BILL ANALYSIS Ó SENATE COMMITTEE ON HEALTH Senator Ed Hernandez, O.D., Chair BILL NO: SB 1258 --------------------------------------------------------------- |AUTHOR: |Huff | |---------------+-----------------------------------------------| |VERSION: |March 29, 2016 | --------------------------------------------------------------- --------------------------------------------------------------- |HEARING DATE: |April 6, 2016 | | | --------------------------------------------------------------- --------------------------------------------------------------- |CONSULTANT: |Reyes Diaz | --------------------------------------------------------------- SUBJECT : Pupil health: food allergies: local educational agency policy SUMMARY : Requires a school district, county office of education, and charter school to develop a comprehensive policy, as specified, in coordination with specified individuals, to protect pupils with food allergies. Existing law: 1)Requires school districts, county offices of education, and charter schools to provide emergency epinephrine auto-injectors (EAIs) to school nurses and trained personnel who have volunteered, as specified, and would authorize school nurses and trained personnel to use EAIs to provide emergency medical aid to persons suffering, or reasonably believed to be suffering, from an anaphylactic reaction. 2)Requires a qualified supervisor of health or administrator at a school district, county office of education, or charter school to obtain the prescription for EAIs from an authorizing physician and surgeon, as defined, and would authorize the prescription to be filled by local or mail order pharmacies or EAI manufacturers. This bill: 1)Requires a school district, county office of education, and charter school to develop a comprehensive policy to protect pupils with food allergies. Requires the policy to include, at a minimum, protocols for pupils with food allergies that pertain to all of the following: a) School stocking of medication, including storage of medication in classrooms; SB 1258 (Huff) Page 2 of ? b) School parties; c) Lunch time, including seating arrangements; d) Food served by the local educational agency (LEA); e) After-school events; f) Field trips; g) Bullying; h) Recess; and, i) Teacher and employee training. 2)Requires a LEA to create the policy in coordination with, at a minimum: a) A LEA or schoolsite nurse, or if there is no LEA or schoolsite nurse, the LEA or schoolsite's designated health personnel; b) A parent of a pupil with a food allergy; c) An ad hoc parent; and, d) A director of food services. FISCAL EFFECT : This bill has not been analyzed by a fiscal committee. COMMENTS : 1)Author's statement. According to the author, in 2014, recognizing the importance of a new and emerging life threatening health issue, the Legislature acted in a bi-partisan manner and passed SB 1266 (Huff, Chapter 321, Statutes of 2014), which required extra EAIs in public schools in case of emergencies. That landmark legislation helped cement the Legislature's commitment to ensure students with life threatening allergies are safe at school. After my work on SB 1266, it became apparent that schools are lacking in policies and direction on how to accommodate children with food allergies. Whether it be lunch hour seating, field trips, school parties, storage of medication, or bullying, there currently is no comprehensive approach. According to the California School Boards Association (CSBA), approximately 1/3 of schools have policies on this issue. This means many schools have no policies at all, leaving parents and teachers in a predicament on how to ensure children are safe during school hours. The lack of consistency on this issue leaves schools open for liability concerns. SB 1258 will require districts to create a policy to address accommodations and safety measures. These policies will help ensure the safety for the student, provide clear direction to teachers, and ease SB 1258 (Huff) Page 3 of ? liability for the district. 2)Background. According to the Food Allergy Research & Education (FARE) Web site, eight foods account for 90% of all reactions: milk, eggs, peanuts, tree nuts, soy, wheat, fish, and shellfish. Even trace amounts of a food allergen can cause a reaction. Researchers estimate that up to 15 million Americans have food allergies. This potentially deadly disease affects one in every 13 children (under 18 years of age) in the U.S., equaling roughly two in every classroom. According to a study released in 2013 by the Centers for Disease Control and Prevention, food allergies among children increased approximately 50% between 1997 and 2011. FARE's Web site state's the economic cost of children's food allergies is nearly $25 billion per year. Teenagers and young adults with food allergies are at the highest risk of fatal food-induced anaphylaxis. CSBA has a sample policy that addresses students' food allergies and special dietary needs, including the development of guidelines that address things such as strategies for identifying students at risk for allergic reactions, avoidance measures, education of staff regarding typical symptoms, and actions to be taken in the event of a severe allergic reaction. CSBA notes in the sample policy that it is prohibited to exclude students from school activities or otherwise discriminate against, harass, intimidate, or bully them because of their food allergies. 3)What is anaphylaxis? According to the National Institutes of Health, anaphylaxis is a severe, whole-body allergic reaction to a chemical that has become an allergen. After being exposed to a substance, such as bee sting venom, the person's immune system becomes sensitized to it. When the person is exposed to that allergen again, an allergic reaction may occur. Anaphylaxis happens quickly after the exposure, is severe, and involves the whole body. Tissues in different parts of the body release histamine and other substances. This causes the airways to tighten and leads to other symptoms. Some drugs (such as morphine, x-ray dye, and aspirin) may cause an anaphylactic-like reaction when people are first exposed to them. These reactions are not the same as the immune system response that occurs with true anaphylaxis. However, the symptoms, risk for complications, and treatment are the same for both types of reactions. Risks include a history of any type of allergic reaction. According to Food Allergy Research & Education SB 1258 (Huff) Page 4 of ? (FARE), approximately 25% of first-time allergic reactions that require epinephrine happen at school. 4)Double referral. Should this bill pass out of this Committee, it will be referred to the Senate Education Committee. 5)Prior legislation. SB 738 (Huff, Chapter 132, Statutes of 2015), prohibits an authorizing physician and surgeon from being subject to professional review, being liable in a civil action, or being subject to criminal prosecution for the issuance of a prescription or order, unless the physician and surgeon's issuance of the prescription or order constitutes gross negligence or willful or malicious conduct. SB 1266, requires school districts, county offices of education, and charter schools to provide emergency EAIs to school nurses and trained personnel who have volunteered, as specified, and would authorize school nurses and trained personnel to use EAIs to provide emergency medical aid to persons suffering, or reasonably believed to be suffering, from an anaphylactic reaction. SB 669 (Huff, Chapter 725, Statutes of 2013), permits a prehospital emergency medical care person or lay rescuer to obtain and use an EAI in emergency situations with certification of training, as specified. SB 1069 (Pavley, Chapter 512, Statutes of 2010), in addition to expanding the scope of practice for physician assistants in other instances, added physician assistants, in addition to physician and surgeons, from whom a school pupil must obtain a written statement in order to carry and self-administer a prescription EAI. SB 1912 (Ashburn, Chapter 846, Statutes of 2004), permits pupils to carry and self-administer inhaled asthma medication or an EAI at school, as specified. AB 559 (Wiggins, Chapter 458, Statutes of 2001), permits a school district or county office of education to provide emergency EAIs to trained personnel, and permits trained personnel to utilize these EAIs to provide emergency medical aid to persons suffering from an anaphylactic reaction at a school or during a school activity. SB 1258 (Huff) Page 5 of ? SUPPORT AND OPPOSITION : Support: None received Oppose: None received -- END --