Article 1. General Powers—school Boards of California Education Code >> Division 4. >> Title 2. >> Part 27. >> Chapter 9. >> Article 1.
The governing board of any school district shall give
diligent care to the health and physical development of pupils, and
may employ properly certified persons for the work.
(a) It is the intent of the Legislature in enacting this
section to express its concern for the health and safety of school
pupils and school personnel at schools where hazardous materials are
stored on the school premises, and to encourage school districts to
take steps to ensure hazardous materials are properly used and
stored.
(b) The governing board of any school district may request
consultation services from the California Occupational Safety and
Health Consultation Service to ensure hazardous materials are being
used and stored safely in school laboratories.
Contracts between any city, county, or local health district
and the governing board of any school district located wholly or
partially within such city, county, or local health district for the
performance by the health officers or other employees of the health
department of such city, county, or local health district of any or
all of the functions and duties set forth in this chapter, Section
49404, and in Article 1 (commencing with Section 49300) of Chapter 8
of this part relating to health supervision of school buildings and
pupils are hereby authorized.
In any such contracts the consideration shall be such as may be
agreed upon by the governing board and the city, county, or local
health district and shall be paid by the governing board at such
times as shall be specified in the contract. This section shall not
apply to any district which is under the control of a governing board
which has under its control a district or districts having a total
average daily attendance of 100,000 or more pupils.
(a) Notwithstanding any other law, the governing board of a
school district shall cooperate with the local health officer in
measures necessary for the prevention and control of communicable
diseases in schoolage children. For that purpose, the board may use
any funds, property, and personnel of the district, and may permit a
licensed physician and surgeon, or a health care practitioner listed
in subdivision (b) who is acting under the direction of a supervising
physician and surgeon, to administer an immunizing agent to a pupil
whose parent or guardian has consented in writing to the
administration of the immunizing agent.
(b) (1) The following health care practitioners, acting under the
direction of a supervising physician and surgeon, may administer an
immunizing agent within the course of a school immunization program:
(A) A physician assistant.
(B) A nurse practitioner.
(C) A registered nurse.
(D) A licensed vocational nurse.
(E) A nursing student who is acting under the supervision of a
registered nurse, in accordance with applicable provisions of law.
(2) A health care practitioner's authority to administer an
immunizing agent pursuant to this subdivision is subject to the
following conditions:
(A) The administration of an immunizing agent is upon the standing
orders of a supervising physician and surgeon and in accordance with
any written regulations that the State Department of Public Health
may adopt.
(B) The school nurse is notified and he or she maintains control,
as necessary, as supervisor of health in accordance with Sections
44871, 44877, 49422, and subdivision (a) of Section 49426.
(C) The health care practitioner may only administer immunizations
for the prevention and control of any of the following:
(i) Annual seasonal influenza.
(ii) Influenza pandemic episodes.
(iii) Other diseases that represent a current or potential
outbreak as declared by a federal, state, or local public health
officer.
(c) As used in this section, "supervising physician and surgeon"
means the physician and surgeon of the local health department or
school district that is directing the school immunization program.
(d) While nothing in this section shall be construed to require
the physical presence of the supervising physician and surgeon, the
supervising physician and surgeon shall require a health care
practitioner under his or her direction to do both of the following:
(1) Satisfactorily demonstrate competence in the administration of
the immunizing agent, including knowledge of all indications and
contraindications for the administration of the agent, and the
recognition and treatment of emergency reactions to the agent that
constitute a danger to the health or life of the person receiving the
immunization.
(2) Possess the medications and equipment that are required, in
the medical judgment of the supervising physician and surgeon, to
treat any emergency conditions and reactions caused by the immunizing
agents that constitute a danger to the health or life of the person
receiving the immunization, and to demonstrate the ability to
administer the medications and use the equipment as necessary.
(e) It is the intent of the Legislature to encourage school-based
immunization programs, when feasible, to use the California
Immunization Registry to assist providers to track patient records,
reduce missed opportunities, and to help fully immunize all children
in California.
The control of smallpox is under the direction of the State
Department of Health Services, and no rule or regulation on the
subject of vaccination shall be adopted by school or local health
authorities.
