49400. The governing board of any school district shall give
diligent care to the health and physical development of pupils, and
may employ properly certified persons for the work.
49401.5. (a) It is the intent of the Legislature in enacting this
section to express its concern for the health and safety of school
pupils and school personnel at schools where hazardous materials are
stored on the school premises, and to encourage school districts to
take steps to ensure hazardous materials are properly used and
stored.
(b) The governing board of any school district may request
consultation services from the California Occupational Safety and
Health Consultation Service to ensure hazardous materials are being
used and stored safely in school laboratories.
49402. Contracts between any city, county, or local health district
and the governing board of any school district located wholly or
partially within such city, county, or local health district for the
performance by the health officers or other employees of the health
department of such city, county, or local health district of any or
all of the functions and duties set forth in this chapter, Section
49404, and in Article 1 (commencing with Section 49300) of Chapter 8
of this part relating to health supervision of school buildings and
pupils are hereby authorized.
In any such contracts the consideration shall be such as may be
agreed upon by the governing board and the city, county, or local
health district and shall be paid by the governing board at such
times as shall be specified in the contract. This section shall not
apply to any district which is under the control of a governing board
which has under its control a district or districts having a total
average daily attendance of 100,000 or more pupils.
49403. (a) Notwithstanding any other law, the governing board of a
school district shall cooperate with the local health officer in
measures necessary for the prevention and control of communicable
diseases in schoolage children. For that purpose, the board may use
any funds, property, and personnel of the district, and may permit a
licensed physician and surgeon, or a health care practitioner listed
in subdivision (b) who is acting under the direction of a supervising
physician and surgeon, to administer an immunizing agent to a pupil
whose parent or guardian has consented in writing to the
administration of the immunizing agent.
(b) (1) The following health care practitioners, acting under the
direction of a supervising physician and surgeon, may administer an
immunizing agent within the course of a school immunization program:
(A) A physician assistant.
(B) A nurse practitioner.
(C) A registered nurse.
(D) A licensed vocational nurse.
(E) A nursing student who is acting under the supervision of a
registered nurse, in accordance with applicable provisions of law.
(2) A health care practitioner's authority to administer an
immunizing agent pursuant to this subdivision is subject to the
following conditions:
(A) The administration of an immunizing agent is upon the standing
orders of a supervising physician and surgeon and in accordance with
any written regulations that the State Department of Public Health
may adopt.
(B) The school nurse is notified and he or she maintains control,
as necessary, as supervisor of health in accordance with Sections
44871, 44877, 49422, and subdivision (a) of Section 49426.
(C) The health care practitioner may only administer immunizations
for the prevention and control of any of the following:
(i) Annual seasonal influenza.
(ii) Influenza pandemic episodes.
(iii) Other diseases that represent a current or potential
outbreak as declared by a federal, state, or local public health
officer.
(c) As used in this section, "supervising physician and surgeon"
means the physician and surgeon of the local health department or
school district that is directing the school immunization program.
(d) While nothing in this section shall be construed to require
the physical presence of the supervising physician and surgeon, the
supervising physician and surgeon shall require a health care
practitioner under his or her direction to do both of the following:
(1) Satisfactorily demonstrate competence in the administration of
the immunizing agent, including knowledge of all indications and
contraindications for the administration of the agent, and the
recognition and treatment of emergency reactions to the agent that
constitute a danger to the health or life of the person receiving the
immunization.
(2) Possess the medications and equipment that are required, in
the medical judgment of the supervising physician and surgeon, to
treat any emergency conditions and reactions caused by the immunizing
agents that constitute a danger to the health or life of the person
receiving the immunization, and to demonstrate the ability to
administer the medications and use the equipment as necessary.
(e) It is the intent of the Legislature to encourage school-based
immunization programs, when feasible, to use the California
Immunization Registry to assist providers to track patient records,
reduce missed opportunities, and to help fully immunize all children
in California.
49405. The control of smallpox is under the direction of the State
Department of Health Services, and no rule or regulation on the
subject of vaccination shall be adopted by school or local health
authorities.
49406. (a) Except as provided in subdivision (h), no person shall
be initially employed by a school district in a certificated or
classified position unless the person has submitted to an examination
within the past 60 days to determine that he or she is free of
active tuberculosis, by a physician and surgeon licensed under
Chapter 5 (commencing with Section 2000) of Division 2 of the
Business and Professions Code or a physician assistant practicing in
compliance with Chapter 7.7 (commencing with Section 3500) of
Division 2 of the Business and Professions Code. This examination
shall consist of either an approved intradermal tuberculin test or
any other test for tuberculosis infection that is recommended by the
federal Centers for Disease Control and Prevention (CDC) and licensed
by the federal Food and Drug Administration (FDA), which, if
positive, shall be followed by an X-ray of the lungs in accordance
with subdivision (f) of Section 120115 of the Health and Safety Code.
The X-ray film may be taken by a competent and qualified X-ray
technician if the X-ray film is subsequently interpreted by a
physician and surgeon licensed under Chapter 5 (commencing with
Section 2000) of Division 2 of the Business and Professions Code.
The district superintendent or his or her designee may exempt, for
a period not to exceed 60 days following termination of the
pregnancy, a pregnant employee from the requirement that a positive
intradermal tuberculin test be followed by an X-ray of the lungs.
(b) Thereafter, employees who are test negative by either the
tuberculin skin test or any other test for tuberculosis infection
recommended by the CDC and licensed by the FDA shall be required to
undergo the foregoing examination at least once each four years or
more often if directed by the governing board upon recommendation of
the local health officer for so long as the employee's test remains
negative. Once an employee has a documented positive test for
tuberculosis infection conducted pursuant to this subdivision which
has been followed by an X-ray, the foregoing examination is no longer
required, and a referral shall be made within 30 days of completion
of the examination to the local health officer to determine the need
for followup care.
(c) After the examination, each employee shall cause to be on file
with the district superintendent of schools a certificate from the
examining physician and surgeon or physician assistant showing the
employee was examined and found free from active tuberculosis. The
county board of education may require, by rule, that all their
certificates be filed in the office of the county superintendent of
schools or shall require their files be maintained in the office of
the county superintendent of schools if a majority of the governing
boards of the districts within the county so petition the county
board of education, except that in either case a district or
districts with a common board having an average daily attendance of
60,000 or more may elect to maintain the files for its employees in
that district. "Certificate," as used in this section, means a
certificate signed by the examining physician and surgeon or
physician assistant practicing in compliance with Chapter 7.7
(commencing with Section 3500) of Division 2 of the Business and
Professions Code or a notice from a public health agency or unit of
the American Lung Association that indicates freedom from active
tuberculosis. The latter, regardless of form, shall constitute
evidence of compliance with this section. Nothing in this section
shall prevent the governing board, upon recommendation of the local
health officer, from establishing a rule requiring a more extensive
or more frequent physical examination than required by this section,
but the rule shall provide for reimbursement on the same basis as
required in this section.
(d) This examination is a condition of initial employment and the
expense incident thereto shall be borne by the applicant unless
otherwise provided by rules of the governing board. However, the
board may, if an applicant is accepted for employment, reimburse that
person in a like manner prescribed in this section for employees.
(e) The governing board of each district shall reimburse the
employee for the cost, if any, of this examination. The board may
provide for the examination required by this section or may establish
a reasonable fee for the examination that is reimbursable to
employees of the district complying with the provisions of this
section.
(f) At the discretion of the governing board, this section shall
not apply to those employees not requiring certification
qualifications who are employed for any period of time less than a
school year whose functions do not require frequent or prolonged
contact with pupils.
The governing board may, however, require an examination described
in subdivision (b) and may, as a contract condition, require the
examination of persons employed under contract, other than those
persons specified in subdivision (a), if the board believes the
presence of these persons in and around school premises would
constitute a health hazard to pupils.
(g) If the governing board of a school district determines by
resolution, after hearing, that the health of pupils in the district
would not be jeopardized thereby, this section shall not apply to any
employee of the district who files an affidavit stating that he or
she adheres to the faith or teachings of any well-recognized
religious sect, denomination, or organization and in accordance with
its creed, tenets, or principles depends for healing upon prayer in
the practice of religion and that to the best of his or her knowledge
and belief he or she is free from active tuberculosis. If at any
time there should be probable cause to believe that the affiant is
afflicted with active tuberculosis, he or she may be excluded from
service until the governing board of the employing district is
satisfied that he or she is not so afflicted.
(h) A person who transfers his or her employment from one school
or school district to another shall be deemed to meet the
requirements of subdivision (a) if that person can produce a
certificate which shows that he or she was examined within the past
four years and was found to be free of communicable tuberculosis, or
if it is verified by the school previously employing him or her that
it has a certificate on file which contains that showing.
A person who transfers his or her employment from a private or
parochial elementary school, secondary school, or nursery school to a
school or school district subject to this section shall be deemed to
meet the requirements of subdivision (a) if that person can produce
a certificate as provided for in Section 121525 of the Health and
Safety Code that shows that he or she was examined within the past
four years and was found to be free of communicable tuberculosis, or
if it is verified by the school previously employing him or her that
it has a certificate on file which contains that showing.
(i) Any governing board or county superintendent of schools
providing for the transportation of pupils under contract authorized
by Section 39800, 39801, or any other provision of law shall require
as a condition of the contract the examination for active
tuberculosis, as provided by subdivision (a), of all drivers
transporting these pupils, provided that private contracted drivers
who transport these pupils on an infrequent basis, not to exceed once
a month, shall be excluded from this requirement.
