Bill Text: CA SB1266 | 2013-2014 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Pupil health: epinephrine auto-injectors.

Spectrum: Bipartisan Bill

Status: (Passed) 2014-09-15 - Chaptered by Secretary of State. Chapter 321, Statutes of 2014. [SB1266 Detail]

Download: California-2013-SB1266-Amended.html

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BILL NUMBER: SB 1266	AMENDED
	BILL TEXT

	AMENDED IN SENATE  MAY 6, 2014
	AMENDED IN SENATE  APRIL 21, 2014
	AMENDED IN SENATE  MARCH 24, 2014

INTRODUCED BY   Senator Huff
   (Coauthor: Senator Hill)

                        FEBRUARY 21, 2014

   An act  to amend Section 4119.2 of the Business and
Professions Code, and  to amend Section 49414 of the Education
Code, relating to pupil health.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 1266, as amended, Huff. Pupil health: epinephrine
auto-injectors.
   Existing law authorizes a school district or county office of
education to provide emergency epinephrine auto-injectors to trained
personnel, and authorizes trained personnel to use those epinephrine
auto-injectors to provide emergency medical aid to persons suffering
from an anaphylactic reaction. Existing law authorizes each public
and private elementary and secondary school in the state to designate
one or more school personnel on a voluntary basis to receive initial
and annual refresher training regarding the storage and emergency
use of an epinephrine auto-injector, as specified. Existing law
authorizes a school nurse, or a person who has received the training
described above if the school does not have a school nurse, to, among
other things, obtain a prescription for epinephrine auto-injectors,
as specified.  Existing law authorizes a pharmacy to furnish
epinephrine auto-injectors to a school district or county office of
education if certain requirements are met. 
   This bill would require school districts, county offices of
education, and charter schools to provide emergency epinephrine
auto-injectors to trained personnel and would authorize trained
personnel to use those epinephrine auto-injectors to provide
emergency medical aid to persons  suffering  
suffering, or reasonably believed to be suffering,  from an
anaphylactic reaction. The bill would require each public elementary
and secondary school  in the state to designate one or more
school personnel on a voluntary basis   ,   if
no school personnel volunteers as a designee, to require a school
nurse or, if the school does not have a school nurse or the school
nurse is not onsite or available, a school administrator  to
receive initial and annual refresher training regarding the storage
and emergency use of an epinephrine auto-injector, as specified. The
bill would require a school nurse, or a school administrator 
or his or her designee who has received the training described above
 if the school does not have a school nurse or the school
nurse is not onsite or available, to obtain the prescription for
epinephrine auto-injectors, as specified, and would authorize the
prescription for epinephrine auto-injectors to be filled by local or
mail order pharmacies or epinephrine auto-injector manufacturers.
 The bill would authorize a pharmacy to also   furnish
epinephrine auto-injectors to a charter school if certain conditions
are met.  The bill would require an epinephrine auto-injector to
be restocked as soon as possible after it is used and before its
expiration date.
   The bill would require the school nurse or  designated
  voluntarily designated  employee to report any
incident of epinephrine auto-injector use to the school district,
county office of education, or chartering authority on a form
developed by the State Department of Education within 30 days after
the last day of each school year. The bill would require the school
district, county office of education, or chartering authority to
report any incident of epinephrine auto-injector use to the
department on those forms and would require the department to
annually post the result of those forms on its Internet Web site. The
bill would require a school district, county office of education, or
charter school to ensure that each employee who volunteers is
provided defense and indemnification by the school district, county
office of education, or charter school for any and all civil
liability, as specified. The bill would authorize a public school to
accept gifts, grants, and donations from any source for the support
of the public school carrying out these provisions.
   By requiring  school districts and county offices of
education  local educational agencies  to perform
additional duties related to epinephrine auto-injectors, the bill
would impose a state-mandated local program.
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    Section 4119.2 of the  
Business and Professions Code   is amended to read: 
   4119.2.  (a) Notwithstanding any other  provision of
 law, a pharmacy may furnish epinephrine auto-injectors to a
school  district or   district,  county
office of education  , or charter school  pursuant to
Section 49414 of the Education Code if all of the following are met:
   (1) The epinephrine auto-injectors are furnished exclusively for
use at a school district  site or   site, 
county office of  education.   education, or
charter school. 
   (2) A physician and surgeon provides a written order that
specifies the quantity of epinephrine auto-injectors to be furnished.

