BILL NUMBER: AB 1386 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 16, 2015
AMENDED IN ASSEMBLY MARCH 26, 2015
INTRODUCED BY Assembly Member Low
FEBRUARY 27, 2015
An act to amend add Section
7099.4 of 4119.4 to the Business and
Professions Code, to amend Section 1714.23 of the Civil Code,
and to amend Section 1797.197a of the Health and Safety
Code, relating to contractors.
emergency medical care.
LEGISLATIVE COUNSEL'S DIGEST
AB 1386, as amended, Low. Contractors: discipline:
citation. Emergency medical care: epinephrine
auto-injectors.
(1) Existing law authorizes a prehospital emergency medical care
person, first responder, or lay rescuer to use an epinephrine
auto-injector to render emergency care to another person, as
specified. Existing law also requires the California Emergency
Medical Services (EMS) Authority to establish or approve authorized
training providers and minimum standards for training and the use and
administration of epinephrine auto-injectors, in consultation with
the local emergency medical system agency, the county health
department, the manufacturer, the State Department of Health Care
Services, and other private organizations. The Pharmacy Law also
authorizes a pharmacy to dispense epinephrine auto-injectors to a
prehospital emergency medical care person, first responder, or lay
rescuer for the purpose of rendering emergency care in accordance
with these provisions. A violation of the Pharmacy Law is a crime.
This bill would authorize an "authorized entity," as defined, to
use an epinephrine auto-injector to render emergency care to another
person in accordance with these provisions. The bill would also
authorize a pharmacy to furnish epinephrine auto-injectors to an
authorized entity pursuant to those provisions. Because a violation
of these provisions would be a crime, the bill would impose a
state-mandated local program. The bill would also require an
authorized entity to submit a report to the State Department of
Public Health on incidents related to the administration of
epinephrine auto-injectors, and for the department to issue an annual
report summarizing and analyzing the reports submitted to it.
(2) Under existing law, everyone is generally responsible, not
only for the result of his or her willful acts, but also for an
injury occasioned to another by his or her want of ordinary care or
skill in the management of his or her property or person, except so
far as the latter has, willfully or by want of ordinary care, brought
the injury upon himself or herself. Existing law also provides that
a prehospital emergency care person, first responder, or lay rescuer
who administers an epinephrine auto-injector to another person who
appears to be experiencing anaphylaxis at the scene of an emergency
situation, in good faith and not for compensation, is not liable for
any civil damages resulting from his or her acts or omissions in
administering the epinephrine auto-injector, if that person has
complied with specified certification and training requirements and
standards.
This bill would provide that employees, agents, or other trained
individuals of an authorized entity who administers an epinephrine
auto-injector to another person who appears to be experiencing
anaphylaxis at the scene of an emergency situation, in good faith and
not for compensation, is not liable for any civil damages resulting
from his or her acts or omissions in administering the epinephrine
auto-injector, if that person has complied with specified
certification and training requirements and standards. The bill would
also provide that an authorized entity located in this state shall
not be liable, in this state, for any injuries or related damages
that result from the provision or administration of an epinephrine
auto-injector by its employees or agents outside of this state if the
entity or its employee or agent would not have been liable for those
injuries or related damages had the provision or administration
occurred within this state.
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 no reimbursement is required by this
act for a specified reason.
Existing law, the Contractors' State License Law, provides for the
licensure and regulation of contractors by the Contractors' State
License Board. Existing law, based upon an investigation and probable
cause, authorizes the registrar of contractors, in lieu of
disciplinary proceedings, to issue a citation to a licensee, as
defined, or an applicant for a license for violations of the
Contractors' State License Law. Existing law provides that if the
licensee or applicant fails to notify the registrar that he or she
intends to contest the citation within 15 working days from service
of the citation, the citation is deemed a final order of the
registrar and is not subject to review by any court or agency, as
provided.
This bill would extend the time available for a licensee or
applicant to contest that citation from 15 to 20 working days.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no yes .
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 4119.4 is added to the
Business and Professions Code , to read:
4119.4. (a) Notwithstanding any other law, a pharmacy may furnish
epinephrine auto-injectors to an authorized entity, as defined by
Section 1797.197a of the Health and Safety Code, if both of the
following requirements are met:
(1) The epinephrine auto-injectors are furnished exclusively for
use at or in connection with an authorized entity.
(2) An authorized health care provider provides a prescription
that specifies the quantity of epinephrine auto-injectors to be
furnished.
(b) Records regarding the acquisition and disposition of
epinephrine auto-injectors furnished pursuant to subdivision (a)
shall be maintained by the authorized entity for a period of three
years from the date the records were created. The authorized entity
shall be responsible for monitoring the supply of epinephrine
auto-injectors and ensuring the destruction of expired epinephrine
auto-injectors.
SEC. 2. Section 1714.23 of the Civil
Code is amended to read:
1714.23. (a) For purposes of this section, the following
definitions shall apply:
(1) "Anaphylaxis" means a potentially life-threatening
hypersensitivity or allergic reaction 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,
insect stings or bites, foods, drugs, and other allergens, as well as
idiopathic or exercise-induced anaphylaxis.
