SB2382

SECTION 1. Chapter 302A, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§302A- Administration of emergency seizure rescue medication; training. (a) Beginning January 1, 2022, each school shall have at least one school employee on duty during the entire school day to administer or assist with:

(1) The self-administration of seizure rescue medication or medication prescribed to treat seizure disorder symptoms approved by the United States Food and Drug Administration or any successor agency; and

(2) A manual dose of prescribed electrical stimulation using a vagus nerve simulator magnet as approved by the United States Food and Drug Administration or any successor agency.

(b) The department shall ensure that all personnel assigned to administer or assist with the self-administration of seizure rescue medication, vagus nerve stimulator magnet, or any other medication prescribed to treat seizure disorder symptoms are either trained:

(1) Through a training program adopted by rule in accordance with chapter 91 for the training of school personnel in the health care needs of students diagnosed with a seizure disorder; or

(2) By a physician, advance practice registered nurse, or physician assistant consistent with best practice guidelines on seizure treatment and the recognition of the signs and symptoms of seizures and the appropriate steps for seizure first aid.

(c) Beginning January 1, 2022, and on an annual basis thereafter, all principals, guidance counselors, and teachers employed by the department shall complete at least one hour of self-study review of seizure disorder materials developed by medical professionals with expertise in seizure treatment and consistent with best practice guidelines on the recognition of the signs and symptoms of seizures and the appropriate steps for seizure first aid.

(d) Beginning January 1, 2022, and on an annual basis thereafter, each school shall provide an age appropriate seizure education program to all students on seizures and seizure disorders. The seizure education program shall be consistent with guidelines published by the Epilepsy Foundation of America or any successor organization.

(e) This section shall not apply to any school that does not have at least one student enrolled who has either:

(1) A seizure disorder; or

(2) A seizure rescue medication or medication prescribed to treat seizure disorder symptoms approved by the United States Food and Drug Administration or any successor agency prescribed by the student's health care provider."

SECTION 2. Chapter 302C, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§302C- Administration of emergency seizure rescue medication; training. (a) Beginning January 1, 2022, each private school shall have at least one employee on duty during the entire school day to administer or assist with:

(2) A manual dose of prescribed electrical stimulation using a vagus nerve simulator magnet as approved by the United States Food and Drug Administration or any successor agency.

(b) The private school shall ensure that all personnel assigned to administer or assist with the self-administration of seizure rescue medication, vagus nerve stimulator magnet, or any other medication prescribed to treat seizure disorder symptoms are trained by a physician, advance practice registered nurse, or physician assistant consistent with best practice guidelines on seizure treatment and the recognition of the signs and symptoms of seizures and the appropriate steps for seizure first aid.

(c) Beginning January 1, 2022, and on an annual basis thereafter, all principals, guidance counselors, and teachers employed by the private school shall complete at least one hour of self-study review of seizure disorder materials developed by medical professionals with expertise in seizure treatment and consistent with best practice guidelines on the recognition of the signs and symptoms of seizures and the appropriate steps for seizure first aid.

(d) In the case of any student who is certified by the student's physician, advanced practice registered nurse, or physician assistant as having a seizure disorder, the private school shall establish a seizure action plan for that student, in conjunction with the student's parent or guardian, that shall include, but not be limited to the identification of the employee or employees trained to assist the student in the event of a seizure and the method by which the trained employee or employees are contacted in the event of the seizure. The seizure action plan shall be:

(1) Distributed to every school personnel or volunteer responsible for the supervision or care of the student diagnosed with a seizure disorder; and

(2) Kept on file at the school in which the student is enrolled.

(e) Beginning January 1, 2022, and on an annual basis thereafter, each private school shall provide an age appropriate seizure education program to all students on seizures and seizure disorders. The seizure education program shall be consistent with guidelines published by the Epilepsy Foundation of America or any successor organization.

(f) This section shall not apply to any private school that does not have at least one student enrolled who has either:

(1) A seizure disorder; or

SECTION 3. Chapter 302D, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§302D- Administration of emergency seizure rescue medication; training. (a) Beginning January 1, 2022, each public charter school shall have at least one school employee on duty during the entire school day to administer or assist with:

(2) A manual dose of prescribed electrical stimulation using a vagus nerve simulator magnet as approved by the United States Food and Drug Administration or any successor agency.

