BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 942
                                                                  Page  1

          ASSEMBLY THIRD READING
          AB 942 (Leno)
          As Amended April 24, 2003
          Majority vote 

           EDUCATION           9-0         HEALTH              23-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Goldberg, Cohn, Diaz,     |Ayes:|Frommer, Pacheco, Bates,  |
          |     |Garcia, Hancock, Liu,     |     |Chan, Chu, Cohn, Dutton,  |
          |     |Mullin, Pavley, Reyes     |     |Goldberg, Haynes, Koretz, |
          |     |                          |     |Lieber, Maze, McCarthy,   |
          |     |                          |     |Montanez, Nakanishi,      |
          |     |                          |     |Nakano, Negrete McLeod,   |
          |     |                          |     |Nunez, Plescia, Richman,  |
          |     |                          |     |Ridley-Thomas, Salinas,   |
          |     |                          |     |Yee                       |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           APPROPRIATIONS      24-0                                        
           
           ----------------------------------------------------------------- 
          |Ayes:|Steinberg, Bates, Berg,   |     |                          |
          |     |Calderon, Montanez,       |     |                          |
          |     |Correa, Daucher, Diaz,    |     |                          |
          |     |Firebaugh, Goldberg,      |     |                          |
          |     |Haynes, Leno, Maldonado,  |     |                          |
          |     |Nation,                   |     |                          |
          |     |Negrete McLeod, Nunez,    |     |                          |
          |     |Pacheco, Pavley,          |     |                          |
          |     |Ridley-Thomas, Runner,    |     |                          |
          |     |Samuelian, Simitian,      |     |                          |
          |     |Wiggins, Yee              |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Authorizes school staff to provide emergency medical  
          assistance to diabetic pupils suffering from severe  
          hypoglycemia.  Specifically,  this bill  :

          1)Requires that the American Diabetes Association, in  
            cooperation with the State Department of Education (SDE),  
            California School Nurses Organization, California Medical  
            Association, and American Academy of Pediatrics, to develop  








                                                                  AB 942
                                                                  Page  2

            performance standards for the training and supervision of  
            school personnel in providing emergency medical assistance to  
            pupils with diabetes suffering from severe hypoglycemia.

          2)Requires the Department of Health Services' (DHS) Diabetes  
            Prevention and Control Program to approve the above standards  
            and to make them available upon request.

          3)Authorizes school districts to provide personnel with  
            voluntary training in accordance with the above standards in  
            the absence of a credentialed school nurse or other licensed  
            nurse.

          4)Specifies that the training include recognition and treatment  
            of hypoglycemia, administration of glucagon, and basic  
            emergency follow-up procedures.

          5)Authorizes trained personnel to administer emergency medical  
            assistance to pupils with diabetes suffering from severe  
            hypoglycemia.

          6)Requires a school employee to notify the school nurse when  
            he/she administers glucagon and specifies that all materials  
            necessary to administer glucagon be provided by the student's  
            parent or guardian.

          7)Permits a diabetic student to test his/her blood glucose level  
            with a written request of a parent or guardian and  
            authorization from the student's health care provider.
           
            EXISTING 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.

            FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee, "According to DHS, minor costs likely less than  
          $50,000 to review and approve guidelines, as specified.
           
            COMMENTS  :  According to the author, there is significant  








                                                                  AB 942
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          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 and 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.
           
          Previous legislation, AB 481 (Firebaugh) of 2002, would have  
          required properly trained teachers to administer insulin or  
          glucagon and perform testing and monitoring of a pupil's blood  
          glucose level in the absence of a school nurse.  AB 481 also  
          prohibited school personnel from being required to provide  
          assistance to diabetic pupils unless the parent or guardian has  
          signed a waiver of liability and authorized pupils to test their  
          blood glucose level and provide diabetes self-care.  AB 481 was  
          vetoed by the Governor because it "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."


           Analysis Prepared by  :    Misty Padilla / ED. / (916) 319-2087



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