BILL NUMBER:  AB 1791
  VETOED	DATE: 09/28/2000




SEP 28 2000

To Members of the California Assembly:

I am returning Assembly Bill  1791 without my signature.

This bill would authorize school districts to procure and provide
epinephrine auto-injectors to school nurses and lay school personnel.
  School lay personnel would be authorized to make the medical
judgement to provide emergency medical aid to school children
suffering from anaphylactic reaction by administering epinephrine.
The Superintendent of Public Instruction in consultation with the
Department of Health Services would be required to establish minimum
standards of training for administra tion of epinephrine
auto-injectors by lay school personnel.

The administration of epinephrine auto-injectors by medically trained
personnel such as school nurses could in certain instances be life
saving.  However, the shortage of school nurses with the knowledge
necessary to administer medications would assure that the bulk of
school personnel administering epinephrine in emergencies would be
lay personnel.  While there are training programs for non-licensed
persons that must administer medications conducted by schools of
nursing, medical schools, and schools that train physicians
assistants, such programs require weeks for matriculation and cannot
safely be compressed into a few hours.  Lay persons cannot receive
the necessary background in a limited training program that would
provide the essential medical judgement skills required to administer
medication in an emergency situation.































In addition, the administration of epinephrine auto-injectors to
children suffering anaphylactic reaction by inadequately trained lay
persons can result in life- threatening adverse reactions to the
medication that can only be safely addressed by trained medical
personnel.  The risk associated with these adverse reactions may out
weigh the potential benefit of the administration of the medication.

This bill does not require school districts to meet the same level of
safety standards that would be required of any other provider of
medical services, and; thus, may comprise the safety of California
public school students.

Moreover, this proposal would result in ongoing costs of between
seven and eight million dollars.  These costs were not included in
the budget process.

Sincerely,





GRAY DAVIS