Existing law requires the governing board of a school district, superintendent of schools, or the principal of a public or private school in the state to equip the school with a first aid kit whenever a pupil of the school is conducted or taken on a field trip, as specified. Existing law exempts from civil liability any person who, in good faith and not for compensation, renders emergency medical or nonmedical care or assistance at the scene of an emergency other than an act or omission constituting gross negligence or willful or wanton misconduct.

This bill, commencing with the 202425 school year and contingent upon an appropriation for its purposes, would require each school district, county office of education, and charter school to (1) equip each classroom at each of its schoolsites with a trauma kit, as defined, (2) inspect and replace or replenish each trauma kit, as necessary, upon each use and at least once every three years, and (3) notify, at least once each school year, its employees of the location of the trauma kits and provide them with contact information for training in the use of the trauma kit, as provided. By imposing additional duties on local educational agencies, the bill would impose a state-mandated local program. The bill would exempt from civil liability a person who renders emergency care or treatment by the use of a trauma kit at the scene of an emergency, as specified.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

Existing law requires the governing board of a school district, superintendent of schools, or the principal of a public or private school in the state to equip the school with a first aid kit whenever a pupil of the school is conducted or taken on a field trip, as specified.

This bill, commencing with the 202425 school year and contingent upon an appropriation for its purposes, would require each school district, county office of education, and charter school to (1) equip each classroom at each of its schoolsites with a trauma kit, as defined, (2) inspect and replace or replenish each trauma kit, as necessary, upon each use and at least once every three years, and to (3) notify, at least once each school year, its administrative employees, classified employees, pupil services employees, and teachers employees of the location of the trauma kits and provide them with contact information for training in the use of the trauma kit, as provided. By imposing additional duties on local educational agencies, the bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

Existing law requires the governing board of a school district, superintendent of schools, or the principal of a public or private school in the state to equip the school with a first aid kit whenever a pupil of the school is conducted or taken on a field trip, as specified.

This bill, commencing with the 202425 school year and contingent upon an appropriation for its purposes, would require each school district, county office of education, and charter school to equip each classroom at each of its schoolsites with a trauma kit, as defined. defined, and to notify, at least once each school year, its administrative employees, classified employees, pupil services employees, and teachers of the location of the trauma kits and provide them with contact information for training in the use of the trauma kit, as provided. By imposing additional duties on local educational agencies, the bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

Existing law requires the governing board of a school district, superintendent of schools, or the principal of a public or private school in the state to equip the school with a first aid kit whenever a pupil of the school is conducted or taken on a field trip, as specified.

This bill, commencing with the 202425 school year and contingent upon an appropriation for its purposes, would require each school district, county office of education, and charter school to equip each classroom at each of its schoolsites with a trauma kit, as defined. By imposing additional duties on local educational agencies, the bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

Date of Hearing: August 16, 2023

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Chris Holden, Chair

SBPCA Bill Id:SB 868

Author:(Wilk) – As Amended Ver:July 12, 2023

Urgency: No State Mandated Local Program: Yes Reimbursable: Yes

SUMMARY:

This bill requires, contingent on appropriation, each local educational agency (LEA), beginning with the 2024-25 school year, to equip each classroom at each school site with a trauma kit.

In addition, the bill requires each LEA to inspect and replace or replenish each trauma kit, as necessary, upon each use and at least once every three years. The bill also requires each LEA to notify, at least once each school year, its employees of the location of the trauma kits and provide their employees with contact information for training in the use of the trauma kit. The bill further exempts from civil liability a person who renders emergency care or treatment by the use of a trauma kit at the scene of an emergency

FISCAL EFFECT:

One-time Proposition 98 General Fund costs, likely in the millions of dollars to tens of millions of dollars, to LEAs to purchase the trauma kits. Additionally, ongoing Proposition 98 General Fund costs, likely in the millions of dollars to tens of millions of dollars every three years, to LEAs to regularly inspect and replace the trauma kits and to notify employees of the location of the trauma kits and provide them with training information.

