INITIAL STATEMENT OF REASONS
Administration of Epilepsy Medication: Emergency Medical Assistance
INTRODUCTION
The proposed regulations will implement the provisions of Education Code section 49414.7, which became effective January 1, 2012. The Legislature passed Senate Bill (SB) 161 and it was signed by the Governor on October 7, 2011 (Statutes of 2011, Chapter 560). SB 161 authorizes a school district, county office of education, or charter school to participate in a program to provide nonmedical 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 or charter school—and with a parent’s written authorization—emergency medical assistance to pupils with epilepsy suffering from seizures, in accordance with guidelines to be developed by the California Department of Education (CDE) in consultation with the State Department of Public Health. The CDE is required to post these guidelines on its Web site by July 1, 2012. These regulations are being proposed because SB 161 states that the training must be “consistent” with the guidelines and that a nonmedical school employee who has completed the voluntary training and provides assistance “shall” provide assistance “using the guidelines.” Because the guidelines are to be rules of general application that implement SB 161, it is necessary to adopt them as regulations.
The legislature emphasized pupil safety concerns in passing SB 161, finding that “the safety and welfare of a pupil with epilepsy is compromised without immediate access to an emergency anti-seizure medication” and 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 an emergency anti-seizure medication to pupils in public schools.”
The regulations address the “training” and “supervision” of volunteers called for by SB 161.
PROBLEM AGENCY INTENDS TO ADDRESS
Students with epilepsy who experience severe seizures at school need to havetrained staff administer emergency anti-seizure medication. Given the shortage of school nurses, there is a need to train volunteer nonmedical school personnel to administer emergency anti-seizure medication in the absence of a school nurse.
BENEFITS ANTICIPATED FROM REGULATORY ACTION
The regulations provide school districts, county offices of education and charter schools with the necessary guidance to train volunteer nonmedical school personnel to administer antiseizure medication, in the absence of a school nurse,to students with epilepsy suffering from seizures.
SPECIFIC PURPOSE OF EACH SECTION—GOV. CODE SECTION 11346.2(b)(1)
The specific purpose of each adoption and the rationale for the determination that each adoption is reasonably necessary to carry out the purpose for which it is proposed, together with a description of the public problem, administrative requirement, or other condition or circumstance that each adoption or amendment is intended to address, is as follows:
Proposed section 620 is added to specify that the regulations in this Article, sections 620 through 627, implement the guidelines on training and supervision required by SB 161. This is necessary to communicate the purpose of these regulations.
Proposed section 621 adds definitions of key terms used in this Article. This is necessary to ensure that there is no confusion about the meaning of the terms used in these sections. Sections (a) and (b), emergency anti-seizure medication and emergency medical assistance, as defined in the statute, are included to provide clarity to the reader and allow he or she to find all applicable references in one place. Section (c), nonmedical school personnel, is added in order to provide a clear understanding as to the identity of the volunteers referred to in the statute. Section (d), regular school day, is added to clarify that emergency antiseizure medications may be administered at times such as before and after school. Section (e), supervision, is included to provide a clear understanding as to the meaning of supervision as used in the statute and to clarify that supervision does not necessarily require the immediate presence of the supervisor at all times.
Proposed section 622 is added to specify which persons are authorized to provide the training and supervision described in this Article. The portion relating to training, as stated in the statute, is included to provide clarity to the reader and allow he or she to find all applicable references in one place. The portion relating to supervision is added to clarify, and implement the legislative intent that, licensed health care professionals shall provide not only the training but also the supervision.
Proposed section 623 is added to specify the required content of the training that licensed health care professionals will provide to volunteer nonmedical school employees pursuant to this Article. This portion, as stated in the statute, is included to provide clarity to the reader and allow he or she to find all applicable references in one place. Section 623 also organizes in one place all of the information, contained in different parts of the statute, that would impact the volunteer’s decision whether to volunteer in the first instance and whether to continue to volunteer, and requires that he or she be informed of all of that information during the training. Section 623 is necessary to ensure that the volunteer receives the training necessary to properly administer an emergency anti-seizure medication and clearly understands the nature and extent of his responsibilities.
Proposed section 624 is added to specify that the training provided pursuant to this Article must be in accordance with the instructions of the medication manufacturer and the pupil’s health care provider, and the guidelines in this Article. This is necessary to ensure that the trainer clearly understands the training parameters. Section 624, as stated in the statute, is included to provide clarity to the reader and allow he or she to find all applicable references in one place.
