SB 1347

Introduced by Senator Niello
 An act to amend Section 49414.7 of the Education Code, and to add Section 4119.21 to the Business and Professions Code, relating to pupil health.
pupil health
Pupil health: emergency stock albuterol inhalers.
Existing law authorizes a school district, county office of education, or charter school to provide emergency stock albuterol inhalers, as specified, to school nurses or trained personnel who have volunteered, and authorizes school nurses or trained personnel to use an emergency stock albuterol inhaler to provide emergency medical aid to persons suffering, or reasonably believed to be suffering, from respiratory distress, as provided. Existing law authorizes a prescription for emergency stock albuterol inhalers to be filled by local or mail order pharmacies or stock albuterol inhaler manufacturers.
This bill would revise and recast that latter provision by making its provisions also apply to a childcare program, as defined, that is
			 operated by or contracts with a school district, county office of education, or charter school, as provided. This bill would explicitly authorize a pharmacy to furnish stock albuterol inhalers to a local educational agency pursuant to a written order from an authorized prescriber. The bill would authorize a prescription for emergency stock albuterol inhalers also to be filled by stock albuterol wholesalers or distributers.
The bill, for purposes of these provisions, would change references from the Superintendent of Public Instruction to the Education Commissioner in order to implement changes made by AB 181 of the 2025–26 Regular Session.
The people of the State of California do enact as follows:
SECTION 1.
Section 4119.21 is added to the
Business and Professions Code
, to read:
4119.21.
Notwithstanding any other law, a pharmacy may furnish stock albuterol inhalers to a local educational agency pursuant to a written order from an authorized prescriber pursuant to subdivision (g) of Section 49414.7 of the Education Code.
SEC. 2.
Section 49414.7 of the
Education Code
 is amended to read:
49414.7.
(a) A local educational agency, including a local educational agency that operates or contracts with a childcare program, may provide emergency stock albuterol inhalers, including, if necessary, single-use disposable holding chambers, to school nurses or trained personnel who have volunteered pursuant to subdivision (d), and school nurses or trained personnel may use an emergency stock albuterol inhaler to provide emergency medical aid to persons suffering, or reasonably believed to be suffering, from respiratory distress.
(b) For purposes of this section, the following definitions apply:
(1) “Albuterol” means a
						bronchodilator used to open the airways by relaxing the muscles around the bronchial tubes.
(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) “Childcare program” means a state or federally subsidized childcare program operated by, or under contract with, a local educational agency, including, but not limited to, a California state preschool program or Head Start program pursuant to Chapter 2 (commencing with Section 8200) of Part 6 of Division 1 of Title 1, or a childcare program, including, but not limited to, general childcare and development programs pursuant to Part 1.8
						(commencing with Section 10207) of Division 9 of the Welfare and Institutions Code.
(4) “Inhaler” means a device used for the delivery of prescribed asthma medication that is inhaled.
(5) “Local educational agency” means a school district, county office of education, or charter school.
(6) “Metered-dose inhaler (MDI)” means a pressurized sprayer that delivers a measured amount of a medication.
(7) “Qualified supervisor of health” may include, but is not limited to, a school nurse.
(8) “Respiratory distress” means the sudden appearance of signs and symptoms of difficulty breathing.
						Signs and symptoms of respiratory distress may include one or more of the following:
(A) Complaints of a tight chest or chest pain.
(B) Wheezing or noisy breathing.
(C) Persistent coughing.
(D) Difficulty breathing.
(E) Appears to be in distress.
(F) Lips or fingernails turning blue.
(G) Shortness of breath.
(9) “Stock albuterol inhaler” means albuterol medication in the form of an MDI
						and single-use disposable holding chamber that is ordered by a health care provider and is not prescribed for a specific person.
(10) “Volunteer” or “trained personnel” means an employee of a local educational agency or childcare program operated by or contracted by the local educational agency who has volunteered to administer a stock albuterol inhaler to a person suffering, or reasonably believed to be suffering, from respiratory distress, has been designated by a school, has received training pursuant to subdivision (d), and is subject to the liability
						protection pursuant to subdivision (j).
(c) Each private school in the state may voluntarily determine whether or not to make emergency stock albuterol inhalers and trained personnel available at its school. In making this determination, a private school shall evaluate the emergency medical response time to the school and determine whether initiating emergency medical services is an acceptable alternative to stock albuterol inhalers and trained personnel. A private school choosing to exercise the authority provided under this subdivision shall not receive state funds specifically for purposes of this subdivision.
(d) (1) Each local educational agency, childcare program, and private school in the state may designate one or more volunteers to receive
						initial and annual refresher training, based on the standards developed pursuant to subdivision (e), regarding the storage and emergency use of a stock albuterol inhaler from the school nurse or other qualified person designated by an authorizing physician and surgeon.
(2) A local educational agency, childcare program, or private school is encouraged and recommended to have a minimum of two trained employees per school or childcare program site.