The cost of a trauma kit can range from $25 to over $150, depending on its contents. The state has more than 10,000 school sites which vary greatly in size. Assuming a school site has, on average, 10 to 20 classrooms that would require a trauma kit under this bill, costs to purchase trauma kits could range from $2.5 million to $30 million. In addition, one-time costs could be somewhat higher if an LEA were to purchase a wall mount for the kit. To the extent schools already have purchased some trauma kits as a result of AB 2260 (Rodriguez) described in Comment 3, costs could be less.

If the Commission on State Mandates determines the bill’s requirements to be a reimbursable state mandate, the state would need to reimburse these costs to LEAs or provide funding through the K-12 Mandate Block Grant.

COMMENTS:

1. Purpose. According to the American College of Emergency Physicians, a supporter of this bill:

One-third of people who die from trauma do so from bleeding. Trauma kits are intended to provide potential first responders with the tools that they need for bleeding control. Training programs like Stop the Bleed have been used since 2015 to train non-medical providers and reduce the number of deaths due to uncontrolled bleeding and have been associated with increased confidence in trauma response.

Including trauma kits in classrooms and providing school employees with opportunities for trauma kit training increases the likelihood that they will be able to appropriately respond in the event of an emergency. Expanding access to trauma tools and training will enable school employees to save lives.

1. Background. School shootings have increased dramatically in recent years. This bill requires LEAs to supply trauma kits to classrooms with the intent that the kits will be used to help treat victims of a school shooting immediately at the scene of an emergency. The bill defines a “trauma kit” as a first aid response kit that contains at least one or more tourniquets in sizes that are suitable for younger or smaller pupils; gauze, including a clotting agent or similar properties to control bleeding; and a protective capsule to hold the trauma kit’s contents.
2. Prior Legislation. AB 2260 (Rodriguez), Chapter 586, Statutes of 2022, requires certain newly constructed buildings, including K-12 educational facilities and daycare facilities, to maintain trauma kits on the building’s premises.
3. Related Legislation. AB 70 (Rodriguez) expands AB 2260 (Rodriguez) to include more buildings. The bill is pending on the Senate floor.

AB 71 (Rodriguez) requires the Instructional Quality Commission, when the Health Framework is next revised after January 1, 2024, to consider including bleeding control, and requires the California Department of Education to post on its website information regarding bleeding control on or before July 1, 2024. The bill is pending on the Senate Appropriations Committee suspense file.

Analysis Prepared by: Natasha Collins / APPR. / (916) 319-2081

Date of Hearing: July 11, 2023

ASSEMBLY COMMITTEE ON JUDICIARY

Brian Maienschein, Chair

SBPCA Bill Id:SB 868

Author:(Wilk) – As Amended Ver:June 14, 2023

PROPOSED CONSENT (As Proposed to be Amended)

SENATE VOTE: 40-0

SUBJECT: PUPIL SAFETY: TRAUMA KITS

KEY ISSUES:

1. IF EACH CLASSROOM AT EACH SCHOOLSITE IN THE STATE WERE EQUIPPED WITH A TRAUMA KIT, SHOULD ANY LAY RESCUER USING SUCH A KIT HAVE QUALIFIED IMMUNITY FROM LIABILITY FOR ANY INJURY RESULTING FROM USE OF THE KIT IN AN EMERGENCY?
2. SHOULD THE LAW BE CLARIFIED SO THAT A LAY RESCUER WHO HAPPENS TO BE PAID WHEN PROVIDING EMERGENCY CARE VIA A SCHOOL-SUPPLIED TRAUMA KIT NOT BE CONSIDERED TO BE PROVIDING EMERGENCY CARE “FOR COMPENSATION”?

SYNOPSIS

This bill, sponsored by the American College of Surgeons Joint Advocacy Committee, is one of several in recent years that have sought to make emergency supplies and equipment, including AEDs, epinephrine, and “trauma kits,” more widely available in the community in case of an emergency. It follows AB 2260 (Rodriguez), Chap. 586. Stats. 2022, which requires trauma kits to be installed in public buildings of certain sizes. This bill seeks to make trauma kits available in schools, provide qualified immunity to any lay rescuer who acts as a Good Samaritan by using such a trauma kit to provide care in an emergency; and clarify that a lay rescuer who happens to be paid at the time they provide emergency care via a school-supplied trauma kit is not providing emergency care “for compensation.”