(a) (1) (A) Except as provided in subdivision (j), a person
shall not be initially employed by a school district, or employed
under contract, in a certificated or classified position unless the
person has submitted to a tuberculosis risk assessment within the
past 60 days, and, if tuberculosis risk factors are identified, has
been examined to determine that he or she is free of infectious
tuberculosis by a physician and surgeon licensed under Chapter 5
(commencing with Section 2000) of Division 2 of the Business and
Professions Code, a physician assistant practicing in compliance with
Chapter 7.7 (commencing with Section 3500) of Division 2 of the
Business and Professions Code, or a nurse practitioner practicing in
compliance with Chapter 6 (commencing with Section 2700) of Division
2 of the Business and Professions Code. If no risk factors are
identified, an examination is not required. A person who is subject
to the requirements of this subdivision may submit to an examination
that complies with subparagraph (B) instead of submitting to a
tuberculosis risk assessment.
(B) The examination required by this subdivision shall consist of
either an approved intradermal tuberculin test or any other test for
tuberculosis infection that is recommended by the federal Centers for
Disease Control and Prevention (CDC) and licensed by the federal
Food and Drug Administration (FDA). If the test is positive, the test
shall be followed by an X-ray of the lungs in accordance with
subdivision (f) of Section 120115 of the Health and Safety Code.
(2) The X-ray may be taken by a competent and qualified X-ray
technician if the X-ray is subsequently interpreted by a physician
and surgeon licensed under Chapter 5 (commencing with Section 2000)
of Division 2 of the Business and Professions Code.
(3) The district superintendent of schools or his or her designee
may exempt, for a period not to exceed 60 days following termination
of the pregnancy, a pregnant employee from the requirement that a
positive test for tuberculosis infection be followed by an X-ray of
the lungs.
(b) Thereafter, an employee who has no identified risk factors or
who tests negative for the tuberculosis infection shall be required
to undergo the tuberculosis risk assessment and, if risk factors are
identified, the examination, at least once each four years or more
often if directed by the governing board of the school district upon
recommendation of the local health officer. Once an employee has a
documented positive test for tuberculosis infection conducted
pursuant to this subdivision that has been followed by an X-ray, the
tuberculosis risk assessment is no longer required. A referral shall
be made within 30 days of completion of the examination to the local
health officer to determine the need for followup care.
(c) After the tuberculosis risk assessment and, if indicated, the
examination, the employee shall file with the district superintendent
of schools a certificate from the examining physician and surgeon,
physician assistant, or nurse practitioner showing the employee was
examined and found free from infectious tuberculosis. The county
board of education may require, by rule, that the certificates be
filed in the office of the county superintendent of schools or
maintained in the office of the county superintendent of schools if a
majority of the governing boards of the school districts within the
county petition the county board of education. A school district, or
school districts with a common governing board, having an average
daily attendance of 60,000 or more may elect to maintain the files
for its employees in that school district.
(d) As used in this section, "certificate" means a certificate
signed by the examining physician and surgeon licensed under Chapter
5 (commencing with Section 2000) of Division 2 of the Business and
Professions Code, a physician assistant practicing in compliance with
Chapter 7.7 (commencing with Section 3500) of Division 2 of the
Business and Professions Code, or a nurse practitioner practicing in
compliance with Chapter 6 (commencing with Section 2700) of Division
2 of the Business and Professions Code, or a notice from a public
health agency that indicates freedom from infectious tuberculosis.
The latter, regardless of form, shall constitute evidence of
compliance with this section.
(e) Nothing in this section shall prevent the governing board of a
school district, upon recommendation of the local health officer,
from establishing a rule requiring a more extensive or more frequent
physical examination than required by this section. The rule shall
provide for reimbursement on the same basis as required in this
section.
(f) The tuberculosis risk assessment and, if indicated, the
examination is a condition of initial employment and the expense
shall be borne by the applicant unless otherwise provided by rules of
the governing board of the school district. However, the governing
board of a school district may, if an applicant is accepted for
employment, reimburse that person in a like manner prescribed in this
section for employees.
(g) The governing board of a school district shall reimburse the
employee for the cost, if any, of the tuberculosis risk assessment
and the examination. The governing board of a school district may
provide for the tuberculosis risk assessment and examination required
by this section or may establish a reasonable fee for the
examination that is reimbursable to employees of the school district
complying with this section.
