BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 942
                                                                  Page  1

          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  








                                                                  AB 942
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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