(2) "Epinephrine auto-injector" means a disposable drug delivery
system with a spring-activated concealed needle that is designed for
emergency administration of epinephrine to provide rapid, convenient
first aid for persons suffering from anaphylaxis.
(b) (1) Any person described in subdivision
(b) of Section 1797.197a of the Health and Safety Code or
employees, agents, or other trained individuals of an authorized
entity, as defined by paragraph (2) of subdivision (a) of Section
1797.197a of the Health and Safety Code, who administers an
epinephrine auto-injector, in good faith and not for compensation, to
another person who appears to be experiencing anaphylaxis at the
scene of an emergency situation is not liable for any civil damages
resulting from his or her acts or omissions in administering the
epinephrine auto-injector, if that person has complied with the
requirements and standards of Section 1797.197a of the Health and
Safety Code.
(2) An authorized health care provider that prescribes an
epinephrine auto-injector to a person described in subdivision (b) of
Section 1797.197a of the Health and Safety Code or an authorized
entity is not liable for any civil damages resulting from any act or
omission related to the provision of an epinephrine auto-injector.
(3) A person that conducts the training described in subdivision
(c) of Section 1797.197a of the Health and Safety Code is not liable
for any civil damages resulting from any act or omission related to
the acquisition, possession, administration, or provision of an
epinephrine auto-injector.
(4) An authorized entity located in this state shall not be
liable, in this state, for any injuries or related damages that
result from the provision or administration of an epinephrine
auto-injector by its employees or agents outside of this state if the
entity or its employee or agent would not have been liable for those
injuries or related damages had the provision or administration
occurred within this state.
(5) This subdivision does not eliminate, limit, or reduce any
other immunity or defense that may otherwise be available under state
law.
(c) The protection specified in subdivision (b) shall not apply in
a case of personal injury or wrongful death that results from the
gross negligence or willful or wanton misconduct of the person who
renders emergency care treatment by the use of an epinephrine
auto-injector.
(d) Nothing in this section relieves a manufacturer, designer,
developer, distributor, or supplier of an epinephrine auto-injector
of liability under any other applicable law.
SEC. 3. Section 1797.197a of the Health
and Safety Code is amended to read:
1797.197a. (a) For purposes of this section, the following
definitions shall apply:
(1) "Anaphylaxis" means a potentially life-threatening
hypersensitivity or allergic reaction 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,
insect stings or bites, foods, drugs, and other allergens, as well as
idiopathic or exercise-induced anaphylaxis.
(2) "Authorized entity" means any entity or organization in
connection with, or at which, allergens capable of causing
anaphylaxis may be present, including, but not limited to, recreation
camps, colleges and universities, day care facilities, youth sport
leagues, amusement parks, restaurants, places of employment, and
sports arenas.
(2)
(3) "Epinephrine auto-injector" means a disposable drug
delivery system with a spring-activated concealed needle that is
designed for emergency administration of epinephrine to provide
rapid, convenient first aid for persons suffering from anaphylaxis.
(3)
(4) "Lay rescuer" means any person who has met the
training standards and other requirements of this section but who is
not otherwise licensed or certified to use an epinephrine
auto-injector on another person.
(4)
(5) "Prehospital emergency medical care person" has the
same meaning as defined in paragraph (2) of subdivision (a) of
Section 1797.189.
(b) A prehospital emergency medical care person or
person, lay rescuer
rescuer, or employees, agents, or other trained individuals of an
authorized entity may use an epinephrine auto-injector to
render emergency care to another person if all of the following
requirements are met:
(1) The epinephrine auto-injector is legally obtained by
prescription from an authorized health care provider.
provider or from an authorized entity that acquired
the epinephrine auto-injector pursuant to subdivision (e). An
authorized health care provider may issue a prescription for an
epinephrine auto-injector to a person described in this subdivision
for the purpose of rendering emergency care to another person, upon
presentation of current certification demonstrating that person is
trained and qualified to administer an epinephrine auto-injector as a
prehospital emergency medical care person or lay rescuer, pursuant
to this section or any other statute or regulation.
(2) The epinephrine auto-injector is used on another, with the
expressed or implied consent of that person, to treat anaphylaxis.
(3) The epinephrine auto-injector is stored and maintained as
directed by the manufacturer's instructions for that product.
(4) The person using the epinephrine auto-injector has
successfully completed a course of training with an authorized
training provider, as described in subdivision (c), and has current
certification of training issued by the provider.
(5) The epinephrine auto-injectors obtained by prehospital
emergency medical care personnel pursuant to Section 4119.3 of the
Business and Professions Code shall be used only when functioning
outside the course of the person's occupational duties, or as a
volunteer, pursuant to this section.
(6) The Emergency Medical Services System is activated as soon as
practicable when an epinephrine auto-injector is used.
(c) (1) The authorized training providers shall be approved, and
the minimum standards for training and the use and administration of
epinephrine auto-injectors pursuant to this section shall be
established and approved, by the California Emergency Medical
Services (EMS) Authority. The authority may designate existing
training standards for the use and administration of epinephrine
auto-injectors by prehospital emergency medical care personnel to
satisfy the requirements of this section.
