BILL ANALYSIS
AB 1937
Page 1
Date of Hearing: May 4, 2010
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Mary Hayashi, Chair
AB 1937 (Fletcher) - As Amended: April 28, 2010
SUBJECT : Pupil health: immunizations.
SUMMARY : Expands the individuals who are authorized to
administer school immunizations, as specified. Specifically,
this bill :
1)Authorizes the governing board (board) of a school district to
allow the following individuals, acting under the direction of
a supervising physician and surgeon (SPS), to administer
certain immunizations to a pupil whose parent or guardian has
consented in writing:
a) A physician assistant (PA);
b) A nurse practitioner (NP);
c) A registered nurse (RN);
d) A licensed nurse (LN); or
e) A student nurse (SN) acting under the supervision of a
registered nurse as authorized under current law.
2)Permits the authorized individuals to perform immunizations as
part of a school immunization program if:
a) The administration of an immunizing agent is upon the
standing orders of a SPS and in accordance with any written
regulations adopted by the State Department of Public
Health; and,
b) The school nurse is notified and he or she maintains
control, as specified.
3)Requires the SPS to require the PA, NP, RN, LN, or SN to:
a) Satisfactorily demonstrate competence in the
administration of the immunizing agent, including
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knowledge of all indications and contraindications for the
administration of the agent, and the recognition and
treatment of emergency reactions to the agent that
constitute a danger to the health or life of the person
receiving the immunization; and,
b) Possess the medications and equipment that are required,
in the medical judgment of the SPS, to treat any emergency
conditions or reactions caused by the immunizing agents
that constitute a danger to the health or life of the
person receiving the immunization, and to demonstrate the
ability to administer the medications and use the equipment
as necessary.
4)Authorizes the PA, NP, RN, LN, or SN to administer, as
specified, an immunization agent that controls the following:
a) Annual seasonal influenza;
b) Influenza pandemic episodes; and,
c) Other diseases that represent a current or potential
outbreak, as declared by a local, state, or federal public
health officer.
5)Declares legislative intent.
6)Defines "SPS" as the physician and surgeon of the local health
department or school district that is directing the school
immunization program.
EXISTING LAW:
1)Requires the board to cooperate with the local health officer
in measures necessary for the prevention and control of
communicable diseases in schoolage children, and authorizes
the board to permit a licensed physician and surgeon or a
licensed RN acting under the direction of a SPS to administer
an immunizing agent to a pupil whose parents have consented,
as specified.
2)Permits the following health care practitioners to administer
immunizations: physicians and surgeons, NPs, PAs, RNs,
licensed vocational nurses (LVN), medical assistants (MA),
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pharmacists, and paramedics.
FISCAL EFFECT : Unknown. This bill is keyed non-fiscal.
COMMENTS :
Purpose of this bill . According to the author's office, "This
proposed legislation would allow school districts to
'voluntarily' add additional medical personnel, currently
permitted to administer vaccinations, in order to implement a
school based immunization program. Further, this would
supplement the work of a school nurse by permitting more
licensed medical personnel to assist with the administering of
vaccines during a school based immunization program. As a
result, there is the potential for more children to be immunized
or allow multiple programs to be held on a single day with
increased qualified healthcare staff."
Background . Current law requires a board to cooperate with the
local health officer to help prevent and control communicable
diseases in school age children. California Education Code
permits only a licensed physician and surgeon or a licensed RN
acting under the direction of a SPS to administer immunizations
to pupils. However, California Business and Professions Code
authorizes a greater number of individuals to administer
vaccinations according to their scopes of practice, in addition
to a physician and surgeon and a RN. Under varying
circumstances, the following individuals may administer
immunizations: physicians and surgeons, NPs, PAs, RNs, LVNs,
MAs, pharmacists, and paramedics. This bill would more closely
reconcile the two codes relating to health professionals'
practice scopes.
The California School Immunization Law (CSIL) requires that
children receive a series of immunizations before entry to
schools, child care centers, or family child care homes. In
addition, CSIL requires schools, child care centers, and family
child care homes to enforce immunization requirements, to
maintain immunization records of all children enrolled, and to
submit reports to the health department.
Arguments in support . MedImmune, Inc. writes, "AB 1937 is
narrow in scope and does not give immunization authority to any
person who is not currently permitted to do so, nor does it
eliminate the role of the school nurses in a school based
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immunization program. Due to the shortage of school nurses in
California and many districts only having one or two nurses, AB
1937 has the potential to immunize more children, reach more
schools in a shorter period of time and limit the amount of time
a child is actually out of the classroom."
Arguments in opposition . American Nurses Association writes,
"Currently, the only health care practitioners who can give
immunizations are physicians, registered nurses, LVNs, and PAs.
RNs, LVNs and PAs all do so under the auspices of the physician.
This bill is not needed to authorize the [healthcare providers
listed in the bill] to give immunizations."
REGISTERED SUPPORT / OPPOSITION :
Support
California Academy of Family Physicians
California Healthcare Institute
California Medical Association
California School Nurses Organization
The Health Officers Association of California
Kaiser Permanente Medical Care Program
MedImmune, Inc.
Opposition
American Nurses Association, California
California Nurses Association
Analysis Prepared by : Sarah Weaver / B., P. & C. P. / (916)
319-3301