BILL NUMBER: SB 161 AMENDED
BILL TEXT
AMENDED IN SENATE APRIL 25, 2011
AMENDED IN SENATE MARCH 9, 2011
INTRODUCED BY Senator Huff
(Coauthor: Senator Rubio)
(Coauthor: Assembly Member Halderman)
FEBRUARY 2, 2011
An act to add and repeal Section 49414.7 of the Education Code,
relating to pupil health.
LEGISLATIVE COUNSEL'S DIGEST
F SB 161, as amended, Huff. Schools: emergency medical assistance:
administration of epilepsy medication.
Existing law provides that in the absence of a credentialed school
nurse or other licensed nurse onsite at the school, a school
district is authorized to provide school personnel with voluntary
medical training to provide emergency medical assistance to pupils
with diabetes suffering from severe hypoglycemia.
This bill would authorize a school district to provide school
employees with voluntary emergency medical training to provide, in
the absence of a credentialed school nurse or other licensed nurse
onsite at the school, emergency medical assistance to pupils with
epilepsy suffering from seizures, in accordance with guidelines
developed by specified entities. The bill would allow a parent or
guardian of a pupil with epilepsy who has been prescribed
Diastat an emergency antiseizure medication by
the pupil's health care provider , to request the pupil's
school to have one or more of its employees receive voluntary
training, as specified, in order to administer Diastat
the emergency antiseizure medication , as
defined, in the event that the pupil suffers a seizure when a nurse
is not available. The bill would require a school that
decides elects to train school employees to
distribute an electronic notice, as specified, to all staff regarding
the request. The bill would authorize the State Department of
Education to include, on its Internet Web site, a clearinghouse of
best practices in training nonmedical personnel in administering an
emergency antiseizure medication pursuant to these provisions.
The bill would make various legislative findings and declarations and
state the intent of the Legislature in enacting this measure. The
bill would repeal these provisions on January 1, 2017.
Vote: majority. Appropriation: no. Fiscal committee: no
yes . State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
F SECTION 1. (a) The Legislature finds and declares all of the
following:
(1) All individuals with exceptional needs have a right to
participate in a free appropriate public education, and that special
instruction and services for these individuals are needed in order to
ensure they have the right to an appropriate educational opportunity
to meet their unique needs in compliance with the federal
Individuals with Disabilities Education Act (20 U.S.C. Sec. 1400 et
seq.).
(2) The federal Food and Drug Administration has determined that
Diastat is an emergency medication approved for administration by
trained, nonmedical persons.
(3) If all of the following specific circumstances are met, then
the safety and welfare of a pupil may be compromised, necessitating
the authorization of nonmedical school staff, who have volunteered
and been trained, to administer Diastat to a pupil:
(A) A pupil's health care provider states that Diastat must be
administered within a timeframe that a licensed medical person or a
paramedic cannot reasonably be expected to respond and be available.
(B) Failure to administer Diastat in a timely manner can
reasonably be expected to result in death or permanent physical
injury to the pupil.
(C) Diastat and the procedure for its administration has been
found to be safe from harmful side effects by competent personnel.
(2) The safety and welfare of a pupil with epilepsy is compromised
without immediate access to an emergency antiseizure medication and,
therefore, clarification is needed to ensure that nonmedical school
staff, who have volunteered and have been trained in its correct
administration, may administer an emergency antiseizure medication.
(3) As used in this section, "immediate access" means the time
period that the pupil's health care provider states that an
antiseizure medication must be administered, provided that it is
within the timeframe that a licensed medical person or paramedic can
reasonably be expected to respond and be available.