Under existing common law tort rules, a person who voluntarily comes to the aid of another person suffering a medical emergency is immune from liability for injuries and even death, so long as that person acts in a reasonably prudent manner under the circumstances. In addition, in 2009, California adopted a so-called "Good Samaritan" statute, which grants qualified immunity to any person who renders medical or non-medical aid in an emergency, so long as that person acts in good faith and not for compensation, and so long as that person's conduct is not grossly negligent or does not constitute willful or wanton misconduct. In recent years, this Committee has heard, and the Legislature has enacted, bills providing express immunity from liability for lay people (as well as off-duty professionals) who voluntarily render medical aid in specific emergency situations. These provisions may be unnecessary given that any of these methods of administering medical or non-medical care by a lay rescuer at the scene of an emergency would most certainly qualify as rendering medical aid in an emergency by a Good Samaritan, regardless of the mechanism by which care is administered.

The bill in print, however, provides virtually unlimited immunity to school employees, providing that, “Any employee of a local educational agency who in good faith, and not for compensation, renders emergency care or treatment by the use of a trauma kit at the scene of an emergency shall not be liable for civil damages resulting from any act or omission.” This language is inconsistent with virtually all other immunity statutes – such as Section 1799.102—as well as with common law. As a result, school employees would be immune from liability for all injuries caused by their use of a trauma kit, even if, for example, they intentionally misused a tourniquet and caused the amputation of a limb. In order to address the overbreadth of the immunity provided under the bill, the author proposes amendments to limit immunity in a manner consistent with existing law. The author’s amendments also clarify that a lay rescuer who happens to be paid at the time they provide emergency care is not providing care “for compensation.” The amendments are incorporated in the SUMMARY, below, and explained in the analysis. The bill is supported by a large number of health and public safety advocacy organizations. It has no opposition on file.

SUMMARY: Requires each local educational agency (LEA) to equip each classroom at each schoolsite with a trauma kit; provides qualified immunity to any lay rescuer who acts as a Good Samaritan by using such a trauma kit to provide care in an emergency; and clarifies that a lay rescuer who happens to be paid at the time they provide emergency care via a school-supplied trauma kit is not providing emergency care “for compensation.” Specifically, this bill:

1. Requires LEAs to equip each classroom at each of its schoolsites with a trauma kit by the beginning of the 2024-25 school year, and to inspect and replace or replenish each trauma kit, as necessary to maintain the required contents, upon each use and at least once every three years.
2. Requires LEAs at least once each school year, to notify all employees of the location of the trauma kits and provide them with contact information for at least one potential source of training in the use of the trauma kit, including, but not limited to the following:
3. The Stop the Bleed national awareness campaign of the United States Department of Homeland Security;
4. The American College of Surgeons Committee on Trauma;
5. The American Red Cross;
6. The Committee for Tactical Emergency Casualty Care;
7. Any other partner of the United States Department of Defense;
8. A level 1 trauma center or other hospital that provides community-based education regarding trauma care or similar first aid care; or
9. Other reputable providers of first aid or trauma care training.
10. Specifies that subdivision (b) of Section 1799.102 of the Health and Safety Code, the “Good Samaritan Law,” applies to any lay rescuer or person who, in good faith and not for compensation, renders emergency care or treatment by the use of a trauma kit at the scene of an emergency.
11. Clarifies that a person who renders emergency care or treatment by the use of a trauma kit at the scene of an emergency and who receives compensation as a result of their employment by a local educational agency, or any other private or public employer, but is not compensated to provide emergency medical care, is not providing emergency medical care “for compensation.”
12. Defines “local educational agency” as a school district, county office of education (COE), or charter school.
13. Defines “trauma kit” as a first aid response kit that contains at least all of the following:
14. One tourniquet endorsed by the Committee on Tactical Combat Casualty Care.
15. One bleeding control bandage;
16. One pair of nonlatex protective gloves and a marker;
17. One pair of scissors;
18. Instructional documents developed by the Stop the Bleed national awareness campaign of the United States Department of Homeland Security or the American College of Surgeons Committee on Trauma, the American Red Cross, the Committee for Tactical Emergency Casualty Care, or any other partner of the United States Department of Defense; and
19. Medical materials and equipment approved by the medical director of the local emergency medical services agency may be included as supplements in addition to the items described if they adequately treat a traumatic injury and can be stored in a readily available kit.
20. Specifies that the trauma kit may also include: one or more additional tourniquets in sizes that are suitable for younger students; gauze, including a clotting agent or similar properties to control bleeding; and a protective capsule to hold the contents of the trauma kit.
21. Prohibits anything in this section from being construed to create a private right of action against an LEA.
22. Specifies that the implementation of these provisions is contingent upon an appropriation for these purposes in the annual Budget Act or another statute.