49407. Notwithstanding any provision of any law, no school
district, officer of any school district, school principal,
physician, or hospital treating any child enrolled in any school in
any district shall be held liable for the reasonable treatment of a
child without the consent of a parent or guardian of the child when
the child is ill or injured during regular school hours, requires
reasonable medical treatment, and the parent or guardian cannot be
reached, unless the parent or guardian has previously filed with the
school district a written objection to any medical treatment other
than first aid.
49408. For the protection of a pupil's health and welfare, the
governing board of a school district may require the parent or legal
guardian of a pupil to keep current at the pupil's school of
attendance, emergency information including the home address and
telephone number, business address and telephone number of the
parents or guardian, and the name, address and telephone number of a
relative or friend who is authorized to care for the pupil in any
emergency situation if the parent or legal guardian cannot be
reached.
49409. Notwithstanding any provision of any law, no physician and
surgeon who in good faith and without compensation renders voluntary
emergency medical assistance to a participant in a school athletic
event or contest at the site thereof, or during transportation to a
health care facility, for an injury suffered in the course of the
event or contest, shall be liable for any civil damages as a result
of any acts or omissions by the physician and surgeon in rendering
the emergency medical care. The immunity granted by this paragraph
shall not apply in the event of an act or omission constituting gross
negligence.
49410. (a) The Legislature finds that:
(1) There is substantial scientific and medical evidence that
human exposure to asbestos fibers significantly increases the
likelihood of contracting cancer and other debilitating or fatal
diseases such as asbestosis.
(2) Medical and epidemiological evidence suggests that children
exposed to asbestos fibers may be especially susceptible to the
environmentally induced diseases associated with the exposure.
(3) Substantial amounts of asbestos materials were used in school
construction during the period from 1946 through 1973 for
fireproofing, soundproofing, decoration, and other purposes.
(4) When these materials age, deteriorate, or become damaged or
friable, they release asbestos fibers into the ambient air. This can
result in the exposure of school children and school employees to
potentially dangerous levels of asbestos fibers.
(5) The presence of asbestos in the air in concentrations far
exceeding the normal ambient levels has been found in schools,
especially where the asbestos materials have reached a damaged,
deteriorated, or disturbed state as a result of abuse, abrasion,
water leakage, or forced air circulation.
(6) In view of the fact that the State of California has
compulsory attendance laws for children of school age, and these
children must be educated in a safe and healthy environment, the
hazard presented by asbestos materials in the schools is of special
concern to the Legislature.
(b) As a result of the findings in subdivision (a), it is the
intent of the Legislature to provide for the safe and expeditious
containment or removal of asbestos materials posing a hazard to
health in schools.
(c) As used in this section and Sections 49410.2 and 49410.5, the
following terms have the following meanings:
(1) "Asbestos" means naturally occurring hydrated mineral
silicates separable into commercially used fibers: specifically
chrysotile, amosite, crocidolite, tremolite, anthrophyllite, and
actinolite.
(2) "Asbestos materials" means materials formed by mixing asbestos
fibers with other products, including, but not limited to, rock
wool, plaster, cellulose, clay, vermiculite, perlite, and a variety
of adhesives. Some of these materials may be sprayed on surfaces or
applied to surfaces in the form of plaster or a textured paint.
(3) "Hazard to health" means that the asbestos material is loose,
friable, flaking, or dusting, or is likely to become so within the
service life of the material in place.
49410.2. School districts and county offices of education may apply
to the State Allocation Board pursuant to Section 39619.6 for funds
for the purposes of containment or removal of asbestos materials
posing a hazard to health.
49410.5. (a) The State Allocation Board shall retain all
information provided by school districts making application for funds
pursuant to Sections 39619.6, 39619.7, and 39619.8 regarding the
actual or estimated cost of inspection and testing for, and
encapsulation or removal of, asbestos.
(b) The Legislature finds and declares that:
(1) Federal moneys may be made available to reimburse schools for
costs related to asbestos inspection, testing, encapsulation, and
removal, and that the distribution of these moneys will be expedited
by the early collection of these data.
(2) School districts shall comply with guidelines suggested by the
Environmental Protection Agency for the purposes of inspection and
testing for asbestos materials, and for the protection and safety of
workers and all other individuals during the encapsulation and
removal of asbestos.
49410.7. (a) For purposes of funding pursuant to Section 39619.9,
the factors determining the need for abatement of friable asbestos or
potentially friable asbestos shall include, but not be limited to,
visual inspection and bulk samples and air monitoring showing an
airborne concentration of asbestos in the school building in excess
of the standard 0.01 fibers/cc by Transmission Electron Microscopy
(TEM) monitoring, as specified in subdivision (b), or the
concurrently measured concentration of asbestos in the ambient air
immediately adjacent to the building, whichever is higher. For
purposes of reconstruction and rehabilitation projects approved
pursuant to Chapter 22 (commencing with Section 17700) of Part 10 of
the Education Code, for which asbestos abatement related work
commenced on or after October 2, 1985, and for purposes of abating
asbestos contained in pipe and block insulation, air monitoring shall
not be required to determine the need for abatement of friable
asbestos or potentially friable asbestos.
(b) For purposes of air monitoring, the operating agency for each
public school building in which friable asbestos-containing materials
(other than pipe and block insulation or materials to be abated
during rehabilitation or reconstruction projects as specified in
subdivision (a)) have been identified shall monitor airborne asbestos
levels in each sampling area. Each sampling area in which
asbestos-containing materials have been identified shall be monitored
for at least eight hours during a period of normal building
activity. Analysis of samples shall be by Transmission Electron
Microscopy (TEM) methods, in accordance with the Environmental
Protection Agency provisional method and update, to measure the
number of observable asbestos fibers. The results of this monitoring
shall be recorded in terms of the number of visible fibers greater
than 1 micron in length per cubic centimeter of air (f/cc) in accord
with standard definitions for asbestos monitoring established by the
Occupational Safety and Health Administration.
"Sampling area," as used in this section, means any area, whether
contiguous or not, within a building that contains friable material
that is homogenous in texture and appearance.
(c) Any public primary or secondary school building in which
asbestos abatement work has been performed shall not be reoccupied
until air monitoring has been conducted to show that the airborne
concentration of asbestos does not exceed the air monitoring standard
of subdivision (a). Not less than one month after the reoccupancy of
the school building where asbestos abatement work has occurred, the
building shall be remonitored to determine compliance with
subdivision (b).
(d) "School building," as used in this section, means any of the
following:
(1) Structures used for the instruction of public school children,
including classrooms, laboratories, libraries, research facilities,
and administrative facilities.
(2) School eating facilities and school kitchens.
(3) Gymnasiums or other facilities used for athletic or
recreational activities or for courses in physical education.
(4) Dormitories or other living areas of residential schools.
(5) Maintenance, storage, or utility facilities essential to the
operation of the facilities described in paragraphs (1) to (4).
(e) School districts and county offices of education may apply for
reimbursement from the Asbestos Abatement Fund for the costs of air
monitoring completed pursuant to this section.
49411. (a) The State Department of Education, in cooperation with
the Division of Occupational Safety and Health within the Department
of Industrial Relations, shall formulate a listing of chemical
compounds used in school programs that includes the potential hazards
and estimated shelf life of each compound.
(b) The Superintendent of Public Instruction, in cooperation with
the Division of Occupational Safety and Health within the Department
of Industrial Relations, shall develop guidelines for school
districts for the regular removal and disposal of all chemicals whose
estimated shelf life has elapsed.
(c) The county superintendent of schools may implement a system
for disposing of chemicals from schools within the county or may
permit school districts to arrange for the disposal of the chemicals.
49412. (a) Except as provided in subdivision (b), counties and
school districts, in the utilization of funds allocated pursuant to
any appropriation from any account in the Cigarette and Tobacco
Products Surtax Fund for the provision of health care to school
populations, shall give initial consideration to the use of those of
credentialed school nurses and school nurse practitioners employed by
the school districts, to the extent those services are within the
scope of practice of those nurses, and to the extent these purposes
are consistent with the Tobacco Tax and Health Protection Act of 1988
and Chapter 1331 of the Statutes of 1989.
(b) Subdivision (a) does not apply to funds appropriated from the
Health Education Account in the Cigarette and Tobacco Products Surtax
Fund, except for purposes of providing health screenings through the
Child Health and Disability Prevention Screening program.
(c) Any county which, after the initial consideration regarding
the utilization of funds, as required by subdivision (a), elects to
utilize funds to which subdivisions (a) and (b) apply for the
credentialed school nurses and school nurse practitioners employed by
school districts may allocate those funds to the school districts
for those purposes.
49413. (a) The Legislature recognizes the importance of first aid
and cardiopulmonary resuscitation training. In enacting this section,
it is the intent of the Legislature to encourage school districts
and schools, individually or jointly, to develop a program whereby
their staff and pupils understand the importance of this training and
have an appropriate opportunity to develop these skills.
(b) A school district or school, individually or jointly with
another school district or school, may provide a comprehensive
program in first aid or cardiopulmonary resuscitation (CPR) training,
or both, to pupils and employees. The program shall be developed
using the following guidelines:
(1) The school district or school collaborates with existing local
resources, including, but not limited to, parent teacher
associations, hospitals, school nurses, fire departments, and other
local agencies that promote safety, to make first aid or CPR
training, or both, available to the pupils and employees of the
school district or school.
(2) Each school district that develops a program, or the school
district that has jurisdiction over a school that develops a program,
compiles a list of resources for first aid or CPR information, to be
distributed to all of the schools in the district.
(3) The first aid and CPR training are based on standards that are
at least equivalent to the standards currently used by the American
Red Cross or the American Heart Association.