(h) At the discretion of the governing board of a school district,
this section shall not apply to those employees not requiring
certification qualifications who are employed for any period of time
less than a school year whose functions do not require frequent or
prolonged contact with pupils.
(i) If the governing board of a school district determines by
resolution, after hearing, that the health of pupils in the school
district would not be jeopardized, this section shall not apply to an
employee of the school district who files an affidavit stating that
he or she adheres to the faith or teachings of a well-recognized
religious sect, denomination, or organization and, in accordance with
its creed, tenets, or principles, depends for healing upon prayer in
the practice of religion, and that to the best of his or her
knowledge and belief, he or she is free from infectious tuberculosis.
If at any time there is probable cause to believe that the affiant
is afflicted with infectious tuberculosis, he or she may be excluded
from service until the governing board of the school district is
satisfied that he or she is not afflicted.
(j) A person who transfers employment from one school or school
district to another school or school district shall be deemed to meet
the requirements of subdivision (a) if that person can produce a
certificate that shows he or she was found to be free of infectious
tuberculosis within 60 days of initial hire, or the school previously
employing the person verifies that the person has a certificate on
file showing that the person is free from infectious tuberculosis.
(k) A person who transfers his or her employment from a private or
parochial elementary school, secondary school, or nursery school to
a school or school district subject to this section shall be deemed
to meet the requirements of subdivision (a) if that person can
produce a certificate as provided for in Section 121525 of the Health
and Safety Code that shows that he or she was found to be free of
infectious tuberculosis within 60 days of initial hire, or if the
school previously employing the person verifies that the person has a
certificate on file showing that the person is free from infectious
tuberculosis.
(l) A governing board or county superintendent of schools
providing for the transportation of pupils under contract authorized
by Section 39800, 39801, or any other provision of law shall require
as a condition of the contract the tuberculosis risk assessment and,
if indicated, the examination for infectious tuberculosis within 60
days of initial hire, as provided by subdivision (a), of all drivers
transporting pupils. At the discretion of the governing board or
county superintendent of schools, this subdivision shall not apply to
a private contracted driver who transports pupils infrequently
without prolonged contact with the pupils.
(m) A volunteer in a school shall also be required to have on file
with the school a certificate showing that, upon initial volunteer
assignment, the person submitted to a tuberculosis risk assessment
and, if tuberculosis risk factors were identified, was examined and
found to be free of infectious tuberculosis. If no risk factors are
identified, an examination is not required. At the discretion of the
governing board of a school district, this section shall not apply to
a volunteer whose functions do not require frequent or prolonged
contact with pupils.
(n) The State Department of Public Health, in consultation with
the California Tuberculosis Controllers Association, shall develop a
risk assessment questionnaire, to be used to conduct tuberculosis
risk assessments pursuant to this section. The risk assessment
questionnaire shall be administered by a health care provider, which
shall be specified on the questionnaire. This risk assessment
questionnaire shall be exempt from the rulemaking provisions of the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code).
Notwithstanding any provision of any law, no school
district, officer of any school district, school principal,
physician, or hospital treating any child enrolled in any school in
any district shall be held liable for the reasonable treatment of a
child without the consent of a parent or guardian of the child when
the child is ill or injured during regular school hours, requires
reasonable medical treatment, and the parent or guardian cannot be
reached, unless the parent or guardian has previously filed with the
school district a written objection to any medical treatment other
than first aid.
For the protection of a pupil's health and welfare, the
governing board of a school district may require the parent or legal
guardian of a pupil to keep current at the pupil's school of
attendance, emergency information including the home address and
telephone number, business address and telephone number of the
parents or guardian, and the name, address and telephone number of a
relative or friend who is authorized to care for the pupil in any
emergency situation if the parent or legal guardian cannot be
reached.
Notwithstanding any provision of any law, no physician and
surgeon who in good faith and without compensation renders voluntary
emergency medical assistance to a participant in a school athletic
event or contest at the site thereof, or during transportation to a
health care facility, for an injury suffered in the course of the
event or contest, shall be liable for any civil damages as a result
of any acts or omissions by the physician and surgeon in rendering
the emergency medical care. The immunity granted by this paragraph
shall not apply in the event of an act or omission constituting gross
negligence.
