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<ns0:Id>20250SB__056892CHP</ns0:Id>
<ns0:VersionNum>92</ns0:VersionNum>
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<ns0:ActionText>INTRODUCED</ns0:ActionText>
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<ns0:ActionText>AMENDED_SENATE</ns0:ActionText>
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<ns0:ActionText>AMENDED_SENATE</ns0:ActionText>
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<ns0:Action>
<ns0:ActionText>CHAPTERED</ns0:ActionText>
<ns0:ActionDate>2025-10-03</ns0:ActionDate>
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<ns0:Action>
<ns0:ActionText>APPROVED</ns0:ActionText>
<ns0:ActionDate>2025-10-03</ns0:ActionDate>
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<ns0:Action>
<ns0:ActionText>FILED</ns0:ActionText>
<ns0:ActionDate>2025-10-03</ns0:ActionDate>
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<ns0:LegislativeInfo>
<ns0:SessionYear>2025</ns0:SessionYear>
<ns0:SessionNum>0</ns0:SessionNum>
<ns0:MeasureType>SB</ns0:MeasureType>
<ns0:MeasureNum>568</ns0:MeasureNum>
<ns0:MeasureState>CHP</ns0:MeasureState>
<ns0:ChapterYear>2025</ns0:ChapterYear>
<ns0:ChapterType>CHP</ns0:ChapterType>
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<ns0:ChapterNum>322</ns0:ChapterNum>
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<ns0:AuthorText authorType="LEAD_AUTHOR">Introduced by Senator Niello</ns0:AuthorText>
<ns0:Authors>
<ns0:Legislator>
<ns0:Contribution>LEAD_AUTHOR</ns0:Contribution>
<ns0:House>SENATE</ns0:House>
<ns0:Name>Niello</ns0:Name>
</ns0:Legislator>
</ns0:Authors>
<ns0:Title> An act to amend Section 4119.2 of the Business and Professions Code, and to amend Sections 49414 and 49423 of the Education Code, relating to pupil health. </ns0:Title>
<ns0:RelatingClause>pupil health</ns0:RelatingClause>
<ns0:GeneralSubject>
<ns0:Subject>Pupil health: epinephrine delivery systems: schoolsites and childcare programs.</ns0:Subject>
</ns0:GeneralSubject>
<ns0:DigestText>
<html:p>
(1)
<html:span class="EnSpace"/>
Existing law prohibits specified medical professionals, including nurses, not employed in that capacity by the State Department of Health Care Services, and any other person, from being employed or permitted to supervise the health and physical development of pupils unless that person holds a services credential with a specialization in health or a valid credential, as provided.
</html:p>
<html:p>Notwithstanding that provision, existing law authorizes any pupil who is required to take, during the regular schoolday, medication prescribed for them by a physician and surgeon or ordered for them by a physician assistant, to be assisted by the school nurse or other designated school personnel, and to carry and self-administer, prescription auto-injectable epinephrine if the school district receives the appropriate written statements, as
specified.</html:p>
<html:p>This bill would revise and recast that latter provision by authorizing assistance with, and the carrying and self-administration of, emergency epinephrine delivery systems, instead of auto-injectors, and making its provisions also apply to county offices of education and charter schools.</html:p>
<html:p>Notwithstanding any other law, existing law requires school districts, county offices of education, and charter schools to provide emergency epinephrine auto-injectors, to be stored in an accessible location upon need for emergency use, to school nurses or trained volunteer personnel, and authorizes school nurses and trained personnel to use epinephrine auto-injectors to provide emergency medical aid to persons suffering, or reasonably believed to be suffering, from an anaphylactic reaction, as provided.</html:p>
<html:p>This bill would revise and recast those provisions by requiring local educational
agencies, defined as a school district, county office of education, or charter school, to provide emergency epinephrine delivery systems, instead of auto-injectors, as provided, to be stored at each schoolsite, including at the location of any state or federally subsidized childcare program operated by or under contract with the local educational agency, and by expanding the definition of “volunteer” or “trained personnel” to include certain employees of childcare programs, as provided.</html:p>
<html:p>To the extent that this bill would impose additional duties on local educational agencies, the bill would impose a state-mandated local program.</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Existing law authorizes a pharmacy to furnish epinephrine auto-injectors to a school district, county office of education, or charter school for purposes of the requirements described in paragraph (1) above if specified requirements are met, including that the
auto-injectors are furnished exclusively for use at a school district site, county office of education, or charter school.