49414. (a) A school district or county office of education may
provide emergency epinephrine auto-injectors to trained personnel,
and trained personnel may utilize those epinephrine auto-injectors to
provide emergency medical aid to persons suffering from an
anaphylactic reaction. Any school district or county office of
education choosing to exercise the authority provided under this
subdivision shall not receive state funds specifically for the
purposes of this subdivision.
(b) For purposes of this section, the following terms have the
following meaning:
(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, food allergy, drug reaction, and exercise.
(2) "Epinephrine auto-injector" means a disposable drug delivery
system with a spring-activated concealed needle that is designed for
emergency administration of epinephrine to provide rapid, convenient
first aid for persons suffering a potentially fatal reaction to
anaphylaxis.
(c) Each public and private elementary and secondary school in the
state may voluntarily determine whether or not to make emergency
epinephrine auto-injectors 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 auto-injectors and trained personnel. Any school
choosing to exercise the authority provided under this subdivision
shall not receive state funds specifically for the purposes of this
subdivision.
(d) Each public and private elementary and secondary school in the
state may designate one or more school personnel on a voluntary
basis 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 auto-injector from the
school nurse or other qualified person designated by the school
district physician, the medical director of the local health
department, or the local emergency medical services director. Any
school choosing to exercise the authority provided under this
subdivision shall not receive state funds specifically for the
purposes of this subdivision.
(e) (1) The Superintendent of Public Instruction shall establish
minimum standards of training for the administration of epinephrine
auto-injectors that satisfy the requirements in paragraph (2). For
purposes of this subdivision, the Superintendent of Public
Instruction shall consult with organizations and providers with
expertise in administering epinephrine auto-injectors and
administering medication in a school environment, including, but not
limited to, the State Department of Health Services, 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,
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 and emergency use of
epinephrine auto-injectors.
(C) Emergency follow-up procedures, including calling the
emergency 911 phone number and contacting, if possible, the pupil's
parent and physician.
(D) Instruction and certification in cardiopulmonary
resuscitation.
(E) Written materials covering the information required under this
subdivision.
(3) A school shall retain for reference the written materials
prepared under subparagraph (E) of paragraph (2).
(f) A school nurse, or if the school does not have a school nurse,
a person who has received training pursuant to subdivision (d), may
do the following:
(1) Obtain from the school district physician, the medical
director of the local health department, or the local emergency
medical services director a prescription for epinephrine
auto-injectors.
(2) Immediately administer an epinephrine auto-injector to a
person exhibiting potentially life-threatening symptoms of
anaphylaxis at school or a school activity when a physician is not
immediately available.
(g) A person who has received training as set forth in subdivision
(d) or a school nurse shall initiate emergency medical services or
other appropriate medical follow up in accordance with the training
materials retained pursuant to paragraph (3) of subdivision (e).
(h) Any school district or county office of education electing to
utilize epinephrine auto-injectors for emergency medical aid shall
create a plan to address all of the following issues:
(1) Designation of the individual or individuals who will provide
the training pursuant to subdivision (d).
(2) Designation of the school district physician, the medical
director of the local health department, or the local emergency
medical services director that the school district or county office
of education will consult for the prescription for epinephrine
auto-injectors pursuant to paragraph (1) of subdivision (f).
(3) Documentation as to which individual, the school nurse or
other trained person pursuant to subdivision (f), in the school
district or county office of education will obtain the prescription
from the physician and the medication from a pharmacist.
(4) Documentation as to where the medication is stored and how the
medication will be made readily available in case of an emergency.
49414.5. (a) In the absence of a credentialed school nurse or other
licensed nurse onsite at the school, each school district may
provide school personnel with voluntary emergency medical training to
provide emergency medical assistance to pupils with diabetes
suffering from severe hypoglycemia, and volunteer personnel shall
provide this emergency care, in accordance with standards established
pursuant to subdivision (b) and the performance instructions set
forth by the licensed health care provider of the pupil. A school
employee who does not volunteer or who has not been trained pursuant
to subdivision (b) may not be required to provide emergency medical
assistance pursuant to this subdivision.
(b) (1) The Legislature encourages the American Diabetes
Association to develop performance standards for the training and
supervision of school personnel in providing emergency medical
assistance to pupils with diabetes suffering from severe
hypoglycemia. The performance standards shall be developed in
cooperation with the department, the California School Nurses
Organization, the California Medical Association, and the American
Academy of Pediatrics. Upon the development of the performance
standards pursuant to this paragraph, the State Department of Health
Services' Diabetes Prevention and Control Program shall approve the
performance standards for distribution and make those standards
available upon request.
(2) Training established pursuant to this subdivision shall
include all of the following:
(A) Recognition and treatment of hypoglycemia.
(B) Administration of glucagon.
(C) Basic emergency followup procedures, including, but not
limited to, calling the emergency 911 telephone number and
contacting, if possible, the pupil's parent or guardian and licensed
health care provider.
(3) Training by a physician, credentialed school nurse, registered
nurse, or certificated public health nurse according to the
standards established pursuant to this section shall be deemed
adequate training for the purposes of this section.
(4) (A) A school employee shall notify the credentialed school
nurse assigned to the school district if he or she administers
glucagon pursuant to this section.
(B) If a credentialed school nurse is not assigned to the school
district, the school employee shall notify the superintendent of the
school district, or his or her designee, if he or she administers
glucagon pursuant to this section.
(5) All materials necessary to administer the glucagon shall be
provided by the parent or guardian of the pupil.
(c) In the case of a pupil who is able to self-test and monitor
his or her blood glucose level, upon written request of the parent or
guardian, and with authorization of the licensed health care
provider of the pupil, a pupil with diabetes shall be permitted to
test his or her blood glucose level and to otherwise provide diabetes
self-care in the classroom, in any area of the school or school
grounds, during any school-related activity, and, upon specific
request by a parent or guardian, in a private location.
(d) For the purposes of this section, the following terms have the
following meanings:
(1) "School personnel" means any one or more employees of a school
district who volunteers to be trained to administer emergency
medical assistance to a pupil with diabetes.
(2) "Emergency medical assistance" means the administration of
glucagon to a pupil who is suffering from severe hypoglycemia.
49415. On or before July 1, 2004, the State Board of Education
shall adopt maximum weight standards for textbooks used by pupils in
elementary and secondary schools. The weight standards shall take
into consideration the health risks to pupils who transport textbooks
to and from school each day.
49400. The governing board of any school district shall give
diligent care to the health and physical development of pupils, and
may employ properly certified persons for the work.
49401.5. (a) It is the intent of the Legislature in enacting this
section to express its concern for the health and safety of school
pupils and school personnel at schools where hazardous materials are
stored on the school premises, and to encourage school districts to
take steps to ensure hazardous materials are properly used and
stored.
(b) The governing board of any school district may request
consultation services from the California Occupational Safety and
Health Consultation Service to ensure hazardous materials are being
used and stored safely in school laboratories.
49402. Contracts between any city, county, or local health district
and the governing board of any school district located wholly or
partially within such city, county, or local health district for the
performance by the health officers or other employees of the health
department of such city, county, or local health district of any or
all of the functions and duties set forth in this chapter, Section
49404, and in Article 1 (commencing with Section 49300) of Chapter 8
of this part relating to health supervision of school buildings and
pupils are hereby authorized.
In any such contracts the consideration shall be such as may be
agreed upon by the governing board and the city, county, or local
health district and shall be paid by the governing board at such
times as shall be specified in the contract. This section shall not
apply to any district which is under the control of a governing board
which has under its control a district or districts having a total
average daily attendance of 100,000 or more pupils.
49403. (a) Notwithstanding any other law, the governing board of a
school district shall cooperate with the local health officer in
measures necessary for the prevention and control of communicable
diseases in schoolage children. For that purpose, the board may use
any funds, property, and personnel of the district, and may permit a
licensed physician and surgeon, or a health care practitioner listed
in subdivision (b) who is acting under the direction of a supervising
physician and surgeon, to administer an immunizing agent to a pupil
whose parent or guardian has consented in writing to the
administration of the immunizing agent.
(b) (1) The following health care practitioners, acting under the
direction of a supervising physician and surgeon, may administer an
immunizing agent within the course of a school immunization program:
(A) A physician assistant.
(B) A nurse practitioner.
(C) A registered nurse.
(D) A licensed vocational nurse.
(E) A nursing student who is acting under the supervision of a
registered nurse, in accordance with applicable provisions of law.
(2) A health care practitioner's authority to administer an
immunizing agent pursuant to this subdivision is subject to the
following conditions:
(A) The administration of an immunizing agent is upon the standing
orders of a supervising physician and surgeon and in accordance with
any written regulations that the State Department of Public Health
may adopt.
(B) The school nurse is notified and he or she maintains control,
as necessary, as supervisor of health in accordance with Sections
44871, 44877, 49422, and subdivision (a) of Section 49426.
(C) The health care practitioner may only administer immunizations
for the prevention and control of any of the following:
(i) Annual seasonal influenza.
(ii) Influenza pandemic episodes.
(iii) Other diseases that represent a current or potential
outbreak as declared by a federal, state, or local public health
officer.
(c) As used in this section, "supervising physician and surgeon"
means the physician and surgeon of the local health department or
school district that is directing the school immunization program.
(d) While nothing in this section shall be construed to require
the physical presence of the supervising physician and surgeon, the
supervising physician and surgeon shall require a health care
practitioner under his or her direction to do both of the following:
(1) Satisfactorily demonstrate competence in the administration of
the immunizing agent, including knowledge of all indications and
contraindications for the administration of the agent, and the
recognition and treatment of emergency reactions to the agent that
constitute a danger to the health or life of the person receiving the
immunization.