(b) The public charter school shall ensure that all personnel assigned to administer or assist with the self-administration of seizure rescue medication, vagus nerve stimulator magnet, or any other medication prescribed to treat seizure disorder symptoms are trained by a physician, advance practice registered nurse, or physician assistant consistent with best practice guidelines on seizure treatment and the recognition of the signs and symptoms of seizures and the appropriate steps for seizure first aid.

(c) Beginning January 1, 2022, and on an annual basis thereafter, all principals, guidance counselors and teachers employed by the public charter school shall complete at least one hour of self-study review of seizure disorder materials developed by medical professionals with expertise in seizure treatment and consistent with best practice guidelines on the recognition of the signs and symptoms of seizures and the appropriate steps for seizure first aid.

(d) In the case of any student who is certified by the student's physician, advanced practice registered nurse, or physician assistant as having a seizure disorder, the public charter school shall establish a seizure action plan for that student, in conjunction with the student's parent or guardian, that shall include, but not be limited to the identification of the employee or employees trained to assist the student in the event of a seizure and the method by which the trained employee or employees are contacted in the event of the seizure. The seizure action plan shall be:

(1) Distributed to every school personnel or volunteer responsible for the supervision or care of the student diagnosed with a seizure disorder; and

(2) Kept on file at the school in which the student is enrolled.

(e) Beginning January 1, 2022, and on an annual basis thereafter, each public charter school shall provide an age appropriate seizure education program to all students on seizures and seizure disorders. The seizure education program shall be consistent with guidelines published by the Epilepsy Foundation of America or any successor organization.

(f) This section shall not apply to any public charter school that does not have at least one student enrolled who has either:

(1) A seizure disorder; or

SECTION 4. Section 302A-1164, Hawaii Revised Statutes, is amended to read as follows:

"§302A-1164 Self-administration of medication by student and emergency administration[~~; self-testing and self-management of diabetes by student; assistance with diabetes testing; blood glucose monitoring by student; assistance with blood glucose monitoring;~~] permitted. (a) The department shall permit:

(1) The self-administration of:

(A) Medication by a student for asthma, anaphylaxis, diabetes, seizure disorders, or other potentially life‑threatening illnesses; and

(B) Blood glucose monitoring by a student; and

(2) Department employees and agents to volunteer to administer:

(A) Insulin or assist a student in administering insulin via the insulin delivery system that the student uses;

(B) Glucagon in an emergency situation to students with diabetes;

(D) Seizure medication or vagus nerve stimulation in an emergency situation to students with seizure disorders; or

[~~(D)~~] (E) Blood glucose monitoring or assist a student with blood glucose monitoring.

(b) The student's parent or guardian shall provide the department with:

(1) Written authorization for the self-administration of medication or the emergency administration of glucagon [or] auto-injectable epinephrine[;], seizure medications, or vagus nerve stimulation magnet;

(2) In the case of self‑administration of medication:

(A) Written certification from the student's physician, advanced practice registered nurse, or physician assistant stating that the student with diabetes may perform the student's own blood glucose checks, administer insulin through the student's insulin delivery system, and otherwise attend to the care and management of the student's diabetes during any school-related activity, and that the student may possess on the student's person all necessary supplies and equipment to perform the diabetes monitoring and treatment activities, if applicable; and

(B) Written certification from the student's physician, advanced practice registered nurse, or physician assistant stating that the student:

(i) Has asthma, anaphylaxis, seizure disorder, or another potentially life-threatening illness; and

(ii) Is capable of, and has been instructed in, the proper method of self-administration of medication or blood glucose monitoring; and

(3) In the case of administration of insulin or emergency administration of glucagon to a student with diabetes, blood glucose monitoring of a student, [or] auto-injectable epinephrine to a student with anaphylaxis, or administration of seizure medication or vagus nerve stimulation to the student with a seizure disorder, written certification from the student's physician, advanced practice registered nurse, or physician assistant stating that the student has medical orders that insulin, glucagon, blood glucose monitoring, [or] auto-injectable epinephrine, seizure medication, or vagus nerve stimulation may be administered by a volunteer.

