California Senate Bill SB1266 Amended / Bill

 BILL NUMBER: SB 1266AMENDED 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.