(2) Possess the medications and equipment that are required, in
the medical judgment of the supervising physician and surgeon, to
treat any emergency conditions and reactions caused by the immunizing
agents that constitute a danger to the health or life of the person
receiving the immunization, and to demonstrate the ability to
administer the medications and use the equipment as necessary.
(e) It is the intent of the Legislature to encourage school-based
immunization programs, when feasible, to use the California
Immunization Registry to assist providers to track patient records,
reduce missed opportunities, and to help fully immunize all children
in California.
49405. The control of smallpox is under the direction of the State
Department of Health Services, and no rule or regulation on the
subject of vaccination shall be adopted by school or local health
authorities.
49406. (a) Except as provided in subdivision (h), no person shall
be initially employed by a school district in a certificated or
classified position unless the person has submitted to an examination
within the past 60 days to determine that he or she is free of
active tuberculosis, by a physician and surgeon licensed under
Chapter 5 (commencing with Section 2000) of Division 2 of the
Business and Professions Code or a physician assistant practicing in
compliance with Chapter 7.7 (commencing with Section 3500) of
Division 2 of the Business and Professions Code. This examination
shall consist of either an approved intradermal tuberculin test or
any other test for tuberculosis infection that is recommended by the
federal Centers for Disease Control and Prevention (CDC) and licensed
by the federal Food and Drug Administration (FDA), which, if
positive, shall be followed by an X-ray of the lungs in accordance
with subdivision (f) of Section 120115 of the Health and Safety Code.
The X-ray film may be taken by a competent and qualified X-ray
technician if the X-ray film is subsequently interpreted by a
physician and surgeon licensed under Chapter 5 (commencing with
Section 2000) of Division 2 of the Business and Professions Code.
The district superintendent or his or her designee may exempt, for
a period not to exceed 60 days following termination of the
pregnancy, a pregnant employee from the requirement that a positive
intradermal tuberculin test be followed by an X-ray of the lungs.
(b) Thereafter, employees who are test negative by either the
tuberculin skin test or any other test for tuberculosis infection
recommended by the CDC and licensed by the FDA shall be required to
undergo the foregoing examination at least once each four years or
more often if directed by the governing board upon recommendation of
the local health officer for so long as the employee's test remains
negative. Once an employee has a documented positive test for
tuberculosis infection conducted pursuant to this subdivision which
has been followed by an X-ray, the foregoing examination is no longer
required, and a referral shall be made within 30 days of completion
of the examination to the local health officer to determine the need
for followup care.
(c) After the examination, each employee shall cause to be on file
with the district superintendent of schools a certificate from the
examining physician and surgeon or physician assistant showing the
employee was examined and found free from active tuberculosis. The
county board of education may require, by rule, that all their
certificates be filed in the office of the county superintendent of
schools or shall require their files be maintained in the office of
the county superintendent of schools if a majority of the governing
boards of the districts within the county so petition the county
board of education, except that in either case a district or
districts with a common board having an average daily attendance of
60,000 or more may elect to maintain the files for its employees in
that district. "Certificate," as used in this section, means a
certificate signed by the examining physician and surgeon or
physician assistant practicing in compliance with Chapter 7.7
(commencing with Section 3500) of Division 2 of the Business and
Professions Code or a notice from a public health agency or unit of
the American Lung Association that indicates freedom from active
tuberculosis. The latter, regardless of form, shall constitute
evidence of compliance with this section. Nothing in this section
shall prevent the governing board, upon recommendation of the local
health officer, from establishing a rule requiring a more extensive
or more frequent physical examination than required by this section,
but the rule shall provide for reimbursement on the same basis as
required in this section.
(d) This examination is a condition of initial employment and the
expense incident thereto shall be borne by the applicant unless
otherwise provided by rules of the governing board. However, the
board may, if an applicant is accepted for employment, reimburse that
person in a like manner prescribed in this section for employees.
(e) The governing board of each district shall reimburse the
employee for the cost, if any, of this examination. The board may
provide for the examination required by this section or may establish
a reasonable fee for the examination that is reimbursable to
employees of the district complying with the provisions of this
section.
(f) At the discretion of the governing board, this section shall
not apply to those employees not requiring certification
qualifications who are employed for any period of time less than a
school year whose functions do not require frequent or prolonged
contact with pupils.
The governing board may, however, require an examination described
in subdivision (b) and may, as a contract condition, require the
examination of persons employed under contract, other than those
persons specified in subdivision (a), if the board believes the
presence of these persons in and around school premises would
constitute a health hazard to pupils.
(g) If the governing board of a school district determines by
resolution, after hearing, that the health of pupils in the district
would not be jeopardized thereby, this section shall not apply to any
employee of the district who files an affidavit stating that he or
she adheres to the faith or teachings of any well-recognized
religious sect, denomination, or organization and in accordance with
its creed, tenets, or principles depends for healing upon prayer in
the practice of religion and that to the best of his or her knowledge
and belief he or she is free from active tuberculosis. If at any
time there should be probable cause to believe that the affiant is
afflicted with active tuberculosis, he or she may be excluded from
service until the governing board of the employing district is
satisfied that he or she is not so afflicted.
(h) A person who transfers his or her employment from one school
or school district to another shall be deemed to meet the
requirements of subdivision (a) if that person can produce a
certificate which shows that he or she was examined within the past
four years and was found to be free of communicable tuberculosis, or
if it is verified by the school previously employing him or her that
it has a certificate on file which contains that showing.
A person who transfers his or her employment from a private or
parochial elementary school, secondary school, or nursery school to a
school or school district subject to this section shall be deemed to
meet the requirements of subdivision (a) if that person can produce
a certificate as provided for in Section 121525 of the Health and
Safety Code that shows that he or she was examined within the past
four years and was found to be free of communicable tuberculosis, or
if it is verified by the school previously employing him or her that
it has a certificate on file which contains that showing.
(i) Any governing board or county superintendent of schools
providing for the transportation of pupils under contract authorized
by Section 39800, 39801, or any other provision of law shall require
as a condition of the contract the examination for active
tuberculosis, as provided by subdivision (a), of all drivers
transporting these pupils, provided that private contracted drivers
who transport these pupils on an infrequent basis, not to exceed once
a month, shall be excluded from this requirement.
49407. Notwithstanding any provision of any law, no school
district, officer of any school district, school principal,
physician, or hospital treating any child enrolled in any school in
any district shall be held liable for the reasonable treatment of a
child without the consent of a parent or guardian of the child when
the child is ill or injured during regular school hours, requires
reasonable medical treatment, and the parent or guardian cannot be
reached, unless the parent or guardian has previously filed with the
school district a written objection to any medical treatment other
than first aid.
49408. For the protection of a pupil's health and welfare, the
governing board of a school district may require the parent or legal
guardian of a pupil to keep current at the pupil's school of
attendance, emergency information including the home address and
telephone number, business address and telephone number of the
parents or guardian, and the name, address and telephone number of a
relative or friend who is authorized to care for the pupil in any
emergency situation if the parent or legal guardian cannot be
reached.
49409. Notwithstanding any provision of any law, no physician and
surgeon who in good faith and without compensation renders voluntary
emergency medical assistance to a participant in a school athletic
event or contest at the site thereof, or during transportation to a
health care facility, for an injury suffered in the course of the
event or contest, shall be liable for any civil damages as a result
of any acts or omissions by the physician and surgeon in rendering
the emergency medical care. The immunity granted by this paragraph
shall not apply in the event of an act or omission constituting gross
negligence.
49410. (a) The Legislature finds that:
(1) There is substantial scientific and medical evidence that
human exposure to asbestos fibers significantly increases the
likelihood of contracting cancer and other debilitating or fatal
diseases such as asbestosis.
(2) Medical and epidemiological evidence suggests that children
exposed to asbestos fibers may be especially susceptible to the
environmentally induced diseases associated with the exposure.
(3) Substantial amounts of asbestos materials were used in school
construction during the period from 1946 through 1973 for
fireproofing, soundproofing, decoration, and other purposes.
(4) When these materials age, deteriorate, or become damaged or
friable, they release asbestos fibers into the ambient air. This can
result in the exposure of school children and school employees to
potentially dangerous levels of asbestos fibers.
(5) The presence of asbestos in the air in concentrations far
exceeding the normal ambient levels has been found in schools,
especially where the asbestos materials have reached a damaged,
deteriorated, or disturbed state as a result of abuse, abrasion,
water leakage, or forced air circulation.
(6) In view of the fact that the State of California has
compulsory attendance laws for children of school age, and these
children must be educated in a safe and healthy environment, the
hazard presented by asbestos materials in the schools is of special
concern to the Legislature.
(b) As a result of the findings in subdivision (a), it is the
intent of the Legislature to provide for the safe and expeditious
containment or removal of asbestos materials posing a hazard to
health in schools.
(c) As used in this section and Sections 49410.2 and 49410.5, the
following terms have the following meanings:
(1) "Asbestos" means naturally occurring hydrated mineral
silicates separable into commercially used fibers: specifically
chrysotile, amosite, crocidolite, tremolite, anthrophyllite, and
actinolite.
(2) "Asbestos materials" means materials formed by mixing asbestos
fibers with other products, including, but not limited to, rock
wool, plaster, cellulose, clay, vermiculite, perlite, and a variety
of adhesives. Some of these materials may be sprayed on surfaces or
applied to surfaces in the form of plaster or a textured paint.