   (b) Records regarding the acquisition and disposition of
epinephrine auto-injectors furnished pursuant to subdivision (a)
shall be maintained by  both the   a 
school  district or   district,  county
office of education  , or charter school  for a period of
three years from the date the records were created. The school
 district or   district,  county office of
education  , or charter school  shall be responsible for
monitoring the supply of auto-injectors and assuring the destruction
of expired auto-injectors.
   SECTION 1.   SEC. 2.   Section 49414 of
the Education Code is amended to read:
   49414.  (a) School districts, county offices of education, and
charter schools shall provide emergency epinephrine auto-injectors to
trained personnel, and trained personnel may use those epinephrine
auto-injectors to provide emergency medical aid to persons suffering
 , or reasonably believed to be suffering,  from an
anaphylactic reaction.
   (b) For purposes of this section, the following terms have the
following meanings:
   (1) "Anaphylaxis" means a potentially life-threatening
hypersensitivity to a substance.
   (A) Symptoms of anaphylaxis may include shortness of breath,
wheezing, difficulty breathing, difficulty talking or swallowing,
hives, itching, swelling, shock, or asthma.
   (B) Causes of anaphylaxis may include, but are not limited to, an
insect sting, food allergy, drug reaction, and exercise.
   (2) "Epinephrine auto-injector" means a disposable drug delivery
system with a spring-activated needle that is designed for emergency
administration of epinephrine to provide rapid, convenient first aid
for persons suffering a potentially fatal reaction to anaphylaxis.
   (c) Each private elementary and secondary school in the state may
voluntarily determine whether or not to make emergency epinephrine
auto-injectors and trained personnel available at its school. In
making this determination, a school shall evaluate the emergency
medical response time to the school and determine whether initiating
emergency medical services is an acceptable alternative to
epinephrine auto-injectors and trained personnel. A private
elementary or secondary school choosing to exercise the authority
provided under this subdivision shall not receive state funds
specifically for purposes of this subdivision.
   (d) Each public  elementary and secondary school in the
state shall,  and  each  private elementary
and secondary school in the state  may,   may
 designate one or more school personnel on a voluntary basis to
receive initial and annual refresher training, based on the standards
developed pursuant to subdivision  (e),   (f),
 regarding the storage and emergency use of an epinephrine
auto-injector from the school nurse or other qualified person
designated by the local educational agency physician, the medical
director of the local health department, or the local emergency
medical services director.  However, each public school shall
designate and have trained at least one person for the purposes
listed in subdivisions (f), (g), and (h).  
   (e) Each public elementary and secondary school, including each
charter school, shall, if no school personnel volunteers as a
designee pursuant to subdivision (d), require a school nurse or, if
the school does not have a school nurse or the school nurse is not
onsite or available, a school administrator to receive initial and
annual refresher training, based on the standards developed pursuant
to subdivision (f), regarding the storage and emergency use of an
epinephrine auto-injector and for the purposes listed in subdivisions
(g), (h), and (i).  
   (e) 
    (f)  (1) Every five years, or sooner as deemed necessary
by the Superintendent, the Superintendent shall review minimum
standards of training for the administration of epinephrine
auto-injectors that satisfy the requirements of paragraph (2). For
purposes of this subdivision, the Superintendent shall consult with
organizations and providers with expertise in administering
epinephrine auto-injectors and administering medication in a school
environment, including, but not limited to, the State Department of
 Health Care Services,   Public Health, 
the Emergency Medical Services Authority, the American Academy of
Allergy,  Asthma,   Asthma  and Immunology,
the California School Nurses Organization, the California Medical
Association, the American Academy of Pediatrics, Food Allergy
Research and Education, the California Society of Allergy, Asthma and
Immunology, the American College of Allergy, Asthma and Immunology,
and others.
   (2) Training established pursuant to this subdivision shall
include all of the following:
   (A) Techniques for recognizing symptoms of anaphylaxis.
   (B) Standards and procedures for the  storage 
 storage, restocking,  and emergency use of epinephrine
auto-injectors.
   (C) Emergency follow-up procedures, including calling the
emergency 911  phone   telephone  number
and contacting, if possible, the pupil's parent and physician.
   (D) Instruction and certification in cardiopulmonary
resuscitation.
   (E) Instruction on how to determine whether to use an adult
epinephrine auto-injector or a junior epinephrine auto-injector.
   (F) Written materials covering the information required under this