</html:p>
<html:p>This bill would authorize a pharmacy to furnish epinephrine delivery systems, instead of auto-injectors, to those local educational agencies, subject to the same requirements, except that the delivery systems may also be furnished exclusively for use at any state or federally subsidized childcare program operated by or under contract with one of those local educational agencies.</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
</html:p>
<html:p>This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to the statutory provisions noted above.</html:p>
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<ns0:DigestKey>
<ns0:VoteRequired>MAJORITY</ns0:VoteRequired>
<ns0:Appropriation>NO</ns0:Appropriation>
<ns0:FiscalCommittee>YES</ns0:FiscalCommittee>
<ns0:LocalProgram>YES</ns0:LocalProgram>
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<ns0:ImmediateEffect>NO</ns0:ImmediateEffect>
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<ns0:Election>NO</ns0:Election>
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<ns0:Preamble>The people of the State of California do enact as follows:</ns0:Preamble>
<ns0:BillSection id="id_D2BDC286-CC67-4BD7-AED7-17FC0AD286B5">
<ns0:Num>SECTION 1.</ns0:Num>
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Section 4119.2 of the
<ns0:DocName>Business and Professions Code</ns0:DocName>
is amended to read:
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<ns0:Num>4119.2.</ns0:Num>
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<html:p>
(a)
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Notwithstanding any other law, a pharmacy may furnish epinephrine delivery systems to a local educational agency pursuant to Section 49414 of the Education Code if all of the following are met:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
The epinephrine delivery systems are furnished exclusively for use at a local educational agency, as that term is defined in Section 49414 of the Education Code, including at any state or federally subsidized childcare program operated by or under contract with the local educational agency.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
A physician and surgeon provides a written order that specifies the quantity of epinephrine delivery systems to be furnished.
</html:p>
<html:p>
(b)
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Records regarding the acquisition and disposition of epinephrine delivery systems furnished pursuant to subdivision (a) shall be maintained by the local educational agency for a period of three years from the date the records were created. The local educational agency shall be responsible for monitoring the supply of epinephrine delivery systems and ensuring the destruction of expired epinephrine delivery systems.
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<ns0:Num>SEC. 2.</ns0:Num>
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Section 49414 of the
<ns0:DocName>Education Code</ns0:DocName>
is amended to read:
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<ns0:LawSection id="id_9D886C7F-D89A-4428-B6E4-D40C4770DB42">
<ns0:Num>49414.</ns0:Num>
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<ns0:Content>
<html:p>
(a)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
For purposes of this section, the following definitions apply:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
“Anaphylaxis” means a potentially life-threatening hypersensitivity to a substance.
</html:p>
<html:p>
(A)
<html:span class="EnSpace"/>
Symptoms of anaphylaxis may include shortness of breath, wheezing, difficulty breathing, difficulty talking or swallowing, hives, itching, swelling, shock, or asthma.
</html:p>
<html:p>
(B)
<html:span class="EnSpace"/>
Causes of anaphylaxis may include, but are not limited to, an insect sting, a food allergy, a drug reaction, or exercise.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
“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.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
“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.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
“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.
</html:p>
<html:p>
(5)
<html:span class="EnSpace"/>
“Local educational agency” means a school operated by a school district, county office of education, or charter school.
</html:p>
<html:p>
(6)
<html:span class="EnSpace"/>
“Qualified supervisor of health” may include, but is not limited to, a school nurse.