(3) "Hazard to health" means that the asbestos material is loose,
friable, flaking, or dusting, or is likely to become so within the
service life of the material in place.
49410.2. School districts and county offices of education may apply
to the State Allocation Board pursuant to Section 39619.6 for funds
for the purposes of containment or removal of asbestos materials
posing a hazard to health.
49410.5. (a) The State Allocation Board shall retain all
information provided by school districts making application for funds
pursuant to Sections 39619.6, 39619.7, and 39619.8 regarding the
actual or estimated cost of inspection and testing for, and
encapsulation or removal of, asbestos.
(b) The Legislature finds and declares that:
(1) Federal moneys may be made available to reimburse schools for
costs related to asbestos inspection, testing, encapsulation, and
removal, and that the distribution of these moneys will be expedited
by the early collection of these data.
(2) School districts shall comply with guidelines suggested by the
Environmental Protection Agency for the purposes of inspection and
testing for asbestos materials, and for the protection and safety of
workers and all other individuals during the encapsulation and
removal of asbestos.
49410.7. (a) For purposes of funding pursuant to Section 39619.9,
the factors determining the need for abatement of friable asbestos or
potentially friable asbestos shall include, but not be limited to,
visual inspection and bulk samples and air monitoring showing an
airborne concentration of asbestos in the school building in excess
of the standard 0.01 fibers/cc by Transmission Electron Microscopy
(TEM) monitoring, as specified in subdivision (b), or the
concurrently measured concentration of asbestos in the ambient air
immediately adjacent to the building, whichever is higher. For
purposes of reconstruction and rehabilitation projects approved
pursuant to Chapter 22 (commencing with Section 17700) of Part 10 of
the Education Code, for which asbestos abatement related work
commenced on or after October 2, 1985, and for purposes of abating
asbestos contained in pipe and block insulation, air monitoring shall
not be required to determine the need for abatement of friable
asbestos or potentially friable asbestos.
(b) For purposes of air monitoring, the operating agency for each
public school building in which friable asbestos-containing materials
(other than pipe and block insulation or materials to be abated
during rehabilitation or reconstruction projects as specified in
subdivision (a)) have been identified shall monitor airborne asbestos
levels in each sampling area. Each sampling area in which
asbestos-containing materials have been identified shall be monitored
for at least eight hours during a period of normal building
activity. Analysis of samples shall be by Transmission Electron
Microscopy (TEM) methods, in accordance with the Environmental
Protection Agency provisional method and update, to measure the
number of observable asbestos fibers. The results of this monitoring
shall be recorded in terms of the number of visible fibers greater
than 1 micron in length per cubic centimeter of air (f/cc) in accord
with standard definitions for asbestos monitoring established by the
Occupational Safety and Health Administration.
"Sampling area," as used in this section, means any area, whether
contiguous or not, within a building that contains friable material
that is homogenous in texture and appearance.
(c) Any public primary or secondary school building in which
asbestos abatement work has been performed shall not be reoccupied
until air monitoring has been conducted to show that the airborne
concentration of asbestos does not exceed the air monitoring standard
of subdivision (a). Not less than one month after the reoccupancy of
the school building where asbestos abatement work has occurred, the
building shall be remonitored to determine compliance with
subdivision (b).
(d) "School building," as used in this section, means any of the
following:
(1) Structures used for the instruction of public school children,
including classrooms, laboratories, libraries, research facilities,
and administrative facilities.
(2) School eating facilities and school kitchens.
(3) Gymnasiums or other facilities used for athletic or
recreational activities or for courses in physical education.
(4) Dormitories or other living areas of residential schools.
(5) Maintenance, storage, or utility facilities essential to the
operation of the facilities described in paragraphs (1) to (4).
(e) School districts and county offices of education may apply for
reimbursement from the Asbestos Abatement Fund for the costs of air
monitoring completed pursuant to this section.
49411. (a) The State Department of Education, in cooperation with
the Division of Occupational Safety and Health within the Department
of Industrial Relations, shall formulate a listing of chemical
compounds used in school programs that includes the potential hazards
and estimated shelf life of each compound.
(b) The Superintendent of Public Instruction, in cooperation with
the Division of Occupational Safety and Health within the Department
of Industrial Relations, shall develop guidelines for school
districts for the regular removal and disposal of all chemicals whose
estimated shelf life has elapsed.
(c) The county superintendent of schools may implement a system
for disposing of chemicals from schools within the county or may
permit school districts to arrange for the disposal of the chemicals.
49412. (a) Except as provided in subdivision (b), counties and
school districts, in the utilization of funds allocated pursuant to
any appropriation from any account in the Cigarette and Tobacco
Products Surtax Fund for the provision of health care to school
populations, shall give initial consideration to the use of those of
credentialed school nurses and school nurse practitioners employed by
the school districts, to the extent those services are within the
scope of practice of those nurses, and to the extent these purposes
are consistent with the Tobacco Tax and Health Protection Act of 1988
and Chapter 1331 of the Statutes of 1989.
(b) Subdivision (a) does not apply to funds appropriated from the
Health Education Account in the Cigarette and Tobacco Products Surtax
Fund, except for purposes of providing health screenings through the
Child Health and Disability Prevention Screening program.
(c) Any county which, after the initial consideration regarding
the utilization of funds, as required by subdivision (a), elects to
utilize funds to which subdivisions (a) and (b) apply for the
credentialed school nurses and school nurse practitioners employed by
school districts may allocate those funds to the school districts
for those purposes.
49413. (a) The Legislature recognizes the importance of first aid
and cardiopulmonary resuscitation training. In enacting this section,
it is the intent of the Legislature to encourage school districts
and schools, individually or jointly, to develop a program whereby
their staff and pupils understand the importance of this training and
have an appropriate opportunity to develop these skills.
(b) A school district or school, individually or jointly with
another school district or school, may provide a comprehensive
program in first aid or cardiopulmonary resuscitation (CPR) training,
or both, to pupils and employees. The program shall be developed
using the following guidelines:
(1) The school district or school collaborates with existing local
resources, including, but not limited to, parent teacher
associations, hospitals, school nurses, fire departments, and other
local agencies that promote safety, to make first aid or CPR
training, or both, available to the pupils and employees of the
school district or school.
(2) Each school district that develops a program, or the school
district that has jurisdiction over a school that develops a program,
compiles a list of resources for first aid or CPR information, to be
distributed to all of the schools in the district.
(3) The first aid and CPR training are based on standards that are
at least equivalent to the standards currently used by the American
Red Cross or the American Heart Association.
49414. (a) A school district or county office of education may
provide emergency epinephrine auto-injectors to trained personnel,
and trained personnel may utilize those epinephrine auto-injectors to
provide emergency medical aid to persons suffering from an
anaphylactic reaction. Any school district or county office of
education choosing to exercise the authority provided under this
subdivision shall not receive state funds specifically for the
purposes of this subdivision.
(b) For purposes of this section, the following terms have the
following meaning:
(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, food allergy, drug reaction, and exercise.
(2) "Epinephrine auto-injector" means a disposable drug delivery
system with a spring-activated concealed needle that is designed for
emergency administration of epinephrine to provide rapid, convenient
first aid for persons suffering a potentially fatal reaction to
anaphylaxis.
(c) Each public and private elementary and secondary school in the
state may voluntarily determine whether or not to make emergency
epinephrine auto-injectors 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 auto-injectors and trained personnel. Any school
choosing to exercise the authority provided under this subdivision
shall not receive state funds specifically for the purposes of this
subdivision.
(d) Each public and private elementary and secondary school in the
state may designate one or more school personnel on a voluntary
basis 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 auto-injector from the
school nurse or other qualified person designated by the school
district physician, the medical director of the local health
department, or the local emergency medical services director. Any
school choosing to exercise the authority provided under this
subdivision shall not receive state funds specifically for the
purposes of this subdivision.
(e) (1) The Superintendent of Public Instruction shall establish
minimum standards of training for the administration of epinephrine
auto-injectors that satisfy the requirements in paragraph (2). For
purposes of this subdivision, the Superintendent of Public
Instruction shall consult with organizations and providers with
expertise in administering epinephrine auto-injectors and
administering medication in a school environment, including, but not
limited to, the State Department of Health Services, 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,
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 and emergency use of
epinephrine auto-injectors.
(C) Emergency follow-up procedures, including calling the
emergency 911 phone number and contacting, if possible, the pupil's
parent and physician.
(D) Instruction and certification in cardiopulmonary
resuscitation.
(E) Written materials covering the information required under this
subdivision.
(3) A school shall retain for reference the written materials
prepared under subparagraph (E) of paragraph (2).
(f) A school nurse, or if the school does not have a school nurse,
a person who has received training pursuant to subdivision (d), may
do the following:
(1) Obtain from the school district physician, the medical
director of the local health department, or the local emergency
medical services director a prescription for epinephrine
auto-injectors.
(2) Immediately administer an epinephrine auto-injector to a
person exhibiting potentially life-threatening symptoms of
anaphylaxis at school or a school activity when a physician is not
immediately available.
(g) A person who has received training as set forth in subdivision
(d) or a school nurse shall initiate emergency medical services or
other appropriate medical follow up in accordance with the training
materials retained pursuant to paragraph (3) of subdivision (e).
(h) Any school district or county office of education electing to
utilize epinephrine auto-injectors for emergency medical aid shall
create a plan to address all of the following issues:
(1) Designation of the individual or individuals who will provide
the training pursuant to subdivision (d).
(2) Designation of the school district physician, the medical
director of the local health department, or the local emergency
medical services director that the school district or county office
of education will consult for the prescription for epinephrine
auto-injectors pursuant to paragraph (1) of subdivision (f).
