BILL NUMBER: SB 161	AMENDED
	BILL TEXT

	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


   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 
performance standards   guidelines  developed by
specified entities.  The bill would authorize the State
Department of Public Health to approve the performance standards for
distribution and make the standards available upon request. 
The bill would allow a parent or guardian of a pupil with epilepsy
who has been prescribed Diastat 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, 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 to train school employees to distribute an electronic notice,
as specified, to all staff regarding the request. 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:  yes
  no  . State-mandated local program: no.


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

  SECTION 1.  (a) The Legislature finds and declares  that
all   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.). 
   (b) The Legislature finds and declares that there are specific
circumstances when it is necessary for nonmedical school staff, who
have volunteered and been trained, to administer medication to
pupils. The Legislature further finds and declares that the
circumstances necessitating nonmedical personnel to administer
medication to a pupil shall meet the following criteria: 

   (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:  
   (1) The 
    (A)     A  pupil's health care
provider states that  the medication   Diastat
 must be administered within a timeframe that a licensed medical
person or a paramedic cannot reasonably be expected to respond and
be available. 
   (2) 
    (B)  Failure to administer  the medication
  Diastat  in a timely manner can reasonably be
expected to result in death or permanent physical injury to the
pupil. 
   (3) The medication 
    (C)     Diastat  and the procedure for
 the administration of the medication   its
administration  has been found to be safe from harmful side
effects by competent personnel. 
   (c) 
    (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 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 and believe that
Diastat 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
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 should be administered by a school 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  standards   guidelines
 established pursuant to subdivision (k), 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) shall not be required to provide
emergency medical assistance pursuant to this section.
   (c) If a pupil with epilepsy has been prescribed Diastat 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 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, the school shall notify the parent or guardian
that his or her child may qualify for services or accommodations,
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,
 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
a 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.
   (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
a 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.
   (h) 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 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:
   (1) Identification of existing licensed staff within the district
or region who could be trained in the administration of Diastat and
could be available to respond to an emergency need to administer
Diastat. 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.
   (3) Written authorization from the parent or guardian for a
nonmedical school employee to administer Diastat.
   (4) The requirement that the parent or guardian notify the school
if the pupil has had Diastat administered within the past four hours
on a schoolday.
   (5) Notification of the parent or guardian that Diastat 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)  The length of time the seizure may continue before
  Detailed seizure symptoms, including frequency, type,
or length of seizures that identify when  the administration of
Diastat 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
the pupil should be under direct observation.
   (j) A school that chooses to allow volunteers to administer
Diastat shall compensate a volunteer when the administration of
Diastat and subsequent monitoring of a pupil requires a volunteer to
work beyond his or her normally scheduled hours.
   (k) (1) The Legislature encourages the Epilepsy Foundation of
America to develop  performance standards  
guidelines  for the training and supervision of school employees
in providing emergency medical assistance to pupils with epilepsy
suffering from seizures. The  performance standards 
 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 performance standards,
the State Department of Public Health may approve the performance
standards for distribution and make those standards available upon
request. 
   (2) 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.
   (C) Basic emergency followup procedures  ,  including,
but not limited to, calling the emergency 911 telephone number and
contacting the pupil's parent or guardian.
   (D) Techniques and procedures to ensure pupil privacy.
   (3) 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 assistant.  
   (B) 
    (C)  A credentialed school nurse. 
   (C) 
    (D)  A registered nurse. 
   (D) 
    (E)  A certificated public health nurse.
   (4) Training provided in accordance with the  performance
standards   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) A school employee shall notify the credentialed school
nurse assigned to the school district if he or she administers
Diastat pursuant to this section.
   (B) 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 pursuant to this section.
   (C) A school shall retain all records relating to the
administration of Diastat while a pupil is under the supervision of
school staff.
   (6) The pupil's parent or guardian shall provide all materials
necessary to administer Diastat, including the information described
in paragraph (6) of subdivision (i). 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.
   (m) 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.