</html:p>
<html:p>
(7)
<html:span class="EnSpace"/>
“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.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Training established pursuant to this subdivision shall include all of the following:
</html:p>
<html:p>
(A)
<html:span class="EnSpace"/>
Techniques for recognizing symptoms of anaphylaxis.
</html:p>
<html:p>
(B)
<html:span class="EnSpace"/>
Standards and procedures for the storage, restocking, and emergency use of epinephrine delivery systems.
</html:p>
<html:p>
(C)
<html:span class="EnSpace"/>
Emergency followup procedures, including calling the emergency 911 telephone number and contacting, if possible, the pupil’s parent and physician.
</html:p>
<html:p>
(D)
<html:span class="EnSpace"/>
Recommendations on the necessity of instruction and certification in cardiopulmonary resuscitation.
</html:p>
<html:p>
(E)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(F)
<html:span class="EnSpace"/>
Written materials covering the information required under this subdivision.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(f)
<html:span class="EnSpace"/>
A local educational agency shall distribute a notice at least once per school year to all staff that contains the following information:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
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).
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
A description of the training that the volunteer will receive pursuant to subdivision (d).
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
The location of the epinephrine delivery system at each schoolsite.
</html:p>
<html:p>
(g)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
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).
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
A prescription pursuant to this
subdivision may be filled by local or mail order pharmacies or epinephrine delivery system manufacturers.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(h)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(i)
<html:span class="EnSpace"/>
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).
</html:p>
<html:p>
(j)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(k)
<html:span class="EnSpace"/>
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.
</html:p>
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<ns0:Num>SEC. 3.</ns0:Num>
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Section 49423 of the
<ns0:DocName>Education Code</ns0:DocName>
is amended to read:
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<ns0:Num>49423.</ns0:Num>
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<html:p>
(a)
<html:span class="EnSpace"/>
Notwithstanding Section 49422, any pupil who is required to take, during the regular schoolday, medication prescribed for the pupil by a physician and surgeon or ordered for the pupil by a physician assistant practicing in compliance with Chapter 7.7 (commencing with Section 3500) of Division 2 of the Business and Professions Code, may be assisted by the school nurse or other designated school personnel, or may carry and self-administer a prescription epinephrine delivery system, if the local educational agency receives the appropriate written statements identified in subdivision (b).
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
In order for a pupil to be assisted by a school nurse or other
designated school personnel pursuant to subdivision (a), the local educational agency shall obtain both a written statement from the physician and surgeon or physician assistant detailing the name of the medication, method, amount, and time schedules by which the medication is to be taken and a written statement from the parent, foster parent, or guardian of the pupil indicating the desire that the local educational agency assist the pupil in the matters set forth in the statement of the physician and surgeon or physician assistant.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
In order for a pupil to carry and self-administer a prescription
epinephrine delivery system pursuant to subdivision (a), the local educational agency shall obtain both a written statement from the physician and surgeon or physician assistant detailing the name of the medication, method, amount, and time schedules by which the medication is to be taken, and confirming that the pupil is able to self-administer the epinephrine delivery system, and a written statement from the parent, foster parent, or guardian of the pupil consenting to the self-administration, providing a release for the school nurse or other designated school personnel to consult with the health care provider of the pupil regarding any questions that may arise with regard to the medication, and releasing the local educational agency and school personnel from civil liability if the self-administering pupil suffers an adverse reaction as a result of self-administering medication pursuant
to this paragraph.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
The written statements specified in this subdivision shall be provided at least annually and more frequently if the medication, dosage, frequency of administration, or reason for administration changes.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
A pupil may be subject to disciplinary action pursuant to Section 48900 if that pupil uses an epinephrine delivery system in a manner other than as prescribed.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
For purposes of this section, “local educational agency” means a school district, county office of education, or charter school.
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<ns0:BillSection id="id_B4B5B86A-515C-4804-A8CA-DF869EBB3ACF">
<ns0:Num>SEC. 4.</ns0:Num>
<ns0:Content>
<html:p>If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.</html:p>
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</ns0:BillSection>
</ns0:Bill>
</ns0:MeasureDoc>
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