(3) Documentation as to which individual, the school nurse or
other trained person pursuant to subdivision (f), in the school
district or county office of education will obtain the prescription
from the physician and the medication from a pharmacist.
(4) Documentation as to where the medication is stored and how the
medication will be made readily available in case of an emergency.
49414.5. (a) In the absence of a credentialed school nurse or other
licensed nurse onsite at the school, each school district may
provide school personnel with voluntary emergency medical training to
provide emergency medical assistance to pupils with diabetes
suffering from severe hypoglycemia, and volunteer personnel shall
provide this emergency care, in accordance with standards established
pursuant to subdivision (b) and the performance instructions set
forth by the licensed health care provider of the pupil. A school
employee who does not volunteer or who has not been trained pursuant
to subdivision (b) may not be required to provide emergency medical
assistance pursuant to this subdivision.
(b) (1) The Legislature encourages the American Diabetes
Association to develop performance standards for the training and
supervision of school personnel in providing emergency medical
assistance to pupils with diabetes suffering from severe
hypoglycemia. The performance standards shall be developed in
cooperation with the department, the California School Nurses
Organization, the California Medical Association, and the American
Academy of Pediatrics. Upon the development of the performance
standards pursuant to this paragraph, the State Department of Health
Services' Diabetes Prevention and Control Program shall approve the
performance standards for distribution and make those standards
available upon request.
(2) Training established pursuant to this subdivision shall
include all of the following:
(A) Recognition and treatment of hypoglycemia.
(B) Administration of glucagon.
(C) Basic emergency followup procedures, including, but not
limited to, calling the emergency 911 telephone number and
contacting, if possible, the pupil's parent or guardian and licensed
health care provider.
(3) Training by a physician, credentialed school nurse, registered
nurse, or certificated public health nurse according to the
standards established pursuant to this section shall be deemed
adequate training for the purposes of this section.
(4) (A) A school employee shall notify the credentialed school
nurse assigned to the school district if he or she administers
glucagon pursuant to this section.
(B) If a credentialed school nurse is not assigned to the school
district, the school employee shall notify the superintendent of the
school district, or his or her designee, if he or she administers
glucagon pursuant to this section.
(5) All materials necessary to administer the glucagon shall be
provided by the parent or guardian of the pupil.
(c) In the case of a pupil who is able to self-test and monitor
his or her blood glucose level, upon written request of the parent or
guardian, and with authorization of the licensed health care
provider of the pupil, a pupil with diabetes shall be permitted to
test his or her blood glucose level and to otherwise provide diabetes
self-care in the classroom, in any area of the school or school
grounds, during any school-related activity, and, upon specific
request by a parent or guardian, in a private location.
(d) For the purposes of this section, the following terms have the
following meanings:
(1) "School personnel" means any one or more employees of a school
district who volunteers to be trained to administer emergency
medical assistance to a pupil with diabetes.
(2) "Emergency medical assistance" means the administration of
glucagon to a pupil who is suffering from severe hypoglycemia.
49415. On or before July 1, 2004, the State Board of Education
shall adopt maximum weight standards for textbooks used by pupils in
elementary and secondary schools. The weight standards shall take
into consideration the health risks to pupils who transport textbooks
to and from school each day.
49400. The governing board of any school district shall give
diligent care to the health and physical development of pupils, and
may employ properly certified persons for the work.
49401.5. (a) It is the intent of the Legislature in enacting this
section to express its concern for the health and safety of school
pupils and school personnel at schools where hazardous materials are
stored on the school premises, and to encourage school districts to
take steps to ensure hazardous materials are properly used and
stored.
(b) The governing board of any school district may request
consultation services from the California Occupational Safety and
Health Consultation Service to ensure hazardous materials are being
used and stored safely in school laboratories.
49402. Contracts between any city, county, or local health district
and the governing board of any school district located wholly or
partially within such city, county, or local health district for the
performance by the health officers or other employees of the health
department of such city, county, or local health district of any or
all of the functions and duties set forth in this chapter, Section
49404, and in Article 1 (commencing with Section 49300) of Chapter 8
of this part relating to health supervision of school buildings and
pupils are hereby authorized.
In any such contracts the consideration shall be such as may be
agreed upon by the governing board and the city, county, or local
health district and shall be paid by the governing board at such
times as shall be specified in the contract. This section shall not
apply to any district which is under the control of a governing board
which has under its control a district or districts having a total
average daily attendance of 100,000 or more pupils.
49403. (a) Notwithstanding any other law, the governing board of a
school district shall cooperate with the local health officer in
measures necessary for the prevention and control of communicable
diseases in schoolage children. For that purpose, the board may use
any funds, property, and personnel of the district, and may permit a
licensed physician and surgeon, or a health care practitioner listed
in subdivision (b) who is acting under the direction of a supervising
physician and surgeon, to administer an immunizing agent to a pupil
whose parent or guardian has consented in writing to the
administration of the immunizing agent.
(b) (1) The following health care practitioners, acting under the
direction of a supervising physician and surgeon, may administer an
immunizing agent within the course of a school immunization program:
(A) A physician assistant.
(B) A nurse practitioner.
(C) A registered nurse.
(D) A licensed vocational nurse.
(E) A nursing student who is acting under the supervision of a
registered nurse, in accordance with applicable provisions of law.
(2) A health care practitioner's authority to administer an
immunizing agent pursuant to this subdivision is subject to the
following conditions:
(A) The administration of an immunizing agent is upon the standing
orders of a supervising physician and surgeon and in accordance with
any written regulations that the State Department of Public Health
may adopt.
(B) The school nurse is notified and he or she maintains control,
as necessary, as supervisor of health in accordance with Sections
44871, 44877, 49422, and subdivision (a) of Section 49426.
(C) The health care practitioner may only administer immunizations
for the prevention and control of any of the following:
(i) Annual seasonal influenza.
(ii) Influenza pandemic episodes.
(iii) Other diseases that represent a current or potential
outbreak as declared by a federal, state, or local public health
officer.
(c) As used in this section, "supervising physician and surgeon"
means the physician and surgeon of the local health department or
school district that is directing the school immunization program.
(d) While nothing in this section shall be construed to require
the physical presence of the supervising physician and surgeon, the
supervising physician and surgeon shall require a health care
practitioner under his or her direction to do both of the following:
(1) Satisfactorily demonstrate competence in the administration of
the immunizing agent, including knowledge of all indications and
contraindications for the administration of the agent, and the
recognition and treatment of emergency reactions to the agent that
constitute a danger to the health or life of the person receiving the
immunization.
(2) Possess the medications and equipment that are required, in
the medical judgment of the supervising physician and surgeon, to
treat any emergency conditions and reactions caused by the immunizing
agents that constitute a danger to the health or life of the person
receiving the immunization, and to demonstrate the ability to
administer the medications and use the equipment as necessary.
(e) It is the intent of the Legislature to encourage school-based
immunization programs, when feasible, to use the California
Immunization Registry to assist providers to track patient records,
reduce missed opportunities, and to help fully immunize all children
in California.
49405. The control of smallpox is under the direction of the State
Department of Health Services, and no rule or regulation on the
subject of vaccination shall be adopted by school or local health
authorities.
49406. (a) Except as provided in subdivision (h), no person shall
be initially employed by a school district in a certificated or
classified position unless the person has submitted to an examination
within the past 60 days to determine that he or she is free of
active tuberculosis, by a physician and surgeon licensed under
Chapter 5 (commencing with Section 2000) of Division 2 of the
Business and Professions Code or a physician assistant practicing in
compliance with Chapter 7.7 (commencing with Section 3500) of
Division 2 of the Business and Professions Code. This examination
shall consist of either an approved intradermal tuberculin test or
any other test for tuberculosis infection that is recommended by the
federal Centers for Disease Control and Prevention (CDC) and licensed
by the federal Food and Drug Administration (FDA), which, if
positive, shall be followed by an X-ray of the lungs in accordance
with subdivision (f) of Section 120115 of the Health and Safety Code.
The X-ray film may be taken by a competent and qualified X-ray
technician if the X-ray film is subsequently interpreted by a
physician and surgeon licensed under Chapter 5 (commencing with
Section 2000) of Division 2 of the Business and Professions Code.
The district superintendent or his or her designee may exempt, for
a period not to exceed 60 days following termination of the
pregnancy, a pregnant employee from the requirement that a positive
intradermal tuberculin test be followed by an X-ray of the lungs.
(b) Thereafter, employees who are test negative by either the
tuberculin skin test or any other test for tuberculosis infection
recommended by the CDC and licensed by the FDA shall be required to
undergo the foregoing examination at least once each four years or
more often if directed by the governing board upon recommendation of
the local health officer for so long as the employee's test remains
negative. Once an employee has a documented positive test for
tuberculosis infection conducted pursuant to this subdivision which
has been followed by an X-ray, the foregoing examination is no longer
required, and a referral shall be made within 30 days of completion
of the examination to the local health officer to determine the need
for followup care.
(c) After the examination, each employee shall cause to be on file
with the district superintendent of schools a certificate from the
examining physician and surgeon or physician assistant showing the
employee was examined and found free from active tuberculosis. The
county board of education may require, by rule, that all their
certificates be filed in the office of the county superintendent of
schools or shall require their files be maintained in the office of
the county superintendent of schools if a majority of the governing
boards of the districts within the county so petition the county
board of education, except that in either case a district or
districts with a common board having an average daily attendance of
60,000 or more may elect to maintain the files for its employees in
that district. "Certificate," as used in this section, means a
certificate signed by the examining physician and surgeon or
physician assistant practicing in compliance with Chapter 7.7
(commencing with Section 3500) of Division 2 of the Business and
Professions Code or a notice from a public health agency or unit of
the American Lung Association that indicates freedom from active
tuberculosis. The latter, regardless of form, shall constitute
evidence of compliance with this section. Nothing in this section
shall prevent the governing board, upon recommendation of the local
health officer, from establishing a rule requiring a more extensive
or more frequent physical examination than required by this section,
but the rule shall provide for reimbursement on the same basis as
required in this section.