(a) The Legislature finds that:
(1) There is substantial scientific and medical evidence that
human exposure to asbestos fibers significantly increases the
likelihood of contracting cancer and other debilitating or fatal
diseases such as asbestosis.
(2) Medical and epidemiological evidence suggests that children
exposed to asbestos fibers may be especially susceptible to the
environmentally induced diseases associated with the exposure.
(3) Substantial amounts of asbestos materials were used in school
construction during the period from 1946 through 1973 for
fireproofing, soundproofing, decoration, and other purposes.
(4) When these materials age, deteriorate, or become damaged or
friable, they release asbestos fibers into the ambient air. This can
result in the exposure of school children and school employees to
potentially dangerous levels of asbestos fibers.
(5) The presence of asbestos in the air in concentrations far
exceeding the normal ambient levels has been found in schools,
especially where the asbestos materials have reached a damaged,
deteriorated, or disturbed state as a result of abuse, abrasion,
water leakage, or forced air circulation.
(6) In view of the fact that the State of California has
compulsory attendance laws for children of school age, and these
children must be educated in a safe and healthy environment, the
hazard presented by asbestos materials in the schools is of special
concern to the Legislature.
(b) As a result of the findings in subdivision (a), it is the
intent of the Legislature to provide for the safe and expeditious
containment or removal of asbestos materials posing a hazard to
health in schools.
(c) As used in this section and Sections 49410.2 and 49410.5, the
following terms have the following meanings:
(1) "Asbestos" means naturally occurring hydrated mineral
silicates separable into commercially used fibers: specifically
chrysotile, amosite, crocidolite, tremolite, anthrophyllite, and
actinolite.
(2) "Asbestos materials" means materials formed by mixing asbestos
fibers with other products, including, but not limited to, rock
wool, plaster, cellulose, clay, vermiculite, perlite, and a variety
of adhesives. Some of these materials may be sprayed on surfaces or
applied to surfaces in the form of plaster or a textured paint.
(3) "Hazard to health" means that the asbestos material is loose,
friable, flaking, or dusting, or is likely to become so within the
service life of the material in place.
School districts and county offices of education may apply
to the State Allocation Board pursuant to Section 39619.6 for funds
for the purposes of containment or removal of asbestos materials
posing a hazard to health.
(a) The State Allocation Board shall retain all
information provided by school districts making application for funds
pursuant to Sections 39619.6, 39619.7, and 39619.8 regarding the
actual or estimated cost of inspection and testing for, and
encapsulation or removal of, asbestos.
(b) The Legislature finds and declares that:
(1) Federal moneys may be made available to reimburse schools for
costs related to asbestos inspection, testing, encapsulation, and
removal, and that the distribution of these moneys will be expedited
by the early collection of these data.
(2) School districts shall comply with guidelines suggested by the
Environmental Protection Agency for the purposes of inspection and
testing for asbestos materials, and for the protection and safety of
workers and all other individuals during the encapsulation and
removal of asbestos.
(a) For purposes of funding pursuant to Section 39619.9,
the factors determining the need for abatement of friable asbestos or
potentially friable asbestos shall include, but not be limited to,
visual inspection and bulk samples and air monitoring showing an
airborne concentration of asbestos in the school building in excess
of the standard 0.01 fibers/cc by Transmission Electron Microscopy
(TEM) monitoring, as specified in subdivision (b), or the
concurrently measured concentration of asbestos in the ambient air
immediately adjacent to the building, whichever is higher. For
purposes of reconstruction and rehabilitation projects approved
pursuant to Chapter 22 (commencing with Section 17700) of Part 10 of
the Education Code, for which asbestos abatement related work
commenced on or after October 2, 1985, and for purposes of abating
asbestos contained in pipe and block insulation, air monitoring shall
not be required to determine the need for abatement of friable
asbestos or potentially friable asbestos.
(b) For purposes of air monitoring, the operating agency for each
public school building in which friable asbestos-containing materials
(other than pipe and block insulation or materials to be abated
during rehabilitation or reconstruction projects as specified in
subdivision (a)) have been identified shall monitor airborne asbestos
levels in each sampling area. Each sampling area in which
asbestos-containing materials have been identified shall be monitored
for at least eight hours during a period of normal building
activity. Analysis of samples shall be by Transmission Electron
Microscopy (TEM) methods, in accordance with the Environmental
Protection Agency provisional method and update, to measure the
number of observable asbestos fibers. The results of this monitoring
shall be recorded in terms of the number of visible fibers greater
than 1 micron in length per cubic centimeter of air (f/cc) in accord
with standard definitions for asbestos monitoring established by the
Occupational Safety and Health Administration.