(b) It is the intent of the Legislature that individuals with
exceptional needs and children with disabilities under the federal
Americans with Disabilities Act of 1990 (42 U.S.C. Sec. 12101 et
seq.) and Section 504 of the federal Rehabilitation Act of 1973 (29
U.S.C. Sec. 794) shall have a right to an appropriate educational
opportunity to meet their unique needs, and that children suffering
from seizures due to epilepsy have the right to appropriate programs
and services that are designed to meet their unique needs. In order
to meet that goal, it is the intent of the Legislature to authorize
nurses to train and supervise employees of school districts and
county offices of education to administer Diastat
an emergency antiseizure medication to children with
epilepsy in the public schools. The American Academy of Pediatrics
and the Epilepsy Foundation of America support training of school
employees to administer Diastat an emergency
antiseizure medication and believe that Diastat
an emergency antiseizure medication may be
safely and effectively administered by trained school employees. The
Legislature further finds and declares that, in the absence of a
credentialed school nurse or other licensed nurse onsite at the
school, it is in the best interest of the health and safety of
children to allow trained school employees to administer
Diastat an emergency antiseizure medication to
pupils in public schools.
SEC. 2. Section 49414.7 is added to the Education Code, to read:
49414.7. (a) It is the intent of the Legislature that, whenever
possible, Diastat an emergency antiseizure
medication should be administered by a school nurse or
licensed vocational nurse who has been trained in its
administration.
(b) Notwithstanding Sections 2052 and 2732 of the Business and
Professions Code, in the absence of a credentialed school nurse or
other licensed nurse onsite at the school, a school district may
provide school employees with voluntary emergency medical training to
provide emergency medical assistance to pupils with epilepsy
suffering from seizures. A school employee with voluntary emergency
medical training shall provide this emergency medical
assistance in accordance with the guidelines established
assistance using a training plan approved on the department's
Internet Web site pursuant to subdivision (k)
(m) , and the performance instructions set forth
by the licensed health care provider of the pupil. A school employee
who does not volunteer or who has not been trained pursuant to
subdivision (k) (m) shall not be
required to provide emergency medical assistance pursuant to this
section.
(c) If a pupil with epilepsy has been prescribed Diastat
an emergency antiseizure medication by his or
her health care provider, the pupil's parent or guardian may request
the pupil's school to have one or more of its employees receive
training pursuant to this section in the administration of
Diastat an emergency antiseizure medication in
the event that the pupil suffers a seizure when a nurse is not
available.
(d) Pursuant to Section 504 of the federal Rehabilitation Act of
1973, as amended, (29 U.S.C. Sec. 794), upon receipt of the parent's
or guardian's request pursuant to subdivision (c) , the
school shall notify the parent or guardian that his or her child may
qualify for services or accommodations under the Section 504
plan , assist the parent or guardian with the exploration
of that option, including, but not limited to, the
development of a seizure action plan in accordance with the parent's
or guardian's direction of that option , and
encourage the parent or guardian to adopt that option if it is
determined that the child is eligible for a Section 504 plan.
(e) The school may ask the parent or guardian to sign a notice
verifying that the parent or guardian was given information about
Section 504 of the federal Rehabilitation Act of 1973, and that the
parent or guardian understands that it is his or her right to request
Fa Section 504 plan at any time. (f) If the parent or guardian does not choose to have the pupil
assessed for a Section 504 plan, the school may create an
individualized health plan, seizure action plan, or other appropriate
health plan designed to acknowledge and prepare for the child's
health care needs in school. The plan may include the involvement of
trained volunteer school employees or a licensed vocational
nurse .
(g) If a school decides to train school employees pursuant to this
section, the school shall distribute an electronic notice to all
staff that states all of the following:
(1) The notice is a request for volunteers to administer Diastat
to a pupil experiencing a severe epileptic seizure, in the absence of
Fa school nurse. (2) Diastat is an FDA-approved, predosed, rectally administered
gel that reduces the severity of epileptic seizures.
(3) A volunteer will receive training from a licensed health
professional regarding the administration of Diastat.
(4) Any agreement by an employee to administer Diastat is
voluntary, and no employee of the school or district shall directly
or indirectly use or attempt to use his or her authority or influence
for the purpose of intimidating, threatening, coercing, or
attempting to intimidate, threaten, or coerce, any staff member who
does not choose to volunteer.