(d) This examination is a condition of initial employment and the
expense incident thereto shall be borne by the applicant unless
otherwise provided by rules of the governing board. However, the
board may, if an applicant is accepted for employment, reimburse that
person in a like manner prescribed in this section for employees.
(e) The governing board of each district shall reimburse the
employee for the cost, if any, of this examination. The board may
provide for the examination required by this section or may establish
a reasonable fee for the examination that is reimbursable to
employees of the district complying with the provisions of this
section.
(f) At the discretion of the governing board, this section shall
not apply to those employees not requiring certification
qualifications who are employed for any period of time less than a
school year whose functions do not require frequent or prolonged
contact with pupils.
The governing board may, however, require an examination described
in subdivision (b) and may, as a contract condition, require the
examination of persons employed under contract, other than those
persons specified in subdivision (a), if the board believes the
presence of these persons in and around school premises would
constitute a health hazard to pupils.
(g) If the governing board of a school district determines by
resolution, after hearing, that the health of pupils in the district
would not be jeopardized thereby, this section shall not apply to any
employee of the district who files an affidavit stating that he or
she adheres to the faith or teachings of any well-recognized
religious sect, denomination, or organization and in accordance with
its creed, tenets, or principles depends for healing upon prayer in
the practice of religion and that to the best of his or her knowledge
and belief he or she is free from active tuberculosis. If at any
time there should be probable cause to believe that the affiant is
afflicted with active tuberculosis, he or she may be excluded from
service until the governing board of the employing district is
satisfied that he or she is not so afflicted.
(h) A person who transfers his or her employment from one school
or school district to another shall be deemed to meet the
requirements of subdivision (a) if that person can produce a
certificate which shows that he or she was examined within the past
four years and was found to be free of communicable tuberculosis, or
if it is verified by the school previously employing him or her that
it has a certificate on file which contains that showing.
A person who transfers his or her employment from a private or
parochial elementary school, secondary school, or nursery school to a
school or school district subject to this section shall be deemed to
meet the requirements of subdivision (a) if that person can produce
a certificate as provided for in Section 121525 of the Health and
Safety Code that shows that he or she was examined within the past
four years and was found to be free of communicable tuberculosis, or
if it is verified by the school previously employing him or her that
it has a certificate on file which contains that showing.
(i) Any governing board or county superintendent of schools
providing for the transportation of pupils under contract authorized
by Section 39800, 39801, or any other provision of law shall require
as a condition of the contract the examination for active
tuberculosis, as provided by subdivision (a), of all drivers
transporting these pupils, provided that private contracted drivers
who transport these pupils on an infrequent basis, not to exceed once
a month, shall be excluded from this requirement.
49407. Notwithstanding any provision of any law, no school
district, officer of any school district, school principal,
physician, or hospital treating any child enrolled in any school in
any district shall be held liable for the reasonable treatment of a
child without the consent of a parent or guardian of the child when
the child is ill or injured during regular school hours, requires
reasonable medical treatment, and the parent or guardian cannot be
reached, unless the parent or guardian has previously filed with the
school district a written objection to any medical treatment other
than first aid.
49408. For the protection of a pupil's health and welfare, the
governing board of a school district may require the parent or legal
guardian of a pupil to keep current at the pupil's school of
attendance, emergency information including the home address and
telephone number, business address and telephone number of the
parents or guardian, and the name, address and telephone number of a
relative or friend who is authorized to care for the pupil in any
emergency situation if the parent or legal guardian cannot be
reached.
49409. Notwithstanding any provision of any law, no physician and
surgeon who in good faith and without compensation renders voluntary
emergency medical assistance to a participant in a school athletic
event or contest at the site thereof, or during transportation to a
health care facility, for an injury suffered in the course of the
event or contest, shall be liable for any civil damages as a result
of any acts or omissions by the physician and surgeon in rendering
the emergency medical care. The immunity granted by this paragraph
shall not apply in the event of an act or omission constituting gross
negligence.
49410. (a) The Legislature finds that:
(1) There is substantial scientific and medical evidence that
human exposure to asbestos fibers significantly increases the
likelihood of contracting cancer and other debilitating or fatal
diseases such as asbestosis.
(2) Medical and epidemiological evidence suggests that children
exposed to asbestos fibers may be especially susceptible to the
environmentally induced diseases associated with the exposure.
(3) Substantial amounts of asbestos materials were used in school
construction during the period from 1946 through 1973 for
fireproofing, soundproofing, decoration, and other purposes.
(4) When these materials age, deteriorate, or become damaged or
friable, they release asbestos fibers into the ambient air. This can
result in the exposure of school children and school employees to
potentially dangerous levels of asbestos fibers.
(5) The presence of asbestos in the air in concentrations far
exceeding the normal ambient levels has been found in schools,
especially where the asbestos materials have reached a damaged,
deteriorated, or disturbed state as a result of abuse, abrasion,
water leakage, or forced air circulation.
(6) In view of the fact that the State of California has
compulsory attendance laws for children of school age, and these
children must be educated in a safe and healthy environment, the
hazard presented by asbestos materials in the schools is of special
concern to the Legislature.
(b) As a result of the findings in subdivision (a), it is the
intent of the Legislature to provide for the safe and expeditious
containment or removal of asbestos materials posing a hazard to
health in schools.
(c) As used in this section and Sections 49410.2 and 49410.5, the
following terms have the following meanings:
(1) "Asbestos" means naturally occurring hydrated mineral
silicates separable into commercially used fibers: specifically
chrysotile, amosite, crocidolite, tremolite, anthrophyllite, and
actinolite.
(2) "Asbestos materials" means materials formed by mixing asbestos
fibers with other products, including, but not limited to, rock
wool, plaster, cellulose, clay, vermiculite, perlite, and a variety
of adhesives. Some of these materials may be sprayed on surfaces or
applied to surfaces in the form of plaster or a textured paint.
(3) "Hazard to health" means that the asbestos material is loose,
friable, flaking, or dusting, or is likely to become so within the
service life of the material in place.
49410.2. School districts and county offices of education may apply
to the State Allocation Board pursuant to Section 39619.6 for funds
for the purposes of containment or removal of asbestos materials
posing a hazard to health.
49410.5. (a) The State Allocation Board shall retain all
information provided by school districts making application for funds
pursuant to Sections 39619.6, 39619.7, and 39619.8 regarding the
actual or estimated cost of inspection and testing for, and
encapsulation or removal of, asbestos.
(b) The Legislature finds and declares that:
(1) Federal moneys may be made available to reimburse schools for
costs related to asbestos inspection, testing, encapsulation, and
removal, and that the distribution of these moneys will be expedited
by the early collection of these data.
(2) School districts shall comply with guidelines suggested by the
Environmental Protection Agency for the purposes of inspection and
testing for asbestos materials, and for the protection and safety of
workers and all other individuals during the encapsulation and
removal of asbestos.
49410.7. (a) For purposes of funding pursuant to Section 39619.9,
the factors determining the need for abatement of friable asbestos or
potentially friable asbestos shall include, but not be limited to,
visual inspection and bulk samples and air monitoring showing an
airborne concentration of asbestos in the school building in excess
of the standard 0.01 fibers/cc by Transmission Electron Microscopy
(TEM) monitoring, as specified in subdivision (b), or the
concurrently measured concentration of asbestos in the ambient air
immediately adjacent to the building, whichever is higher. For
purposes of reconstruction and rehabilitation projects approved
pursuant to Chapter 22 (commencing with Section 17700) of Part 10 of
the Education Code, for which asbestos abatement related work
commenced on or after October 2, 1985, and for purposes of abating
asbestos contained in pipe and block insulation, air monitoring shall
not be required to determine the need for abatement of friable
asbestos or potentially friable asbestos.
(b) For purposes of air monitoring, the operating agency for each
public school building in which friable asbestos-containing materials
(other than pipe and block insulation or materials to be abated
during rehabilitation or reconstruction projects as specified in
subdivision (a)) have been identified shall monitor airborne asbestos
levels in each sampling area. Each sampling area in which
asbestos-containing materials have been identified shall be monitored
for at least eight hours during a period of normal building
activity. Analysis of samples shall be by Transmission Electron
Microscopy (TEM) methods, in accordance with the Environmental
Protection Agency provisional method and update, to measure the
number of observable asbestos fibers. The results of this monitoring
shall be recorded in terms of the number of visible fibers greater
than 1 micron in length per cubic centimeter of air (f/cc) in accord
with standard definitions for asbestos monitoring established by the
Occupational Safety and Health Administration.
"Sampling area," as used in this section, means any area, whether
contiguous or not, within a building that contains friable material
that is homogenous in texture and appearance.
(c) Any public primary or secondary school building in which
asbestos abatement work has been performed shall not be reoccupied
until air monitoring has been conducted to show that the airborne
concentration of asbestos does not exceed the air monitoring standard
of subdivision (a). Not less than one month after the reoccupancy of
the school building where asbestos abatement work has occurred, the
building shall be remonitored to determine compliance with
subdivision (b).