"Sampling area," as used in this section, means any area, whether
contiguous or not, within a building that contains friable material
that is homogenous in texture and appearance.
(c) Any public primary or secondary school building in which
asbestos abatement work has been performed shall not be reoccupied
until air monitoring has been conducted to show that the airborne
concentration of asbestos does not exceed the air monitoring standard
of subdivision (a). Not less than one month after the reoccupancy of
the school building where asbestos abatement work has occurred, the
building shall be remonitored to determine compliance with
subdivision (b).
(d) "School building," as used in this section, means any of the
following:
(1) Structures used for the instruction of public school children,
including classrooms, laboratories, libraries, research facilities,
and administrative facilities.
(2) School eating facilities and school kitchens.
(3) Gymnasiums or other facilities used for athletic or
recreational activities or for courses in physical education.
(4) Dormitories or other living areas of residential schools.
(5) Maintenance, storage, or utility facilities essential to the
operation of the facilities described in paragraphs (1) to (4).
(e) School districts and county offices of education may apply for
reimbursement from the Asbestos Abatement Fund for the costs of air
monitoring completed pursuant to this section.
(a) The State Department of Education, in cooperation with
the Division of Occupational Safety and Health within the Department
of Industrial Relations, shall formulate a listing of chemical
compounds used in school programs that includes the potential hazards
and estimated shelf life of each compound.
(b) The Superintendent of Public Instruction, in cooperation with
the Division of Occupational Safety and Health within the Department
of Industrial Relations, shall develop guidelines for school
districts for the regular removal and disposal of all chemicals whose
estimated shelf life has elapsed.
(c) The county superintendent of schools may implement a system
for disposing of chemicals from schools within the county or may
permit school districts to arrange for the disposal of the chemicals.
(a) Except as provided in subdivision (b), counties and
school districts, in the utilization of funds allocated pursuant to
any appropriation from any account in the Cigarette and Tobacco
Products Surtax Fund for the provision of health care to school
populations, shall give initial consideration to the use of those of
credentialed school nurses and school nurse practitioners employed by
the school districts, to the extent those services are within the
scope of practice of those nurses, and to the extent these purposes
are consistent with the Tobacco Tax and Health Protection Act of 1988
and Chapter 1331 of the Statutes of 1989.
(b) Subdivision (a) does not apply to funds appropriated from the
Health Education Account in the Cigarette and Tobacco Products Surtax
Fund, except for purposes of providing health screenings through the
Child Health and Disability Prevention Screening program.
(c) Any county which, after the initial consideration regarding
the utilization of funds, as required by subdivision (a), elects to
utilize funds to which subdivisions (a) and (b) apply for the
credentialed school nurses and school nurse practitioners employed by
school districts may allocate those funds to the school districts
for those purposes.
(a) The Legislature recognizes the importance of first aid
and cardiopulmonary resuscitation training. In enacting this section,
it is the intent of the Legislature to encourage school districts
and schools, individually or jointly, to develop a program whereby
their staff and pupils understand the importance of this training and
have an appropriate opportunity to develop these skills.
(b) A school district or school, individually or jointly with
another school district or school, may provide a comprehensive
program in first aid or cardiopulmonary resuscitation (CPR) training,
or both, to pupils and employees. The program shall be developed
using the following guidelines:
(1) The school district or school collaborates with existing local
resources, including, but not limited to, parent teacher
associations, hospitals, school nurses, fire departments, and other
local agencies that promote safety, to make first aid or CPR
training, or both, available to the pupils and employees of the
school district or school.
(2) Each school district that develops a program, or the school
district that has jurisdiction over a school that develops a program,
compiles a list of resources for first aid or CPR information, to be
distributed to all of the schools in the district.
(3) The first aid and CPR training are based on standards that are
at least equivalent to the standards currently used by the American
Red Cross or the American Heart Association.
