1. SB 161 (Senate Bill 161) SB 161, The Huff Bill Approved by the Governor October 7, 2011 Emergency administration of epilepsy medication (trade name Diastat) by non- licensed, non-medical volunteers in the schools Districts have the right to opt in or opt out If Districts opt in, a plan must be developed 1 N at o mas Connecting students to their future Unified School District

2. SB 161- Details 1.Existing law provides that in the absence of a credentialed school nurse, a school district is authorized to provide school personnel with voluntary medical training to provide emergency medical assistance to pupils with diabetes 2.This bill, would authorize school districts to provide non- medical school employees with voluntary emergency medical training to provide, in the absence of a nurse, emergency medical assistance to pupils with epilepsy 3.Must follow guidelines established by CDE and The Department of Public Health 4.A parent or guardian of a child with epilepsy who has been prescribed emergency anti-seizure medication by the student’s health care provider, may request that 1 or more of the employees in the school receive voluntary training in the event that the student suffers a seizure when the nurse is not available 2 N at o mas Connecting students to their future Unified School District

3. SB 161, cont Section 1. The Legislature declares: 1.All students have a right to FAPE 2.Safety and welfare is compromised without immediate access to emergency medication 3.“Immediate Access” is defined as the period of time that the student’s health care provider states that an antiseizure medication must be administered provided that it is within the timeframe that a licensed medical person can reasonably be expected to respond and be available 4.Individuals with exceptional needs have the right to appropriate programs and services that are designed to meet their needs. To meet this goal, it is the intent of the legislature that licensed health care providers train and supervise employees in school districts to administer the medication a)American Academy of Pediatrics and The Epilepsy Foundation of America support the training of school employees and believe that an anti-seizure medication can be safely administered by trained school personnel b)In the absence of a school nurse onsite, it is in the best interest of the health and safety of the children to allow trained school employees to administer emergency antiseizure medication to students in public schools 3 N at o mas Connecting students to their future Unified School District

4. SB 161, cont. Section 2. Section 49414.7 added to the Ed Code 1.Whenever possible, an emergency anti-seizure medication should be administered by a school nurse or LVN who has been trained in its administration 2.In the absence of a nurse, Districts may elect to allow nonmedical employees to volunteer to provide medical assistance upon request of parent. Districts will provide volunteers with emergency medical training following guidelines approved by CDE. A school employee who does not volunteer will not be required to provide emergency medical assistance 3.If a student is prescribed emergency anti-seizure medication the parent may request 1 or more volunteers to receive training in the administration of an emergency anti-seizure medication in the event that a student has seizure and a nurse is not available 4.Section 504/IDEA eligibility 5.Parent right to request an assessment under Section 504 or IDEA 6.Parent right to waive assessment and have a health plan developed. The Health Plan may include the involvement of trained volunteer school employees 4 N at o mas Connecting students to their future Unified School District

5. SB 161, cont. In training employees, the District shall ensure: 1.Receive training from a licensed health care provider. If not trained within the last two years, will be retrained 2.Any agreement by the employee is voluntary and the District shall not attempt to use its authority to coerce any staff member who does not choose to volunteer, including direct contact with the employee 3.Any employee who volunteers may rescind the offer up to three days after completing training. After that, the volunteer may rescind with a two-week notice 4.The District will distribute an electronic notice no more than twice per year per child to all staff 5.The electronic notice is the only means by which a school shall solicit volunteers 6.Districts and employees shall be provided defense and indemnification for any and all civil liability 7.No volunteers- Parents will be notified of their rights under Section 504/IDEA 8.District will be required to develop a comprehensive plan 5 N at o mas Connecting students to their future Unified School District

6. SB 161, cont Training 1.Recognition and treatment of different types of seizures 2.Administration of medication 3.Basic emergency follow up procedures a.Call 911 b.Call parent 4.Techniques to ensure privacy 5.All written materials retained by District 6.Conducted by trained medical personnel 7.Training provided in accordance with manufacturer’s instructions, doctor’s instructions 8.Notification of school nurse 6 N at o mas Connecting students to their future Unified School District

7. ANA vs. Tom Torlakson S184583 American Nurses Association vs. Tom Torlakson and American Diabetes Association 1.Section 504/IDEA 2.October 2005 class action lawsuit against Fremont USD and San Ramon USD a.Refusal to prepare Section 504 plan b.Refusal to include provisions for diabetic care in student’s IEP c.Refusal to permit unlicensed personnel to administer insulin when no nurse available d.Improperly required parents to come to school to administer medication e.Forego employment f.Less frequent insulin injections, less control of glucose levels 3.July 2007 entered into settlement, including required 2007 Legal Advisory summarizing rights of students per Federal and State law 7 N at o mas Connecting students to their future Unified School District

8. 2007 Legal Advisory Authorized in statutory exceptions to the Nursing Practice Act: 1.Students who self administer 2.Medical Staff employed by LEA 3.Other licensed health care providers employed by LEA 4.Licensed contract employees 5.Parents/guardians 6.Persons designated by parents but not school employees 7.Trained, unlicensed school employees acting in emergencies 8 N at o mas Connecting students to their future Unified School District

9. 2007 Legal Advisory 8 th category added: Voluntary unlicensed school employees who have been adequately trained to administer insulin pursuant to the student’s medical orders as required under Section 504 or IDEA. “When Federal and State laws are reconciled, it is clear that it unlawful for a LEA to have a general practice that …does not comply with IDEA/Section 504 because an unlicensed person is not available. In such a case federal rights take precedent over strict adherence to state law so that the educational and health needs of the student are protected…” 9 N at o mas Connecting students to their future Unified School District

10. Appeal Process ANA appealed to the Superior Court- stating that the law does not allow unlicensed school personnel to administer insulin – The appeal was upheld The American Diabetes Association appealed – The Court of Appeal upheld the judgment The case was heard by the California Supreme Court 10 N at o mas Connecting students to their future Unified School District

11. Decision Does California law permit unlicensed school personnel to administer insulin? California law permits trained, unlicensed personnel to administer prescription medication, including insulin, in accordance with written statements from individual student’s treating doctors, with parental consent Staff administer medication in accordance with the doctor’s written statement, therefore state law delegates to each student’s doctor the decision whether insulin may safely be administered by unlicensed school personnel 11 N at o mas Connecting students to their future Unified School District

12. Next Steps 12 N at o mas Connecting students to their future Unified School District