(a)Local educational agencies shall provide emergency epinephrine delivery systems, to be stored at each schoolsite, including at the location of any childcare program operated by or under contract with the local educational agency, in an accessible location upon need for emergency use, to school nurses or trained personnel who have volunteered pursuant to subdivision (d), or to childcare employees who have volunteered, received training, and are subject to liability limitations pursuant to Section 1596.7985 of the Health and Safety Code, and school nurses, trained personnel, and childcare employees may use epinephrine delivery systems to provide emergency medical aid to persons suffering, or reasonably believed to be suffering, from an anaphylactic
reaction.
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(a)
Local educational agencies shall provide emergency epinephrine delivery systems, to be stored at each schoolsite, including at the location of any childcare program operated by or under contract with the local educational agency, in an accessible location upon need for emergency use, to school nurses or trained personnel who have volunteered pursuant to subdivision (d), or to childcare employees who have volunteered, received training, and are subject to liability limitations pursuant to Section 1596.7985 of the Health and Safety Code, and school nurses, trained personnel, and childcare employees may use epinephrine delivery systems 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 definitions apply:
(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, a food allergy, a drug reaction, or 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)
“Childcare program” means a state or federally subsidized childcare program operated by, or under contract with, the local educational agency, including, but not limited to, a California state preschool program or Head Start program pursuant to Chapter 2 (commencing with Section 8200) of Part 6 of Division 1 of Title 1, or a childcare program, including, but not limited to, general childcare and development programs pursuant to Part 1.8 (commencing with Section 10207) of Division 9 of the Welfare and Institutions Code.
(4)
“Epinephrine delivery system” means a disposable delivery
system designed for the delivery of a premeasured dose of epinephrine into the human body to prevent or treat a life-threatening allergic reaction.
(5)
“Local educational agency” means a school operated by a school district, county office of education, or charter school.
(6)
“Qualified supervisor of health” may include, but is not limited to, a school nurse.
(7)
“Volunteer” or “trained personnel” means an employee or a holder of an Activity Supervisor Clearance Certificate pursuant to subdivision (f) of Section 44258.7, who has volunteered to administer epinephrine delivery systems 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), or employees of a childcare program operated by or under contract with a local educational agency, who have volunteered, received training, and are subject to liability limitations pursuant to Section 1596.7985 of the Health and Safety Code.
(c)
Each private school in the state may voluntarily determine whether or not to make emergency epinephrine delivery systems 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 delivery systems and trained personnel. A private 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 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 delivery system 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 delivery systems 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 delivery systems 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 delivery systems.
(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 which epinephrine delivery system to use, which shall include consideration of the age of the person suffering, or reasonably believed to be suffering, from an anaphylactic reaction as a guideline of equivalency for the person’s 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). A copy of these written materials shall be made accessible, such as through publicly posting at the location of the epinephrine delivery systems.
(f)
A local educational agency 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 delivery system 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).
(3)
The location of the epinephrine delivery system at each schoolsite.
(g)
(1)
A qualified supervisor of health at a local
educational agency shall obtain from an authorizing physician and surgeon a prescription for each schoolsite for epinephrine delivery systems that, at a minimum, includes appropriate doses of available epinephrine delivery systems for the ages and weights of individuals at the schoolsite and those participating in any childcare program operated by or under contract with the local educational agency. A qualified supervisor of health at a local educational agency shall be responsible for stocking the epinephrine delivery system and restocking it if it is used.
(2)
If a local educational agency does not have a qualified supervisor of health, an administrator at the local educational agency 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 delivery system 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 schoolsite does not have a school nurse or the school nurse is not onsite or available, a volunteer, may administer an epinephrine delivery system to a person
exhibiting potentially life-threatening symptoms of anaphylaxis at school or a school activity or program operated by or under contract with the local educational agency when a physician is not immediately available. If an epinephrine delivery system is used, it shall be restocked as soon as reasonably possible, but no later than two weeks after it is used. Epinephrine delivery systems 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 local educational agency shall ensure that each employee who volunteers under this section will be provided defense and indemnification by the
local educational agency 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 local educational agency may accept gifts, grants, and donations from any source for the support of the local educational agency carrying out the provisions of this section, including, but not limited to, the acceptance of epinephrine delivery systems from a manufacturer or wholesaler.