(a) School districts, county offices of education, and
charter schools shall provide emergency epinephrine auto-injectors to
school nurses or trained personnel who have volunteered pursuant to
subdivision (d), and school nurses or trained personnel may use
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) "Authorizing physician and surgeon" may include, but is not
limited to, a physician and surgeon employed by, or contracting with,
a local educational agency, a medical director of the local health
department, or a local emergency medical services director.
(3) "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.
(4) "Qualified supervisor of health" may include, but is not
limited to, a school nurse.
(5) "Volunteer" or "trained personnel" means an employee who has
volunteered to administer epinephrine auto-injectors to a person if
the person is suffering, or reasonably believed to be suffering, from
anaphylaxis, has been designated by a school, and has received
training pursuant to subdivision (d).
(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 volunteers to receive initial and
annual refresher training, based on the standards developed pursuant
to subdivision (e), regarding the storage and emergency use of an
epinephrine auto-injector from the school nurse or other qualified
person designated by an authorizing physician and surgeon.
(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, the Sean N. Parker Center for Allergy
Research, 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) Recommendations on the necessity of 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,
which shall include consideration of a pupil's grade level or age as
a guideline of equivalency for the appropriate pupil weight
determination.
(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) A school district, county office of education, or charter
school shall distribute a notice at least once per school year to all
staff that contains the following information:
(1) A description of the volunteer request stating that the
request is for volunteers to be trained to administer an epinephrine
auto-injector to a person if the person is suffering, or reasonably
believed to be suffering, from anaphylaxis, as specified in
subdivision (b).
(2) A description of the training that the volunteer will receive
pursuant to subdivision (d).
(g) (1) A qualified supervisor of health at a school district,
county office of education, or charter school shall obtain from an
authorizing physician and surgeon a prescription for each school 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 schools, middle
schools, and high schools, if there are no pupils who require a
junior epinephrine auto-injector, one regular epinephrine
auto-injector. A qualified supervisor of health at a school district,
county office of education, or charter school shall be responsible
for stocking the epinephrine auto-injector and restocking it if it is
used.
(2) If a school district, county office of education, or charter
school does not have a qualified supervisor of health, an
administrator at the school district, county office of education, or
charter school shall carry out the duties specified in paragraph (1).
(3) A prescription pursuant to this subdivision may be filled by
local or mail order pharmacies or epinephrine auto-injector
manufacturers.
(4) An authorizing physician and surgeon shall not be subject to
professional review, be liable in a civil action, or be subject to
criminal prosecution for the issuance of a prescription or order
pursuant to this section, unless the physician and surgeon's issuance
of the prescription or order constitutes gross negligence or willful
or malicious conduct.
(h) A school nurse or, if the school does not have a school nurse
or the school nurse is not onsite or available, a volunteer 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, but no later than two weeks after it is used.
Epinephrine auto-injectors shall be restocked before their expiration
date.
(i) A volunteer shall initiate emergency medical services or other
appropriate medical followup in accordance with the training
materials retained pursuant to paragraph (4) of subdivision (e).
(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.
(k) A state agency, the department, or 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.
(a) In the absence of a credentialed school nurse or other
licensed nurse onsite at the school, each school district may
provide school personnel with voluntary emergency medical training to
provide emergency medical assistance to pupils with diabetes
suffering from severe hypoglycemia, and volunteer personnel shall
provide this emergency care, in accordance with standards established
pursuant to subdivision (b) 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 (b) may not be required to provide emergency medical
assistance pursuant to this subdivision.
(b) (1) The Legislature encourages the American Diabetes
Association to develop performance standards for the training and
supervision of school personnel in providing emergency medical
assistance to pupils with diabetes suffering from severe
hypoglycemia. The performance standards shall be developed in
cooperation with the department, the California School Nurses
Organization, the California Medical Association, and the American
Academy of Pediatrics. Upon the development of the performance
standards pursuant to this paragraph, the State Department of Health
Services' Diabetes Prevention and Control Program shall approve the
performance standards for distribution and make those standards
available upon request.
(2) Training established pursuant to this subdivision shall
include all of the following:
(A) Recognition and treatment of hypoglycemia.
(B) Administration of glucagon.
(C) Basic emergency followup procedures, including, but not
limited to, calling the emergency 911 telephone number and
contacting, if possible, the pupil's parent or guardian and licensed
health care provider.