(d) "School building," as used in this section, means any of the
following:
(1) Structures used for the instruction of public school children,
including classrooms, laboratories, libraries, research facilities,
and administrative facilities.
(2) School eating facilities and school kitchens.
(3) Gymnasiums or other facilities used for athletic or
recreational activities or for courses in physical education.
(4) Dormitories or other living areas of residential schools.
(5) Maintenance, storage, or utility facilities essential to the
operation of the facilities described in paragraphs (1) to (4).
(e) School districts and county offices of education may apply for
reimbursement from the Asbestos Abatement Fund for the costs of air
monitoring completed pursuant to this section.
49411. (a) The State Department of Education, in cooperation with
the Division of Occupational Safety and Health within the Department
of Industrial Relations, shall formulate a listing of chemical
compounds used in school programs that includes the potential hazards
and estimated shelf life of each compound.
(b) The Superintendent of Public Instruction, in cooperation with
the Division of Occupational Safety and Health within the Department
of Industrial Relations, shall develop guidelines for school
districts for the regular removal and disposal of all chemicals whose
estimated shelf life has elapsed.
(c) The county superintendent of schools may implement a system
for disposing of chemicals from schools within the county or may
permit school districts to arrange for the disposal of the chemicals.
49412. (a) Except as provided in subdivision (b), counties and
school districts, in the utilization of funds allocated pursuant to
any appropriation from any account in the Cigarette and Tobacco
Products Surtax Fund for the provision of health care to school
populations, shall give initial consideration to the use of those of
credentialed school nurses and school nurse practitioners employed by
the school districts, to the extent those services are within the
scope of practice of those nurses, and to the extent these purposes
are consistent with the Tobacco Tax and Health Protection Act of 1988
and Chapter 1331 of the Statutes of 1989.
(b) Subdivision (a) does not apply to funds appropriated from the
Health Education Account in the Cigarette and Tobacco Products Surtax
Fund, except for purposes of providing health screenings through the
Child Health and Disability Prevention Screening program.
(c) Any county which, after the initial consideration regarding
the utilization of funds, as required by subdivision (a), elects to
utilize funds to which subdivisions (a) and (b) apply for the
credentialed school nurses and school nurse practitioners employed by
school districts may allocate those funds to the school districts
for those purposes.
49413. (a) The Legislature recognizes the importance of first aid
and cardiopulmonary resuscitation training. In enacting this section,
it is the intent of the Legislature to encourage school districts
and schools, individually or jointly, to develop a program whereby
their staff and pupils understand the importance of this training and
have an appropriate opportunity to develop these skills.
(b) A school district or school, individually or jointly with
another school district or school, may provide a comprehensive
program in first aid or cardiopulmonary resuscitation (CPR) training,
or both, to pupils and employees. The program shall be developed
using the following guidelines:
(1) The school district or school collaborates with existing local
resources, including, but not limited to, parent teacher
associations, hospitals, school nurses, fire departments, and other
local agencies that promote safety, to make first aid or CPR
training, or both, available to the pupils and employees of the
school district or school.
(2) Each school district that develops a program, or the school
district that has jurisdiction over a school that develops a program,
compiles a list of resources for first aid or CPR information, to be
distributed to all of the schools in the district.
(3) The first aid and CPR training are based on standards that are
at least equivalent to the standards currently used by the American
Red Cross or the American Heart Association.
49414. (a) A school district or county office of education may
provide emergency epinephrine auto-injectors to trained personnel,
and trained personnel may utilize those epinephrine auto-injectors to
provide emergency medical aid to persons suffering from an
anaphylactic reaction. Any school district or county office of
education choosing to exercise the authority provided under this
subdivision shall not receive state funds specifically for the
purposes of this subdivision.
(b) For purposes of this section, the following terms have the
following meaning:
(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, food allergy, drug reaction, and exercise.
(2) "Epinephrine auto-injector" means a disposable drug delivery
system with a spring-activated concealed needle that is designed for
emergency administration of epinephrine to provide rapid, convenient
first aid for persons suffering a potentially fatal reaction to
anaphylaxis.
(c) Each public and private elementary and secondary school in the
state may voluntarily determine whether or not to make emergency
epinephrine auto-injectors 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 auto-injectors and trained personnel. Any school
choosing to exercise the authority provided under this subdivision
shall not receive state funds specifically for the purposes of this
subdivision.
(d) Each public and private elementary and secondary school in the
state may designate one or more school personnel on a voluntary
basis 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 auto-injector from the
school nurse or other qualified person designated by the school
district physician, the medical director of the local health
department, or the local emergency medical services director. Any
school choosing to exercise the authority provided under this
subdivision shall not receive state funds specifically for the
purposes of this subdivision.
(e) (1) The Superintendent of Public Instruction shall establish
minimum standards of training for the administration of epinephrine
auto-injectors that satisfy the requirements in paragraph (2). For
purposes of this subdivision, the Superintendent of Public
Instruction shall consult with organizations and providers with
expertise in administering epinephrine auto-injectors and
administering medication in a school environment, including, but not
limited to, the State Department of Health Services, 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,
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 and emergency use of
epinephrine auto-injectors.
(C) Emergency follow-up procedures, including calling the
emergency 911 phone number and contacting, if possible, the pupil's
parent and physician.
(D) Instruction and certification in cardiopulmonary
resuscitation.
(E) Written materials covering the information required under this
subdivision.
(3) A school shall retain for reference the written materials
prepared under subparagraph (E) of paragraph (2).
(f) A school nurse, or if the school does not have a school nurse,
a person who has received training pursuant to subdivision (d), may
do the following:
(1) Obtain from the school district physician, the medical
director of the local health department, or the local emergency
medical services director a prescription for epinephrine
auto-injectors.
(2) Immediately administer an epinephrine auto-injector to a
person exhibiting potentially life-threatening symptoms of
anaphylaxis at school or a school activity when a physician is not
immediately available.
(g) A person who has received training as set forth in subdivision
(d) or a school nurse shall initiate emergency medical services or
other appropriate medical follow up in accordance with the training
materials retained pursuant to paragraph (3) of subdivision (e).
(h) Any school district or county office of education electing to
utilize epinephrine auto-injectors for emergency medical aid shall
create a plan to address all of the following issues:
(1) Designation of the individual or individuals who will provide
the training pursuant to subdivision (d).
(2) Designation of the school district physician, the medical
director of the local health department, or the local emergency
medical services director that the school district or county office
of education will consult for the prescription for epinephrine
auto-injectors pursuant to paragraph (1) of subdivision (f).
(3) Documentation as to which individual, the school nurse or
other trained person pursuant to subdivision (f), in the school
district or county office of education will obtain the prescription
from the physician and the medication from a pharmacist.
(4) Documentation as to where the medication is stored and how the
medication will be made readily available in case of an emergency.
49414.5. (a) In the absence of a credentialed school nurse or other
licensed nurse onsite at the school, each school district may
provide school personnel with voluntary emergency medical training to
provide emergency medical assistance to pupils with diabetes
suffering from severe hypoglycemia, and volunteer personnel shall
provide this emergency care, in accordance with standards established
pursuant to subdivision (b) and the performance instructions set
forth by the licensed health care provider of the pupil. A school
employee who does not volunteer or who has not been trained pursuant
to subdivision (b) may not be required to provide emergency medical
assistance pursuant to this subdivision.
(b) (1) The Legislature encourages the American Diabetes
Association to develop performance standards for the training and
supervision of school personnel in providing emergency medical
assistance to pupils with diabetes suffering from severe
hypoglycemia. The performance standards shall be developed in
cooperation with the department, the California School Nurses
Organization, the California Medical Association, and the American
Academy of Pediatrics. Upon the development of the performance
standards pursuant to this paragraph, the State Department of Health
Services' Diabetes Prevention and Control Program shall approve the
performance standards for distribution and make those standards
available upon request.
(2) Training established pursuant to this subdivision shall
include all of the following:
(A) Recognition and treatment of hypoglycemia.
(B) Administration of glucagon.
(C) Basic emergency followup procedures, including, but not
limited to, calling the emergency 911 telephone number and
contacting, if possible, the pupil's parent or guardian and licensed
health care provider.
(3) Training by a physician, credentialed school nurse, registered
nurse, or certificated public health nurse according to the
standards established pursuant to this section shall be deemed
adequate training for the purposes of this section.
(4) (A) A school employee shall notify the credentialed school
nurse assigned to the school district if he or she administers
glucagon pursuant to this section.
(B) If a credentialed school nurse is not assigned to the school
district, the school employee shall notify the superintendent of the
school district, or his or her designee, if he or she administers
glucagon pursuant to this section.
(5) All materials necessary to administer the glucagon shall be
provided by the parent or guardian of the pupil.
(c) In the case of a pupil who is able to self-test and monitor
his or her blood glucose level, upon written request of the parent or
guardian, and with authorization of the licensed health care
provider of the pupil, a pupil with diabetes shall be permitted to
test his or her blood glucose level and to otherwise provide diabetes
self-care in the classroom, in any area of the school or school
grounds, during any school-related activity, and, upon specific
request by a parent or guardian, in a private location.
(d) For the purposes of this section, the following terms have the
following meanings:
(1) "School personnel" means any one or more employees of a school
district who volunteers to be trained to administer emergency
medical assistance to a pupil with diabetes.
(2) "Emergency medical assistance" means the administration of
glucagon to a pupil who is suffering from severe hypoglycemia.
49415. On or before July 1, 2004, the State Board of Education
shall adopt maximum weight standards for textbooks used by pupils in
elementary and secondary schools. The weight standards shall take
into consideration the health risks to pupils who transport textbooks
to and from school each day.