(c) In the case of any student who is certified by the student's physician, advanced practice registered nurse, or physician assistant as having a seizure disorder, the department shall establish a seizure action plan for that student, in conjunction with the student's parent or guardian, that shall include, but not be limited to the identification of the school employee or employees trained to assist the student in the event of a seizure and the method by which the trained employee or employees are contacted in the event of the seizure.

The seizure action plan shall be:

(1) Distributed to every school personnel or volunteer responsible for the supervision or care of the student diagnosed with a seizure disorder; and

(2) Kept on file at the school in which the student is enrolled.

[~~(c)~~] (d) The department shall inform the student's parent or guardian in writing that the department and its employees or agents shall not incur any liability as a result of any injury arising from compliance with this section.

[~~(d)~~] (e) The student's parent or guardian shall sign a statement acknowledging that:

(1) The department and its employees or agents shall not incur any liability as a result of any injury arising from compliance with this section; and

(2) The parent or guardian shall indemnify and hold harmless the department and its employees or agents against any claims arising out of compliance with this section.

[~~(e)~~] (f) The permission shall be effective for the school year for which it is granted and shall be renewed for each subsequent school year upon the fulfillment of the requirements in this section.

[~~(f)~~] (g) Notwithstanding any other law to the contrary, a student who is permitted to self-administer medication under this section shall be permitted to carry an inhaler or auto‑injectable epinephrine, or both, at all times if the student does not endanger the student's person or other persons through the misuse of the inhaler; provided that the department, its employees or agents may confiscate a student's medication, inhaler, or auto-injectable epinephrine if the student's self‑administration of the medication exceeds the student's prescribed dosage, or if the student endangers others with the student's medication, inhaler, or auto-injectable epinephrine.

For the purposes of this section, the term "inhaler" includes:

(1) Metered-dose, breath-actuated, and dry powder inhalers; and

(2) Spacers and holding chambers.

[~~(g)~~] (h) Any employee or agent who volunteers to administer insulin [or], glucagon, seizure medication, or vagus nerve stimulation in an emergency situation to a student with diabetes [or], auto-injectable epinephrine to a student with anaphylaxis, or seizure medication or vagus nerve stimulation to a student with a seizure disorder, or who volunteers to administer or assist a student with blood glucose monitoring shall receive instruction in the proper administration of insulin, glucagon, auto-injectable epinephrine, seizure medication or vagus nerve stimulation, or blood glucose monitoring by a qualified health care professional. A "qualified health care professional" means a licensed physician, physician assistant, advanced practice registered nurse or registered nurse, or certified diabetes educator. The student's parent or guardian shall supply the school with the glucagon kit required to administer the glucagon, any supplies necessary to administer insulin, blood glucose monitoring, or with auto-injectable epinephrine supplies to administer epinephrine. The school shall store the glucagon kit, insulin supplies, blood glucose monitoring supplies, seizure medication or vagus nerve stimulation magnet, or auto-injectable epinephrine supplies in a secure but accessible location.

[~~(h)~~] (i) Any person, except for a qualified health care professional providing the training required in subsection (g), who acts in accordance with the requirements of this section shall be immune from any civil or criminal liability arising from these acts, except where the person's conduct would constitute gross negligence, willful and wanton misconduct, or intentional misconduct."

SECTION 5. There is appropriated out of the general revenues of the State of Hawaii the sum of $100,000 or so much thereof as may be necessary for fiscal year 2020-2021 to train employees to administer or assist with the self-administration of seizure rescue medication at each public school and public charter school.

The sum appropriated shall be expended by the department of education for the purposes of this Act.

SECTION 6. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 7. This Act shall take effect upon its approval; provided that section 5 shall take effect on July 1, 2020.

INTRODUCED BY:	_____________________________

THE SENATE	S.B. NO.	2382
THIRTIETH LEGISLATURE, 2020
STATE OF HAWAII