(3) Training by a physician, credentialed school nurse, registered
nurse, or certificated public health nurse according to the
standards established pursuant to this section shall be deemed
adequate training for the purposes of this section.
(4) (A) A school employee shall notify the credentialed school
nurse assigned to the school district if he or she administers
glucagon 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
glucagon pursuant to this section.
(5) All materials necessary to administer the glucagon shall be
provided by the parent or guardian of the pupil.
(c) In the case of a pupil who is able to self-test and monitor
his or her blood glucose level, upon written request of the parent or
guardian, and with authorization of the licensed health care
provider of the pupil, a pupil with diabetes shall be permitted to
test his or her blood glucose level and to otherwise provide diabetes
self-care in the classroom, in any area of the school or school
grounds, during any school-related activity, and, upon specific
request by a parent or guardian, in a private location.
(d) For the purposes of this section, the following terms have the
following meanings:
(1) "School personnel" means any one or more employees of a school
district who volunteers to be trained to administer emergency
medical assistance to a pupil with diabetes.
(2) "Emergency medical assistance" means the administration of
glucagon to a pupil who is suffering from severe hypoglycemia.
(a) It is the intent of the Legislature that, whenever
possible, 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 or charter school, a school
district, county office of education, or charter school may elect to
participate in a program, pursuant to this section, to allow
nonmedical employees to volunteer to provide medical assistance to
pupils with epilepsy suffering from seizures, upon request by a
parent or guardian pursuant to subdivision (c). If the school
district, county office of education, or charter school elects to
participate in a program pursuant to this section, the school
district, county office of education, or charter school shall provide
school employees who volunteer pursuant to this section with
voluntary emergency medical training, that is consistent with the
training guidelines established pursuant to subdivision (m), 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
using guidelines approved on the department's Internet Web site
pursuant to subdivision (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 (m) shall not be required to provide emergency medical
assistance pursuant to this section.
(c) If a pupil with epilepsy has been prescribed 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 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), and the federal Individuals
with Disabilities Education Act (20 U.S.C. Sec. 1400 et seq.), upon
receipt of the parent's or guardian's request pursuant to subdivision
(c), the school or charter school shall notify the parent or
guardian that his or her child may qualify for services or
accommodations under the Section 504 plan or an individualized
education program, assist the parent or guardian with the exploration
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 or an individualized education program.
(e) The school or charter 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 the federal Individuals with Disabilities Education Act (20
U.S.C. Sec. 1400 et seq.), and that the parent or guardian
understands that it is his or her right to request a Section 504 plan
or an individualized education program at any time.
(f) If the parent or guardian does not choose to have the pupil
assessed for a Section 504 plan or an individualized education
program, the school or charter 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) In training employees pursuant to this section, the school
district, county office of education, or charter 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 an employee of the school or
charter school or an employee of the school district or county
office of education, or the charter school administrator, shall not
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
been developed for an affected pupil, whichever is less.
(4) The school or charter school shall distribute an electronic
notice no more than twice per school year per child 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 rescission timelines described in paragraph (3).
(5) The electronic notice described in paragraph (4) shall be the
only means by which a school or charter school solicits volunteers.
(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 district,
county office of education, or charter school and documentation of
completion is recorded in his or her personnel file.
(i) If a school district, county office of education, or charter
school elects to participate pursuant to this section, the 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.
(j) If there are no volunteers, then the school or charter 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 and the federal
Individuals with Disabilities Education Act (20 U.S.C. Sec. 1400 et
seq.).
(k) A school district, county office of education, or charter
school that elects to participate pursuant to this section shall have
in place a school district, county office of education, or charter
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 an emergency
antiseizure medication and could be available to respond to an
emergency need to administer an emergency antiseizure medication. The
school district or charter school shall consult with the county
office of education to obtain this information.
(2) Identification of pupils who may require the administration of
an emergency antiseizure medication.
(3) Written authorization from the parent or guardian for a
nonmedical school employee to administer an emergency antiseizure
medication.
(4) The requirement that the parent or guardian notify the school
or charter school if the pupil has had an emergency antiseizure
medication administered within the past four hours on a schoolday.
(5) Notification of the parent or guardian, by the school or
charter school administrator or, if the administrator is not
available, by another school staff member, that 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 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
the pupil should be under direct observation.