(g) If a school elects to train employees pursuant to this
section, the school shall ensure the following:
(1) A volunteer receives training from a licensed health care
professional regarding the administration of an emergency antiseizure
medication. A staff member who has completed training shall, if he
or she has not administered an emergency antiseizure medication
within the prior two years and there is a pupil enrolled in the
school who may need the administration of an antiseizure medication,
attend a new training program to retain the ability to administer an
emergency antiseizure medication.
(2) Any agreement by an employee to administer an emergency
antiseizure medication is voluntary, and no employee of the school or
school district shall directly or indirectly use or attempt to use
his or her authority or influence for the purpose of intimidating,
threatening, coercing, or attempting to intimidate, threaten, or
coerce any staff member who does not choose to volunteer, including,
but not limited to, direct contact with the employee.
(3) Any employee who volunteers pursuant to this section may
rescind his or her offer to administer an emergency antiseizure
medication up to three days after the completion of the training.
After that time, a volunteer may rescind his or her offer to
administer an emergency antiseizure medication with a two-week
notice, or until a new individual health plan or Section 504 plan has
Fbeen developed for an affected pupil, whichever is less. (4) The school shall distribute an electronic notice to all staff
that states the following information in bold print:
(A) A description of the volunteer request, stating that the
request is for volunteers to administer an emergency antiseizure
medication to a pupil experiencing a severe epileptic seizure, in the
absence of a school nurse, and that this emergency antiseizure
medication is an FDA-approved, predosed, rectally administered gel
that reduces the severity of epileptic seizures.
(B) A description of the training that the volunteer will receive
pursuant to paragraph (1).
(C) A description of the voluntary nature of the volunteer
program, which includes the information described in paragraph (2).
(D) The volunteer recision timelines described in paragraph (3).
(h) An employee who volunteers pursuant to this section shall not
be required to administer an emergency antiseizure medication until
completion of the training program adopted by the school and
documentation of completion is recorded in his or her personnel file.
F (i) If a school elects to participate pursuant to this section,
the school shall ensure that each volunteer will be provided defense
and indemnification by the school, in accordance with 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.
(h)
(j) If there are no volunteers, then the school shall
renotify the pupil's parent or guardian of the option to be assessed
for services and accommodations guaranteed under Section 504 of the
federal Rehabilitation Act of 1973.
(i) A school that chooses
(k) A school that elects to
participate pursuant to this section shall have in place a school
plan that shall include, but not be limited to, all of the following:
F (1) Identification of existing licensed staff within the district
or region who could be trained in the administration of
Diastat an emergency antiseizure medication and
could be available to respond to an emergency need to administer
Diastat an emergency antiseizure medication
. The school shall consult with the school district or county
office of education to obtain this information.
(2) Identification of pupils who may require the administration of
Diastat an emergency antiseizure medication
.
(3) Written authorization from the parent or guardian for a
nonmedical school employee to administer Diastat
an emergency antiseizure medication .
(4) The requirement that the parent or guardian notify the school
if the pupil has had Diastat an emergency
antiseizure medication administered within the past four hours
on a schoolday.
(5) Notification of the parent or guardian that Diastat
an emergency antiseizure medication has been
administered.
(6) A written statement from the pupil's health care practitioner
that shall include, but not be limited to, all of the following:
(A) The pupil's name.
(B) The name and purpose of the medication.
(C) The prescribed dosage.
(D) Detailed seizure symptoms, including frequency, type, or
length of seizures that identify when the administration of
Diastat an emergency antiseizure medication
becomes necessary.
(E) The method of administration.
(F) The frequency with which the medication may be administered.
(G) The circumstances under which the medication may be
administered.
(H) Any potential adverse responses by the pupil and recommended
mitigation actions, including when to call emergency services.