(2) The minimum training and requirements shall include all of the
following components:
(A) Techniques for recognizing circumstances, signs, and symptoms
of anaphylaxis.
(B) Standards and procedures for proper storage and emergency use
of epinephrine auto-injectors.
(C) Emergency followup procedures, including activation of the
Emergency Medical Services System, by calling the emergency 9-1-1
telephone number or otherwise alerting and summoning more advanced
medical personnel and services.
(D) Compliance with all regulations governing the training,
indications, use, and precautions concerning epinephrine
auto-injectors.
(E) Written material covering the information required under this
provision, including the manufacturer product information sheets on
commonly available models of epinephrine auto-injectors.
(F) Completion of a training course in cardiopulmonary
resuscitation and the use of an automatic external defibrillator
(AED) for infants, children, and adults that complies with
regulations adopted by the EMS Authority and the standards of the
American Heart Association or the American Red Cross, and a current
certification for that training.
(3) Training certification shall be valid for no more than two
years, after which recertification with an authorized training
provider is required.
(4) The director of the authority may, in accordance with
regulations adopted by the authority, deny, suspend, or revoke any
approval issued under this subdivision or may place any approved
training provider on probation upon a finding by the director of an
imminent threat to public health and safety, as evidenced by any of
the following:
(A) Fraud.
(B) Incompetence.
(C) The commission of any fraudulent, dishonest, or corrupt act
that is substantially related to the qualifications, functions, or
duties of training program directors or instructors.
(D) Conviction of any crime that is substantially related to the
qualifications, functions, or duties of training program directors or
instructors. The record of conviction or a certified copy of the
record shall be conclusive evidence of the conviction.
(E) Violating or attempting to violate, directly or indirectly, or
assisting in or abetting the violation of, or conspiring to violate,
any provision of this section or the regulations promulgated by the
authority pertaining to the review and approval of training programs
in anaphylaxis and the use and administration of epinephrine
auto-injectors, as described in this subdivision.
(d) (1) The authority shall assess a fee pursuant to regulation
sufficient to cover the reasonable costs incurred by the authority
for the ongoing review and approval of training and certification
under subdivision (c).
(2) The fees shall be deposited in the Specialized First Aid
Training Program Approval Fund, which is hereby created in the State
Treasury. All moneys deposited in the fund shall be made available,
upon appropriation, to the authority for purposes described in
paragraph (1).
(3) The authority may transfer unused portions of the Specialized
First Aid Training Program Approval Fund to the Surplus Money
Investment Fund. Funds transferred to the Surplus Money Investment
Fund shall be placed in a separate trust account, and shall be
available for transfer to the Specialized First Aid Training Program
Approval Fund, together with the interest earned, when requested by
the authority.
(4) The authority shall maintain a reserve balance in the
Specialized First Aid Training Program Approval Fund of 5 percent of
annual revenues. Any increase in the fees deposited in the
Specialized First Aid Training Program Approval Fund shall be
effective upon determination by the authority that additional moneys
are required to fund expenditures pursuant to subdivision (c).
(e) An authorized health care provider may prescribe epinephrine
auto-injectors to an authorized entity or to an employee or agent of
which that holds a current certification demonstrating that the
person is trained and qualified to administer an epinephrine
auto-injector as a lay rescuer. Epinephrine auto-injectors acquired
by an authorized entity shall be stored in a location readily
accessible in an emergency and in accordance with the epinephrine
auto-injectors instructions for use and any additional requirements
that may be established by the EMS Authority.
(f) An authorized entity that possesses and makes available
epinephrine auto-injectors shall submit to the State Department of
Public Health, on a form developed by the State Department of Public
Health, a report of each incident on the authorized entity's premises
that involves the administration of an epinephrine auto-injector.
The State Department of Public Health shall annually publish a report
that summarizes and analyzes all reports submitted to it under this
subdivision.
(e)
(g) This section shall not apply to a school district
or county office of education, or its personnel, that provides and
utilizes epinephrine auto-injectors to provide emergency medical aid
pursuant to Section 49414 of the Education Code.
(f)
(h) This section shall not be construed to limit or
restrict the ability of prehospital emergency medical care personnel,
under any other statute or regulation, to administer epinephrine,
including the use of epinephrine auto-injectors, or to require
additional training or certification beyond what is already required
under the other statute or regulation.
SEC. 4. No reimbursement is required by this act
pursuant to Section 6 of Article XIII B of the California
Constitution because the only costs that may be incurred by a local
agency or school district will be incurred because this act creates a
new crime or infraction, eliminates a crime or infraction, or
changes the penalty for a crime or infraction, within the meaning of
Section 17556 of the Government Code, or changes the definition of a
crime within the meaning of Section 6 of Article XIII B of the
California Constitution.
SECTION 1. Section 7099.4 of the Business and
Professions Code is amended to read:
7099.4. If within 20 working days from service of the citation
issued by the registrar, the licensee or applicant for licensure
fails to notify the registrar that he or she intends to contest the
citation, the citation shall be deemed a final order of the registrar
and not be subject to review by any court or agency. The 20-day
period may be extended by the registrar for cause.