subdivision.
   (3) Training established pursuant to this subdivision shall be
consistent with the most recent Voluntary Guidelines for Managing
Food Allergies In Schools and Early Care and Education Programs
published by the federal Centers for Disease Control and Prevention
and the most recent guidelines for medication administration issued
by the department.
   (4) A school shall retain for reference the written materials
prepared under subparagraph (F) of paragraph (2). 
   (f) 
    (g)  A school  nurse, or   nurse
or,  if the school does not have a school nurse or the school
nurse is not onsite or available, a school  administrator or
his or her designee who has received training pursuant to subdivision
(d),   administrator,  shall obtain from the local
educational agency physician, a physician contracting with the local
educational agency, the medical director of the local health
department, or the local emergency medical services director a
prescription for epinephrine auto-injectors that, at a minimum,
 includes one adult   includes, for elementary
schools, one regular  epinephrine auto-injector and one junior
epinephrine  auto-injector, and for junior high or middle schools
and high schools, if there are no pupils who require a junior
epinephrine auto-injector, one regular epinephrine 
auto-injector. The prescription may be filled by local or mail order
pharmacies or epinephrine auto-injector manufacturers. 
   (g) 
    (h)  A school nurse, or if the school does not have a
school nurse or the school nurse is not onsite or available, a school
administrator or his or her  voluntary  designee who has
received training pursuant to subdivision (d)  ,  may
administer an epinephrine auto-injector to a person exhibiting
potentially life-threatening symptoms of anaphylaxis at school or a
school activity when a physician is not immediately available. If the
epinephrine auto-injector is used it shall be restocked as soon as
reasonably possible. Epinephrine auto-injectors shall be restocked
before their expiration date. 
   (h) 
    (i)  A person who has received training as set forth in
 subdivision   (d) or a school nurse
  subdivisions (d) and (e)  shall initiate
emergency medical services or other appropriate medical followup in
accordance with the training materials retained pursuant to paragraph
(4) of subdivision  (e).   (f).  
   (i) 
    (j)  No later than 30 days after the last day of each
school year, the school nurse or  designated  
voluntarily designated  employee shall report any incident of
epinephrine auto-injector use to the school district, county office
of education, or chartering authority on a form developed by the
department. The school district, county office of education, or
chartering authority shall report any incident of epinephrine
auto-injector use to the department on the form developed by the
department. Without violating federal and state privacy laws, the
department shall annually publish the results of the submitted forms
on its Internet Web site. 
   (j) 
    (k)  A school district, county office of education, or
charter school using epinephrine auto-injectors for emergency medical
aid shall create a plan to address all of the following issues:
   (1) Designation of the individual or individuals who will provide
the training pursuant to subdivision (d).
   (2) Designation of the local educational agency physician, the
medical director of the local health department, or the local
emergency medical services director that the school district, county
office of education, or charter school will consult for the
prescription for epinephrine auto-injectors pursuant to subdivision
 (f).   (g). 
   (3) Documentation as to which individual, the school nurse or
 other trained person pursuant to subdivision (f), 
 school administrator,  in the school district, county
office of education, or charter school will obtain the prescription
from the physician and the medication from a pharmacist.
   (4) Documentation as to where the medication is stored  , when
the medication was restocked,  and how the medication will be
made readily available in case of an emergency. 
   (k) 
    (l)  A school district, county office of education, or
charter school shall ensure that each employee who volunteers under
this section will be provided defense and indemnification by the
school district, county office of education, or charter school for
any and all civil liability, in accordance with, but not limited to,
that provided in Division 3.6 (commencing with Section 810) of Title
1 of the Government Code. This information shall be reduced to
writing, provided to the volunteer, and retained in the volunteer's
personnel file. 
   (l) 
    (m)  A public school may accept gifts, grants, and
donations from any source for the support of the public school
carrying out the provisions of this section, including, but not
limited to, the acceptance of epinephrine auto-injectors from a
manufacturer or wholesaler.
   SEC. 2.   SEC. 3.   If the Commission on
State Mandates determines that this act contains costs mandated by
the state, reimbursement to local agencies and school districts for
those costs shall be made pursuant to Part 7 (commencing with Section
17500) of Division 4 of Title 2 of the Government Code.