EXISTING LAW:

1. Provides that no local agency, entity of state or local government, private business or nonprofit organization included on the statewide registry that voluntarily and without expectation and receipt of compensation donates services, goods, labor, equipment, resources, or other public or private organization which sponsors, authorizes, supports, finances, or supervises the training of people, or certifies those people, excluding physicians and surgeons, registered nurses, and licensed vocational nurses in emergency medical services, shall be liable for any civil damages alleged to result from those training programs. (Health and Safety Code Section 1799.100. All further statutory references are to this code, unless otherwise indicated.)
2. Provides that a “Good Samaritan” who in good faith, and not for compensation, renders medical or nonmedical care at the scene of an emergency 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 or wanton misconduct. (Section 1799.102.)
3. Requires certain buildings and structures that are occupied to have an Automated External Defibrillator (AED) installed on their premises. (Section 19300.)
4. Provides that a person or entity that acquires an AED for emergency use is not liable for any civil damages resulting from any acts or omissions when the AED is used to render emergency care, provided that the person or entity has complied with all of the following specified maintenance, training, and notice requirements:
   1. Comply with all regulations governing the placement of an AED.
   2. Notify an agent of the local EMS agency of the existence, location, and type of AED acquired.
   3. Ensure that the AED is maintained and tested according to the operation and maintenance guidelines set forth by the manufacturer.
   4. Ensure that the AED is tested at least biannually and after each use.
   5. Ensure that an inspection is made of all AEDs on the premises at least every 90 days for potential issues related to operability of the device, including a blinking light or other obvious defect that may suggest tampering or that another problem has arisen with the functionality of the AED.
   6. Ensure that records of the maintenance and testing required pursuant to this paragraph are maintained. (Section 1797.196 (b)(1).)
5. Requires, when an AED is placed in a building, the building owner to do all of the following:
   1. At least once a year, notify the tenants as to the location of the AED units and provide information to tenants about who they can contact if they want to voluntarily take AED or CPR training.
   2. At least once a year, offer a demonstration to at least one person associated with the building so that the person can be walked through how to use an AED properly in an emergency. The building owner may arrange for the demonstration or partner with a nonprofit organization to do so.
   3. Next to the AED, post instructions, in no less than 14-point type, on how to use the AED. (Section 1797.196 (b)(2).)
6. Applies the immunities of the “Good Samaritan” law codified in Section 1799.102 to persons who, in good faith and not for compensation, render emergency care or treatment by the use of a trauma kit at the scene of an emergency. (Civil Code Section 1714.29 (c).)
7. Provides that a person who renders emergency care or treatment by the use of a trauma kit at the scene of an emergency and who receives compensation as a result of their employment by a property managing entity, a tenant of a building, or any other private or public employer, but is not compensated to provide emergency medical care, is not providing emergency medical care “for compensation” for purposes of Section 1799.102 of the Health and Safety Code. (Civil Code Section 1714.29 (d).)
8. Applies the immunities of Section 1799.100 to a person or entity that voluntarily, and without expectation or receipt of compensation, does the following:
   1. Provides training in the use of trauma kits, as specified; or
   2. Certifies persons, as specified, who are trained in the use of a trauma kit to provide emergency medical treatment to victims of trauma. (Civil Code Section 1714.29 (e).)

FISCAL EFFECT: As currently in print this bill is keyed fiscal.

