Article 1. General Powers--school Boards - California Education Code Section 49414
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California Laws > Education Code > Article 1. General Powers--school Boards - California Education Code Section 49414
49414. (a) School districts, county offices of education, and
charter schools shall provide emergency epinephrine auto-injectors to
school nurses or trained personnel who have volunteered pursuant to
subdivision (d), and school nurses or trained personnel may use
epinephrine auto-injectors to provide emergency medical aid to
persons suffering, or reasonably believed to be suffering, from an
(b) For purposes of this section, the following terms have the
(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) "Authorizing physician and surgeon" may include, but is not
limited to, a physician and surgeon employed by, or contracting with,
a local educational agency, a medical director of the local health
department, or a local emergency medical services director.
(3) "Epinephrine auto-injector" means a disposable drug delivery
system with a spring-activated needle that is designed for emergency
administration of epinephrine to provide rapid, convenient first aid
for persons suffering a potentially fatal reaction to anaphylaxis.
(4) "Qualified supervisor of health" may include, but is not
limited to, a school nurse.
(5) "Volunteer" or "trained personnel" means an employee who has
volunteered to administer epinephrine auto-injectors to a person if
the person is suffering, or reasonably believed to be suffering, from
anaphylaxis, has been designated by a school, and has received
training pursuant to subdivision (d).
(c) Each 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. A private
elementary or secondary school choosing to exercise the authority
provided under this subdivision shall not receive state funds
specifically for purposes of this subdivision.
(d) Each public and private elementary and secondary school in the
state may designate one or more volunteers to receive initial and
annual refresher training, based on the standards developed pursuant
to subdivision (e), regarding the storage and emergency use of an
epinephrine auto-injector from the school nurse or other qualified
person designated by an authorizing physician and surgeon.
(e) (1) Every five years, or sooner as deemed necessary by the
Superintendent, the Superintendent shall review minimum standards of
training for the administration of epinephrine auto-injectors that
satisfy the requirements of paragraph (2). For purposes of this
subdivision, the Superintendent shall consult with organizations and
providers with expertise in administering epinephrine auto-injectors
and administering medication in a school environment, including, but
not limited to, the State Department of Public Health, the Emergency
Medical Services Authority, the American Academy of Allergy, Asthma
and Immunology, the California School Nurses Organization, the
California Medical Association, the American Academy of Pediatrics,
Food Allergy Research and Education, the California Society of
Allergy, Asthma and Immunology, the American College of Allergy,
Asthma and Immunology, the Stanford Allergy Center, 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, restocking, and
emergency use of epinephrine auto-injectors.
(C) Emergency followup procedures, including calling the emergency
911 telephone number and contacting, if possible, the pupil's parent
(D) Recommendations on the necessity of instruction and
certification in cardiopulmonary resuscitation.
(E) Instruction on how to determine whether to use an adult
epinephrine auto-injector or a junior epinephrine auto-injector,
which shall include consideration of a pupil's grade level or age as
a guideline of equivalency for the appropriate pupil weight
(F) Written materials covering the information required under this
(3) Training established pursuant to this subdivision shall be
consistent with the most recent Voluntary Guidelines for Managing
Food Allergies In Schools and Early Care and Education Programs
published by the federal Centers for Disease Control and Prevention
and the most recent guidelines for medication administration issued
by the department.
(4) A school shall retain for reference the written materials
prepared under subparagraph (F) of paragraph (2).
(f) A school district, county office of education, or charter
school shall distribute a notice at least once per school year to all
staff that contains the following information:
(1) A description of the volunteer request stating that the
request is for volunteers to be trained to administer an epinephrine
auto-injector to a person if the person is suffering, or reasonably
believed to be suffering, from anaphylaxis, as specified in
(2) A description of the training that the volunteer will receive
pursuant to subdivision (d).
(g) (1) A qualified supervisor of health at a school district,
county office of education, or charter school shall obtain from an
authorizing physician and surgeon a prescription for each school for
epinephrine auto-injectors that, at a minimum, includes, for
elementary schools, one regular epinephrine auto-injector and one
junior epinephrine auto-injector, and for junior high schools, middle
schools, and high schools, if there are no pupils who require a
junior epinephrine auto-injector, one regular epinephrine
auto-injector. A qualified supervisor of health at a school district,
county office of education, or charter school shall be responsible
for stocking the epinephrine auto-injector and restocking it if it is
(2) If a school district, county office of education, or charter
school does not have a qualified supervisor of health, an
administrator at the school district, county office of education, or
charter school shall carry out the duties specified in paragraph (1).
(3) A prescription pursuant to this subdivision may be filled by
local or mail order pharmacies or epinephrine auto-injector
(h) A school nurse or, if the school does not have a school nurse
or the school nurse is not onsite or available, a volunteer may
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. If the
epinephrine auto-injector is used it shall be restocked as soon as
reasonably possible, but no later than two weeks after it is used.
Epinephrine auto-injectors shall be restocked before their expiration
(i) A volunteer shall initiate emergency medical services or other
appropriate medical followup in accordance with the training
materials retained pursuant to paragraph (4) of subdivision (e).
(j) A school district, county office of education, or charter
school shall ensure that each employee who volunteers under this
section will be provided defense and indemnification by the school
district, county office of education, or charter school for any and
all civil liability, in accordance with, but not limited to, that
provided in Division 3.6 (commencing with Section 810) of Title 1 of
the Government Code. This information shall be reduced to writing,
provided to the volunteer, and retained in the volunteer's personnel
(k) A state agency, the department, or a public school may accept
gifts, grants, and donations from any source for the support of the
public school carrying out the provisions of this section, including,
but not limited to, the acceptance of epinephrine auto-injectors
from a manufacturer or wholesaler.
Last modified: February 16, 2015