Proposed section 625 is added to specify the circumstances under which periodic retraining of volunteer nonmedical school employees is required. This is necessary to ensure that volunteers who have not recently administered an emergency anti-seizure medication retain the knowledge and ability to do so. Section 625, as stated in the statute, is included to provide clarity to the reader and allow he or she to find all applicable references in one place.
Proposed section 626 is added to specify all of the circumstances that must be present in a specific instance in order for a trained volunteer nonmedical school employee to administer an emergency antiseizure medication to a pupil with epilepsy suffering from seizures. This is necessary to ensure that emergency anti-seizure medications are only administered as authorized by law. The requirements of Section 626, as stated in the statute, are included to provide clarity to the reader and allow he or she to find all applicable references in one place. Section 626 also organizes in one place all of the criteria, contained in different parts of the statute, that must be present in order for a volunteer nonmedical school employee to administer an emergency antiseizure medication.
Proposed section 627 is added to identify the required components of supervision by a licensed health care professional of a volunteer nonmedical school employee pursuant to this Article. Because the statute is silent on the components of supervision, this is necessary to ensure that educational agencies have a clear understanding of the components of the “supervision” by a licensed health care professional that is contemplated by the statute. Sections (a) (1) and (2) are included as stated in the statute. Section (a)(3) organizes in one place those records, contained in different parts of the statute, as to which it is critical that the volunteer have access, and adds the requirement that volunteer nonmedical school personnel have ready access to such records in order to fulfill the purpose of the statute. Section (a)(4) adds the requirement that volunteer nonmedical school personnel report every administration of emergency anti-seizure medication to the school administrator, in order that the administrator can fulfill the statutory requirement that he or she notify the parent. Section (a)(5) combines two portions of the statute in one place in order to clarify the meaning of the “records” that must be kept regarding administration of emergency antiseizure medication, specifying that the records should include documentation that the pupil’s health care practicioner’s instructions were followed, as required by the statute. Section (a)(5) also adds a requirement that the “records” regarding administration of emergency antiseizure medication should include the length of the seizure and action taken after the seizure, in order to document that the pupil’s health care practicioner’s protocol for observing the student after a seizure was followed, as required by the statute.
Economic Impact Analysis PER GOVERNMENT CODE SECTION 11346.3, SUBDIVISION (b)
Significant, statewide adverse economic impact directly affecting business including the ability of California businesses to compete with businesses in other states: There will be no impact to businesses because the regulations relate only to school districts.
Cost impacts on a representative private person or businesses: The SBE is not aware of any cost impacts that a representative private person or business would necessarily incur in reasonable compliance with the proposed action.
Adoption of these regulations will not 1) create or eliminate jobs within California; 2) create new businesses or eliminate existing businesses within California; or 3) affect the expansion of businesses currently doing business within California because the regulations relate only to school districts..
The Legislature determined that the benefits of the regulation to the health and welfare of California residents and to the State’s environment are 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 an emergency antiseizure medication to pupils in public schools.
Effect on housing costs: There will be no impact to businesses because the regulations relate only to school districts.
Effect on small businesses: The proposed regulations would not have an effect on any small business because the regulations relate only to school districts and not to small business practices.
OTHER REQUIRED SHOWINGS – GOV. CODE SECTION 11346.2(b)(3), (5) and (6)
Studies, Reports or Documents Relied Upon – Government Code Section 11346.2(b)(3):
The SBE did not rely upon any technical, theoretical or empirical studies, reports, or documents in proposing the adoption of this regulation.
Reasonable Alternatives Considered or Agency’s Reasons for Rejecting Those Alternatives – Government Code Section 11346.2(b)(5)(A):
No other alternatives were presented to or considered by the SBE.
Reasonable Alternatives That Would Lessen the Impact on Small Businesses – Government Code Section 11346.2(b)(5)(B):
The SBE has not identified any alternatives that would lessen any adverse impact on small business.
Evidence Relied Upon to Support the Initial Determination That the Regulation will not Have a Significant Adverse Economic Impact on Business – Government Code Section 11346.2(b)(6):
The proposed regulations would not have a significant economic impact on any business because they relate only to public schools and not to small business practices.
3-22-12 [California Department of Education]
