FINDING OF EMERGENCY
Administration of Epilepsy Medication: Emergency Medical Assistance
The State Board of Education (SBE) finds that an emergency exists and that the emergency regulations adopted are necessary to avoid serious harm to the public peace, health, safety, or general welfare, especially for pupils attending public schools.
SPECIFIC FACTS DEMONSTRATING THE EXISTENCE OF AN EMERGENCY AND THE NEED FOR IMMEDIATE ACTION
This emergency regulations package 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 emergency 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 antiseizure 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 antiseizure medication to pupils in public schools.”
FACTS EXPLAINING THE FAILURE TO ADDRESS THE SITUATION THROUGH NONEMERGENCY REGULATIONS
Senate Bill 161 was signed by the Governor on October 7, 2011 (Statutes of 2011, Chapter 560), became effective on January 1, 2012, and requires that guidelines on training and supervision of volunteer nonmedical personnel be posted by July 1, 2012. CDE has been fulfilling its obligation under SB 161 to consult with the Department of Public Health in the development of the guidelines, and has also sought the input of other interested organizations. Given that the SBE meets on a bimonthly basis, and is a public body that meets pursuant to the requirements of Bagley-Keene, it would be difficult if not impossible to promulgate regulations that would satisfy the July 1, 2012 date through the normal rulemaking process.
AUTHORITY AND REFERENCE
Authority: Sections 33031 and 49414.7, Education Code; Cal. Stats 2011, c. 560 (S.B. 161), sec. 1(b).
Reference: Section 49414.7, Education Code.
INFORMATIVE DIGESTMore than 90,000 children in California have epilepsy, a common symptom of which is seizures. Diastat is a trademark administration system of diazepam (valium) and is currently the only FDA-approved, at-home medication for the treatment of acute repetitive seizures, or "cluster" seizures. Diastat, a rectally-administered gel, was specifically developed to be administered by people without medical training and is considered the fastest, safest and most effective way to treat epileptic seizures. Many seizure patients, despite maintenance medication, experience breakthrough seizures. Up to 35% of patients on anti-seizure medications may not be adequately controlled. Between 50,000 and 200,000 generalized convulsive status epileptic seizures occur every year in the United States, with an overall mortality rate of 20%. Status seizures lasting more than one hour have a mortality rate of 32%, compared with 2.7% for seizures of shorter duration. California's nurse-to-student ratio is approximately 1:2,200. According to the California Basic Educational Data System, about one-half of school districts do not have a school nurse.
TECHNICAL, THEORETICAL, AND/OR EMPIRICAL STUDIES, REPORTS, OR DOCUMENTS
The Legislature relied on the American Academy of Pediatrics and the Epilepsy Foundation of America, both of which support training of school employees to administer an emergency antiseizure medication and believe that an emergency antiseizure medication may be safely and effectively administered by trained school employees.
MANDATE ON LOCAL AGENCIES OR SCHOOL DISTRICTS
The proposed regulations do not impose a mandate on school districts, county offices of education, or charter schools because participation is voluntary.
The emergency regulations would not place any additional costs or savings on local agencies or school districts.
01-10-12 [California Department of Education]