BILL ANALYSIS
AB 942
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Date of Hearing: May 14, 2003
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Darrell Steinberg, Chair
AB 942 (Leno) - As Amended: April 24, 2003
Policy Committee: EducationVote:9-0
Health 23-0
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill permits school districts, in the absence of a
credentialed school nurse or other licensed nurse onsite at a
school, to provide school personnel with voluntary emergency
medical training for the purpose of providing assistance to
pupils with diabetes who are suffering from severe hypoglycemia.
In addition, the bill:
1)Requires the Department of Health Services (DHS) to approve
performance standards for the training and supervision of
school personnel. The bill requires DHS to make the
performance standards available for distribution upon request.
2)Requires the performance standards to be developed by the
American Diabetes Association working in cooperation with the
State Department of Education (SDE), the California School
Nurses Organization, the California Medical Association, and
the American Academy of Pediatrics.
3)Requires the training to include recognizing and treating
hypoglycemia, administering of glucagon, and basic emergency
follow-up procedures, as specified.
4)Specifies that training by a physician, credentialed school
nurse, registered nurse, or certificated public health nurse
shall be deemed adequate training for the purposes of this
measure.
5)Requires a school employee to notify the credentialed school
nurse assigned to the school district if they administer
glucagon, as specified. In addition, requires the parent or
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guardian of the pupil provide all materials necessary to
administer the glucagon.
6)Permits pupils, who are able to self-test and monitor their
blood glucose and provide diabetes self-care, to do so in any
area of the school, as specified, upon written request of the
parent and authorization of the licensed health care provider
of the pupil.
FISCAL EFFECT
According to DHS, minor costs likely less than $50,000 to review
and approve guidelines, as specified.
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COMMENTS
1)Rationale . According to the author, "there is significant
confusion over who can administer medication in schools, which
leads to inconsistent school health policies. Many argue only
licensed nurses can administer medication in schools which
results in a situation where, when there is no school nurse on
site, a child must go without necessary medication. Existing
California law has led to a disconnect, where schools are
required to meet pupil health needs but only certified persons
are permitted to fulfill such obligations. School districts
are not required to employ these certified persons, and many
do not. Consequently, many California schools have no staff
to attend to pupil's emergency health needs. This bill would
address this problem for diabetic students who may require
medication in emergency situations."
2)Current law provides that each pupil who is required to take,
during the regular schoolday, medication prescribed for him or
her by a physician, may be assisted by the school nurse or
other designated school personnel if the school district
receives a written statement from the physician detailing the
method, amount and time schedules by which the medication is
to be taken and a written statement from the parent or
guardian of the pupil indicating the desire that the school
district assist the pupil in the matters set forth in the
physician's statement.
3)Prior legislation . AB 481 (Firebaugh) of 2002 would have
required a credentialed school nurse or other licensed nurse,
or in the absence of a nurse, teachers who have volunteered
and school administrators with appropriate DHS-approved
training, to administer insulin or glucagon and perform
testing and monitoring of a pupil's blood glucose level in
accordance with instructions set forth by the pupil's
physician.
The bill was vetoed because, according to the governor, the bill
"would create a costly new state reimbursable mandate
estimated by the Department of Finance to be potentially tens
of millions of dollars. In addition, I am advised by school
district personnel that the immunity from liability language
may protect neither the school district or school personnel
from liability."
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Analysis Prepared by : Daniel Alvarez / APPR. / (916) 319-2081