BILL ANALYSIS
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
1051 (Huff)
Hearing Date: 05/27/2010 Amended: 05/12/2010
Consultant: Dan Troy Policy Vote: ED 5-1, Health 6-3
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BILL SUMMARY: SB 1051 would authorize a school district, until
January 1, 2016, to provide nonlicensed school employees with
voluntary training for the provision of emergency medical
assistance to a pupil suffering from an epileptic seizure, in
the absence of licensed personnel.
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Fiscal Impact (in thousands)
Major Provisions 2010-11 2011-12 2012-13 Fund
DPH $60
General
Notification, assistance Likely tens or low hundreds
of thousands General*
*Counts toward meeting the Proposition 98 minimum funding
guarantee
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STAFF COMMENTS: SUSPENSE FILE. AS PROPOSED TO BE AMENDED.
Under current law, the Nursing Practice Act sets forth the scope
of practice for nursing, which specifically includes the
administration of medication, and prohibits any person from
engaging in the practice of nursing without a license. Current
law authorizes non-medical school personnel to administer
certain medications (epinephrine auto-injectors, glucagon) to a
pupil in an emergency, as specified. Current allows non-medical
school personnel to assist or administer medication to a pupil
on a routine basis in certain cases, regarding epinephrine,
inhaled asthma medication, or in cases where the pupil's health
care provider gives a written statement with specific
information, such as the medication the pupil is to take, the
dosage, and the period of time during which the medication is to
be taken, and if the pupil's parent provides a written statement
initiating a request to have the medication administered to the
pupil or to have the pupil otherwise assisted in the
administration of the medication.
Section 504 of the federal Rehabilitation Act of 1973 requires
school districts to provide a free appropriate public education
to each qualified person with a disability who is in the school
district's jurisdiction, regardless of the nature or severity of
the person's disability, which includes reasonable
accommodations required for the management of chronic medical
conditions.
Pursuant to a 2007 lawsuit settlement (K.C. v. Jack O'Conneli),
the Department of Education has advised school districts that
they are allowed to have nonmedical personnel administer insulin
to pupils when nurses or health care professionals are
unavailable. The portion of this settlement was challenged and
was overturned by the
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Sacramento Superior Court. Upon an appeal of this decision,
however, a stay has been granted, which allows the Department to
continue advising districts that insulin may be
administered by nonmedical personnel. The ultimate legal status
for the provision of this service by nonlicensed personnel,
thus, remains unsettled. This issue is significant as fewer
than half of all California school districts have a nurse. As
of 2008-09, there were a total of 2,901 nurses employed to cover
medical needs at the state's 10,223 public schools.
This bill would authorize a school district to provide school
employees with voluntary training for the provision of emergency
medical assistance to certain pupils suffering from an epileptic
seizure. The bill provides that the parent of a pupil that is
prescribed diastat may request the school to have one or more
employees trained to administer the drug when a nurse is not
available. Upon receipt of the request, the school would be
required to notify the parent that the pupil may qualify for a
Section 504 plan (under the federal Rehabilitation Act of 1973)
and assist the parent in exploring that option.
If the parent does not choose to have the pupil assessed for a
504 plan, the school may opt to create an individualized health
plan to prepare to meet the pupil's needs. The district may
solicit volunteers to be trained to administer diastat in the
absence of a licensed professional, as specified. If there are
no volunteers, the school would renotify the parent of the
option to be assessed for a 504 plan. The school plan would
include the identification of existing licensed personnel that
could be trained to administer diastat, identification of pupils
who may require the administration, written authorization from
the parent that nonmedical personnel may administer diastat to
the pupil, a requirement that the parent notify the school if
the pupil has had diastat administered within a 4-hour period,
and a written statement from the pupil's health care
practitioner specifying the proper dosage, appropriate time for
administration, and other specified protocols.
The bill would encourage the Epilepsy Foundation of America to
develop performance standards for the training and supervision
of school employees related to the assistance of pupils with
epilepsy suffering from seizures, as specified. The Department
of Public Health (DPH) would be required to approve performance
standards and make them available upon request.
DPH indicates costs of $60,000 to approve performance standards.
According to the sponsor, the range of California school
children in need of diastat administration is between 6,000 and
16,000. As the bill requires notifications and certain
assistance to parents requesting that employees be trained to
administer diastat, there would potentially be some reimbursable
state mandate costs for these efforts, likely in the tens or low
hundreds of thousands. Any costs incurred by the district for
the training of personnel and administration of the drug would
be at local discretion or pursuant to Section 504, so there
should be no increase in state costs for those activities.
Author's proposed amendments would authorize rather than require
DPH to
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adopt standards and would state that notification and assistance
requirements were attributable to Section 504.