BILL ANALYSIS Ó
-----------------------------------------------------------------
|SENATE RULES COMMITTEE | SB 1266|
|Office of Senate Floor Analyses | |
|1020 N Street, Suite 524 | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
-----------------------------------------------------------------
UNFINISHED BUSINESS
Bill No: SB 1266
Author: Huff (R), et al.
Amended: 8/21/14
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
SENATE FLOOR : 37-0, 5/28/14
AYES: Anderson, Beall, Berryhill, Block, Cannella, Corbett,
Correa, De León, DeSaulnier, Evans, Fuller, Gaines, Galgiani,
Hancock, Hernandez, Hill, Hueso, Huff, Jackson, Knight, Lara,
Leno, Lieu, Liu, Mitchell, Monning, Morrell, Nielsen, Padilla,
Pavley, Roth, Steinberg, Torres, Vidak, Walters, Wolk, Wyland
NO VOTE RECORDED: Calderon, Wright, Yee
ASSEMBLY FLOOR : 76-0, 8/27/14 - See last page for vote
SUBJECT : Epinephrine auto-injectors
CONTINUED
SB 1266
Page
2
SOURCE : Food Allergy Research and Education
DIGEST : This bill 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, as specified. Authorizes school nurses or
trained personnel to use the epinephrine auto-injectors to
provide emergency medical aid to persons suffering, or
reasonably believed to be suffering, from an anaphylactic
reaction.
Assembly Amendments clarify the definitions for qualified
supervisor of health and volunteer; clarify training
requirements to include dosing weight training and CPR
(cardiopulmonary resuscitation) evaluation; add a volunteer
solicitation piece; removed reporting requirement; clarify who
can give epinephrine and obtain the school prescription; and add
the Stanford Allergy Center as a collaborator on the training
standards.
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.
CONTINUED
SB 1266
Page
3
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
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 Superintendent of Public Instruction (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.
CONTINUED
SB 1266
Page
4
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, COE, and charter schools to
provide emergency epinephrine auto-injectors to school nurses or
trained personnel who have volunteered, as specified.
Authorizes school nurses or trained personnel to use the
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 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 provide a written order that
specifies the quantity of epinephrine auto-injectors to
be furnished.
2. Requires that records regarding the acquisition and
disposition of epinephrine auto-injectors furnished to 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 terms anaphylaxis, epinephrine auto-injector,
volunteer or trained personnel, authorizing physician and
surgeon, and qualified supervisor of health, for purposes of
the bill.
CONTINUED
SB 1266
Page
5
4. Requires every five years, or sooner as deemed necessary by
the 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, as
specified.
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
grade level or age as a guideline of equivalency for the
appropriate pupil weight determination.
F. Written materials covering the information required
under this bill.
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
CONTINUED
SB 1266
Page
6
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 COE, 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 COE, 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, a COE, or
charter school does not have a qualified supervisor of
health, an administrator at the school district, a COE, 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
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.
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,
CONTINUED
SB 1266
Page
7
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.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
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.
SUPPORT : (Verified 8/27/14)
Food Allergy Research and Education (source)
Allergy & Asthma Associates of Southern California
Allergy & Asthma Medical Group & Research Center
Allergy & Asthma Network Mothers of Asthmatics
Allergy and Asthma Associates of Northern California
American Academy of Allergy Asthma and Immunology
American College of Emergency Physicians
American Nurses Association - California Chapter
American Red Cross
Association of Regional Center Agencies
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
CONTINUED
SB 1266
Page
8
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
Epilepsy California
Food Allergy and Anaphylaxis Connection Team
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 Support Group
San Francisco Bay Area Food Allergy Network
Sanofi
SF 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 8/27/14)
California Federated of Teachers
California Teachers Association
ASSEMBLY FLOOR : 76-0, 8/27/14
AYES: Achadjian, Alejo, Allen, Ammiano, Bigelow, Bloom,
Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian
Calderon, Campos, Chau, Chávez, Chesbro, Conway, Cooley,
Dababneh, Dahle, Daly, Dickinson, Donnelly, Eggman, Fong, Fox,
Frazier, Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gorell,
CONTINUED
SB 1266
Page
9
Gray, Grove, Hagman, Hall, Roger Hernández, Holden, Jones,
Jones-Sawyer, Levine, Linder, Logue, Lowenthal, Maienschein,
Mansoor, Medina, Melendez, Mullin, Muratsuchi, Nazarian,
Nestande, Olsen, Pan, Patterson, Perea, John A. Pérez, V.
Manuel Pérez, Quirk, Quirk-Silva, Rendon, Ridley-Thomas,
Rodriguez, Salas, Skinner, Stone, Ting, Wagner, Waldron,
Weber, Wieckowski, Wilk, Williams, Atkins
NO VOTE RECORDED: Gordon, Harkey, Yamada, Vacancy
PQ:d 8/27/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
**** END ****
CONTINUED