(J) Following a seizure, the pupil's parent and guardian and the
school nurse shall be contacted by the school or charter school
administrator or, if the administrator is not available, by another
school staff member to continue the observation plan as established
in subparagraph (I).
(l) A school district, county office of education, or charter
school that elects to allow volunteers to administer an emergency
antiseizure medication shall compensate a volunteer, in accordance
with that employee volunteer's pay scale pursuant to Section 45128,
when the administration of an emergency antiseizure medication and
subsequent monitoring of a pupil requires a volunteer to work beyond
his or her normally scheduled hours.
(m) (1) The department, in consultation with the State Department
of Public Health, shall develop guidelines for the training and
supervision of school and charter school employees in providing
emergency medical assistance to pupils with epilepsy suffering from
seizures and shall post this information on the department's Internet
Web site by July 1, 2012. The guidelines may be developed in
cooperation with interested organizations. Upon development of the
guidelines, the department shall approve the guidelines for
distribution and shall make those guidelines available upon request.
(2) The department shall include, on its Internet Web site, a
clearinghouse for best practices in training nonmedical personnel to
administer an emergency antiseizure medication to pupils.
(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 an emergency antiseizure medication.
(C) Basic emergency followup procedures, including, but not
limited to, a requirement for the school or charter school
administrator or, if the administrator is not available, another
school staff member to call the emergency 911 telephone number and to
contact the pupil's parent or guardian. The requirement for the
school or charter school administrator or other school staff member
to call the emergency 911 telephone number shall not require a pupil
to be transported to an emergency room.
(D) Techniques and procedures to ensure pupil privacy.
(4) Any written materials used in the training shall be retained
by the school or charter school.
(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 assistant.
(C) A credentialed school nurse.
(D) A registered nurse.
(E) A certificated public health nurse.
(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.
(n) (1) The school or charter school administrator or, if the
administrator is not available, another school staff member shall
notify the credentialed school nurse assigned to the school district,
county office of education, or charter school if an employee at the
schoolsite administers an emergency antiseizure medication pursuant
to this section.
(2) If a credentialed school nurse is not assigned to the school
district, county office of education, or charter school, the school
or charter school administrator or, if the administrator is not
available, another school staff member shall notify the
superintendent of the school district, or his or her designee, the
county superintendent of schools, or his or her designee, or the
charter school administrator, or his or her designee, as appropriate,
if an employee at the schoolsite administers an emergency
antiseizure medication pursuant to this section.
(3) A school or charter school shall retain all records relating
to the administration of an emergency antiseizure medication while a
pupil is under the supervision of school staff.
(o) The pupil's parent or guardian shall provide all materials
necessary to administer an emergency antiseizure medication,
including the information described in paragraph (6) of subdivision
(k). A school or charter school shall not be responsible for
providing any of the necessary materials.
(p) For purposes of this section, the following definitions apply:
(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.
(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.
On or before July 1, 2004, the State Board of Education
shall adopt maximum weight standards for textbooks used by pupils in
elementary and secondary schools. The weight standards shall take
into consideration the health risks to pupils who transport textbooks
to and from school each day.
(a) A public school may solicit and receive nonstate funds
to acquire and maintain an automated external defibrillator (AED).
These funds shall only be used to acquire and maintain an AED and to
provide training to school employees regarding use of an AED.
(b) Except as provided in subdivision (d), if an employee of a
school district complies with Section 1714.21 of the Civil Code in
rendering emergency care or treatment through the use, attempted use,
or nonuse of an AED at the scene of an emergency, the employee shall
not be liable for any civil damages resulting from any act or
omission in the rendering of the emergency care or treatment.
(c) Except as provided in subdivision (d), if a public school or
school district complies with the requirements of Section 1797.196 of
the Health and Safety Code, the public school or school district
shall be covered by Section 1714.21 of the Civil Code and shall not
be liable for any civil damages resulting from any act or omission in
the rendering of the emergency care or treatment.
(d) Subdivisions (b) and (c) do not apply in the case of personal
injury or wrongful death that results from gross negligence or
willful or wanton misconduct on the part of the person who uses,
attempts to use, or maliciously fails to use an AED to render
emergency care or treatment.
(e) This section does not alter the requirements of Section
1797.196 of the Health and Safety Code.