(e) (1) The Education Commissioner shall establish, and post on the department’s internet website, minimum standards of training for the
						administration of stock albuterol inhalers that satisfies the requirements of paragraph (2). Every five years, or sooner as deemed necessary by the Education Commissioner, the Education Commissioner shall review minimum standards of training for the administration of stock albuterol inhalers that satisfy the requirements of paragraph (2). For purposes of this subdivision, the
						Education Commissioner shall consult with organizations and providers with expertise in administering stock albuterol inhalers 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, the California Society of Allergy, Asthma and Immunology, the American College of Allergy, Asthma and Immunology, and others.
(2) Training established pursuant to this subdivision shall include all of the following:
(A) Techniques for recognizing symptoms of respiratory distress.
(B) Standards and procedures for the storage, restocking, and emergency use of stock albuterol inhalers.
(C) Emergency followup procedures, including calling the emergency 911 telephone number and contacting, if possible, the pupil’s parent or guardian and physician.
(D) Recommendations on the necessity of instruction and certification in cardiopulmonary resuscitation.
(E) Written materials covering the information required under this subdivision.
(3) Training established pursuant to this subdivision shall be consistent with the most recent guidelines for medication administration issued by the
						department.
(4) Training established pursuant to this subdivision shall be provided to a volunteer during the volunteer’s regular working hours and at no cost to the volunteer.
(5) Each school or childcare program site shall retain for reference the written materials prepared under subparagraph (E) of paragraph (2).
(f) A local educational agency electing to utilize stock albuterol
						inhalers for emergency aid shall distribute a notice at least once per school year to all staff and to all childcare programs it operates or contracts with that contains the following information:
(1) A description of the volunteer request stating that the request is for volunteers to be trained to administer a stock albuterol inhaler to a person if the person is suffering, or reasonably believed to be suffering, from respiratory distress, as specified in subdivision (b).
(2) A description of the training that the volunteer will receive pursuant to subdivision (d).
(g) (1) A qualified supervisor of health of a local educational agency electing to utilize stock albuterol inhalers for emergency aid
						shall obtain from an authorizing physician and surgeon a prescription for stock albuterol inhalers for each school and childcare program site. The prescription shall, at a minimum, include appropriate doses of available stock albuterol inhalers for the ages of individuals at each school and childcare program site. A qualified supervisor of health of a local educational agency shall be responsible for stocking the stock albuterol inhalers and restocking one if it is used.
(2) If a local educational agency does not have a qualified supervisor of health, an administrator at the local educational agency shall carry out the duties specified in paragraph (1).
(3) A prescription pursuant to this subdivision
						may be filled by local or mail-order pharmacies, stock albuterol inhaler manufacturers, or stock albuterol wholesalers or distributers.
(4) An authorizing physician and surgeon shall not be subject to professional review, be liable in a civil action, or be subject to criminal prosecution for the issuance of a prescription or order pursuant to this section, unless the physician and surgeon’s issuance of the prescription or order constitutes gross negligence or willful or
						malicious conduct.
(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 a stock albuterol inhaler to a person exhibiting potentially life-threatening symptoms of respiratory distress at school or a school activity when a physician is not immediately available. If the stock albuterol inhaler is used, it shall be restocked as soon as reasonably possible, but no later than two weeks after it is used. Stock albuterol inhalers shall be restocked before their expiration date.
(i) A volunteer shall initiate emergency medical services or other appropriate medical followup in accordance with the training materials retained pursuant to paragraph (5) of subdivision (e).
(j) (1) A local educational agency electing to utilize stock albuterol inhalers for emergency aid and any childcare program operated by or under contract with the local educational agency shall not be liable for any civil damages resulting from any act or omission, other than an act or omission constituting gross negligence or willful and wanton misconduct, in the emergency administration of an albuterol inhaler by any of its school nurses or trained volunteers who have volunteered pursuant to subdivision (d).
(2) An employee who volunteers under this section, including an employee of a childcare program, shall be provided defense and indemnification by the local educational agency for any and all civil liability, in accordance with, but not limited to, that provided in Division 3.6 (commencing with Section
						810) of Title 1 of the Government Code. This information shall be reduced to writing, provided to the volunteer, and retained in the volunteer’s personnel file.
(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 stock albuterol inhalers from a manufacturer or wholesaler.
SEC. 3.
The amendments made in Section 2 of this act to amend Section 49414.7 of the Education Code to replace references to the Superintendent of Public Instruction with the Education Commissioner in subdivision (e) of Section 49414.7 of the Education Code are intended to implement Section 24 of Chapter 66 of the Statutes of 2026. Those changes do not require the Education Commissioner to establish new minimum standards of training for the administration of stock albuterol inhalers that satisfies the requirements of paragraph (2) of subdivision (e) of Section 49414.7 of the Education Code.