizing physician and surgeon" may include, but is
not limited to, a physician and surgeon employed by, or
contracting with, a local educational agency, a medical
director of the local health department, or a local
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emergency medical services director.
e) "Qualified supervisor of health" may include, but is not
limited to, a school nurse.
4)Requires every five years, or sooner as deemed necessary by
the Superintendent of Public Instruction (SPI), the SPI to
review minimum standards of training for the administration of
epinephrine auto-injectors; and, requires the SPI to 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 Public Health, 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, the
Stanford Allergy Center, and others.
5)Requires the training 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; and, requires the training to include all of the
following:
a) Techniques for recognizing symptoms of anaphylaxis.
b) Standards and procedures for the storage, restocking,
and emergency use of epinephrine auto-injectors.
c) Emergency follow-up procedures, including calling the
emergency 911 telephone number and contacting, if
possible, the pupil's parent and physician.
d) Recommendation on the necessity of instruction and
certification in cardiopulmonary resuscitation.
e) Instruction on how to determine whether to use an adult
epinephrine auto-injector or a junior epinephrine
auto-injector, which shall include consideration of the
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grade level or age as a guideline of equivalency for the
appropriate pupil weight determination.
f) Written materials covering the information required
under this subdivision.
6)Requires a school district, COE or a charter school, to
distribute a notice at least once per school year to all staff
and that contains the following information:
a) A description of the volunteer request, stating that the
request is for volunteers to be trained to administer
epinephrine auto-injector to a pupil if the pupil is
suffering, or reasonably believed to be suffering from
anaphylaxis.
b) A description of the training that the volunteer will
receive.
7)Requires a qualified supervisor of health at a school
district, a county office of education, or a charter school to
obtain from an authorizing physician and surgeon a
prescription for each school for epinephrine auto-injectors
that, at a minimum, includes, for elementary schools, one
regular epinephrine auto-injector and one junior epinephrine
auto-injector, and for junior high schools, middle schools,
and high schools, if there are no pupils who require a junior
epinephrine auto-injector, one regular epinephrine
auto-injector; requires a qualified supervisor of health at a
school district, a county office of education, or a charter
school to be responsible for stocking the epinephrine
auto-injector and restocking it if it is used; and, requires
if a school district, county office of education, or charter
school does not have a qualified supervisor of health, an
administrator at the school district, county office of
education, or charter school to carry out the duties
specified.
8)Authorizes a school nurse, or if the school does not have a
school nurse or the school nurse is not onsite or available, a
volunteer to 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; specifies if the epinephrine
auto-injector is used it shall be restocked as soon as
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reasonably possible, but no later than two weeks from the use;
and, requires epinephrine auto-injectors to be restocked
before their expiration date.
9)Requires a volunteer to initiate emergency medical services or
other appropriate medical follow-up (calling 911) in
accordance with the training materials; and, requires, no
later than 72 hours after an incident, the school nurse or
volunteer, in conjunction with a school administrator, to
report the incident to the school district, COE, or chartering
authority on a form developed by the department, California
Nurses Association, the California Emergency Medical Services
Authority and the American Academy of Pediatrics; requires the
school district, COE or chartering authority to report
aggregate counts to the department in a manner determined by
the department, commencing July 1, 2016; and, requires the
department to annually publish a summary of the data on its
Internet Web site.
10)Requires a school district, COE, or charter school to ensure
that each employee who volunteers under this section will be
provided defense and indemnification by the school district,
COE, or charter school for any and all civil liability; and,
specifies this information shall be reduced to writing,
provided to the volunteer, and retained in the volunteer's
personnel file.
11)Authorizes a state agency, the department or a public school
to accept gifts, grants, and donations from any source,
including, but not limited to, the acceptance of epinephrine
auto-injectors from a manufacturer or wholesaler.
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 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
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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.
3)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
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.
4)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) 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
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above.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, General Fund/Proposition 98 (1988) state reimbursable
mandated costs, potentially in the low millions, for local
education agencies to purchase and replenish epinephrine
auto-injectors; recruit and train volunteers; and report data.
There are over 9,000 schools and over 1,000 charter schools.
Costs range from $112 to $192 per two-pack of epinephrine
auto-injectors. Costs will vary depending on use at each school
site. These costs could be partially offset to the extent
schools are able to access free pens through certain
manufacturers, for example, the EpiPen4Schools program. LEAs
[local education agencies] will also incur costs to notify staff
of the ability to volunteer to administer epinephrine and to
provide associated volunteer training.
COMMENTS : This bill requires school districts, COEs, and
charter schools to provide emergency epinephrine auto-injectors
to school nurses and trained personnel who have volunteered, who
may use the epinephrine auto-injectors to provide emergency
medical aid to persons suffering, or reasonably believed to be
suffering, from an anaphylactic reaction. This bill requires a
qualified supervisor of health at a school district, COE or
charter operator to obtain an epinephrine auto-injector. If a
school district, COE or charter operator does not have a
qualified supervisor of health, this bill requires an
administrator to obtain an epinephrine auto-injector, only if
there is a volunteer willing to be responsible for injecting the
epinephrine in an emergency. This bill requires all schools
with a school nurse or trained volunteer to stock epinephrine
auto-injectors.
According to the author, the stocking of extra epinephrine
injectors will allow for the administration of the medication if
necessary to someone who is not aware of their life threatening
condition. By requiring stock epinephrine, as described in this
bill, we are enabling our State to possibly compete for federal
dollars and provide our school health professionals the
necessary tools and peace of mind to keep children safe.
Ultimately, we know with certainty this bill WILL be saving
lives as there is ample evidence from schools that have stocked
it, have had occasion to use it and in turn has resulted in
saving the lives of children.
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Analysis Prepared by : Chelsea Kelley / ED. / (916) 319-2087
FN:
0005028