BILL NUMBER: SB 1266 AMENDED
BILL TEXT
AMENDED IN SENATE MAY 27, 2014
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 who have volunteered, as
specified, and would authorize trained personnel to use those
epinephrine auto-injectors to provide emergency medical aid to
persons suffering, or reasonably believed to be suffering, from an
anaphylactic reaction. The bill would require each public
elementary and secondary school, 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 if an employee has
volunteered, as specified, and 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 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. forms. 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 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 law, a pharmacy may furnish
epinephrine auto-injectors to a school 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, county office of 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 a the school
district, county office of education, or charter school for a period
of three years from the date the records were created. The school
district, county office of education, or charter school shall be
responsible for monitoring the supply of epinephrine
auto-injectors and assuring ensuring
the destruction of expired epinephrine auto-injectors.
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, personnel who have
volunteered pursuant to subdivision (d), 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 and private elementary and secondary school in the
state 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 (f),
(e), 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.
(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).
(f)
(e) (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
Public Health, the Emergency Medical Services Authority, the American
Academy of Allergy, 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, restocking, and
emergency use of epinephrine auto-injectors.
(C) Emergency followup procedures, including calling the emergency
911 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).
(g)
(f) 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, administrator if an employee
has volunteered pursuant to subdivision (d), 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, 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.
(h)
(g) 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
volunteer 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.
(i)
(h) A person who has received training as set forth in
subdivisions (d) and (e) subdivision (d)
shall initiate emergency medical services or other appropriate
medical followup in accordance with the training materials retained
pursuant to paragraph (4) of subdivision (f).
(e).
(j)
(i) No later than 30 days after the last day of each
school year, the school nurse or 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.
(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
(g).
(3) Documentation as to which individual, the school nurse or
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.
(l)
(j) 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.
(m)
(k) 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. 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.