(I) A protocol for observing the pupil after a seizure, including,
but not limited to, whether the pupil should rest in the school
office, whether the pupil may return to class, and the length of time
Fthe pupil should be under direct observation. (J) Following a seizure, the pupil's parent and guardian and the
school nurse shall be contacted to continue the observation plan as
established in subparagraph (I).
(j) A school that chooses
(l) A school that elects to allow
volunteers to administer Diastat an
emergency antiseizure medication shall compensate a volunteer
when the administration of Diastat an
emergency antiseizure medication and subsequent monitoring of a
pupil requires a volunteer to work beyond his or her normally
scheduled hours.
(k)
(m) (1) The Legislature encourages the Epilepsy
Foundation of America to develop guidelines for the training and
supervision of school employees in providing emergency medical
assistance to pupils with epilepsy suffering from seizures. The
guidelines may be developed in cooperation with the State Department
of Education, the California School Nurses Organization, the
California Medical Association, and the American Academy of
Pediatrics. Upon development of the guidelines, the department
may approve the guidelines for distribution and make those guidelines
Favailable upon request. (2) The department may include, on its Internet Web site, a
clearinghouse for best practices in training nonmedical personnel to
administer an emergency antiseizure medication to pupils. Before a
training program is placed on the best practices clearinghouse, it
shall be approved by the Professional Advisory Board of the Epilepsy
Foundations of Greater Los Angeles, San Diego County, and Northern
California, in consultation with the department.
(2)
(3) Training established pursuant to this subdivision
shall include, but not be limited to, all of the following:
(A) Recognition and treatment of different types of seizures.
(B) Administration of Diastat an emergency
Fantiseizure medication . (C) Basic emergency followup procedures, including, but not
limited to, calling the emergency 911 telephone number and contacting
Fthe pupil's parent or guardian. (D) Techniques and procedures to ensure pupil privacy.
(4) Any written materials used in the training shall be retained
by the school.
(3)
(5) Training established pursuant to this subdivision
shall be conducted by one or more of the following:
(A) A physician and surgeon.
(B) A physician and surgeon's physician's
assistant.
(C) A credentialed school nurse.
(D) A registered nurse.
(E) A certificated public health nurse.
(4)
(6) Training provided in accordance with the
manufacturer's instructions, the pupil's health care provider's
instructions, and guidelines established pursuant to this section
shall be deemed adequate training for purposes of this section.
(5) (A)
(n) (1) A school employee shall
notify the credentialed school nurse assigned to the school district
if he or she administers Diastat an emergency
Fantiseizure medication pursuant to this section. (B)
(2) If a credentialed school nurse is not assigned to
the school district, the school employee shall notify the
superintendent of the school district, or his or her designee, if he
or she administers Diastat an emergency
antiseizure medication pursuant to this section.
(C)
(3) A school shall retain all records relating to the
administration of Diastat an emergency
antiseizure medication while a pupil is under the supervision
of school staff.
(6)
(o) The pupil's parent or guardian shall provide all
materials necessary to administer Diastat an
emergency antiseizure medication , including the information
described in paragraph (6) of subdivision (i)
(k) . A school shall not be responsible for providing any of
the necessary materials.
( l ) For purposes of this section, "Diastat"
means diazepam rectal gel, marketed as Diastat AcuDial, approved by
the federal Food and Drug Administration for patients with epilepsy
for the management of seizures.
(p) For purposes of this section, the following definitions apply:
F (1) An "emergency antiseizure medication" means diazepam rectal
gel and emergency medications approved by the federal Food and Drug
Administration for patients with epilepsy for the management of
seizures by persons without the medical credentials listed in
paragraph (5) of subdivision (m).
(2) "Emergency medical assistance" means the administration of an
emergency antiseizure medication to a pupil suffering from an
epileptic seizure.
(m)
(q) This section shall remain in effect only until
January 1, 2017, and as of that date is repealed, unless a later
enacted statute, that is enacted before January 1, 2017, deletes or
extends that date.