COMMENTS: This bill, sponsored by the American College of Surgeons Joint Advocacy Committee, is one of several in recent years that have sought to make emergency supplies and equipment, including AEDs, epinephrine, and “trauma kits,” more widely available in the community in case of an emergency. It follows AB 2260 (Rodriguez), Chap. 586. Stats. 2022, which requires trauma kits to be installed in public buildings of certain sizes. This bill seeks to make trauma kits (that include one tourniquet, among other first aid supplies) available in schools, provide qualified immunity to any lay rescuer who acts as a Good Samaritan by using such trauma kit to provide care in an emergency; and clarify that a lay rescuer who happens to be paid at the time they provide emergency care via a school-supplied trauma kit is not providing emergency care “for compensation.” According to the author:

The unfortunate reality is that schools and classrooms are ill-prepared for threats against our kids. School shootings are a terrible and devastating reality in 2023, and schools do not have the resources necessary to save children if a dangerous or life threatening emergency occurs. We must adapt our schools to be prepared for these threats against our children. While many legislative ideas work to prevent these tragedies, we must be prepared for when they do eventually occur. A lack of access to proper tools should not be the barrier faced when a life-threatening injury occurs. In order to improve student safety, this bill would place life-saving trauma kits where they are most likely to be needed in a school emergency: in the classroom.

The Assembly Committee on Education, which recently heard and passed this bill on consent, thoroughly analyzed the bill’s impact on local educational agencies. Relevant to the jurisdiction of this Committee, the bill provides qualified immunity to any lay rescuer who acts as a Good Samaritan by using such a trauma kit to provide care in an emergency; and clarifies that a lay rescuer who happens to be paid at the time they provide emergency care via a school-supplied trauma kit is not providing emergency care “for compensation.” Therefore, those issues are the focus of this analysis.

Tourniquet use by non-medical professionals. Tourniquet use, especially by untrained Good Samaritans, has been somewhat controversial over the years because of the fear that a restriction in blood supply to tissues, causing a shortage of oxygen that is needed to keep the tissue alive, could lead to amputation. (Clinical Queries: “What’s the Stop the Bleed Campaign?,” Nursing 2017, Volume 47, Number 12 (December 2017), p. 15.) If a tourniquet is left on too long or applied incorrectly, it can result in the loss of a limb. However, if the alternative is death, even the loss of a limb is a preferred outcome. For example, “in the case of massive bleeding caused by firearm or shrapnel wounds, the window of opportunity to save a life may be as little as 5 minutes.” (Ibid.) Thus, in 2015, the American Heart Association Guidelines for first aid were updated to provide that, “because the rate of complications is low and the rate of hemostasis [bleeding to death] is high, first aid providers may consider the use of a tourniquet when standard first aid hemorrhage control does not control severe external limb bleeding.” (Ibid.)

However, the 2020 American Heart Association Guidelines for first aid include the following warning about tourniquet use:

A manufactured tourniquet should be used as first-line therapy for life-threatening extremity bleeding and should be placed as soon as possible after the injury. Specifically designed tourniquets appear to be better than ones that are improvised, but tourniquets should only be used with proper training. (Jeffrey L. Pellegrino, et al. 2020 American Heart Association and American Red Cross Focused Update for First Aid (21 Oct 2020), available at https://www.ahajournals.org/doi/10.1161/CIR.0000000000000900.)

Liability and immunity in general. As a general rule, California law provides that persons are responsible not only for the result of their willful acts, but also for an injury occasioned to another by their want of ordinary care or skill in the management of their property or person, except so far as the latter has, willfully or by want of ordinary care, brought the injury upon themselves. (Civil Code Section 1714 (a).) Liability has the primary effect of ensuring that some measure of recourse exists for those persons injured by the negligent or willful acts of others; the risk of that liability has the primary effect of ensuring parties act reasonably to avoid harm to those to whom they owe a duty.

Conversely, immunity from liability disincentivizes careful planning and actions on the part of individuals and entities. Those who have immunity from civil liability are relieved of the responsibility to act with due regard and an appropriate level of care in the conduct of their activities. Immunity provisions are also disfavored because they, by their nature, preclude parties from recovering when they are injured, and force injured parties to absorb losses for which they are not responsible. Liability acts to not only allow a victim to be made whole, but also to encourage appropriate care and compliance with legal requirements.

The "Good Samaritan" Law. Under existing common law tort rules, a person who voluntarily comes to the aid of another person suffering a medical emergency is immune from liability for injuries and even death, so long as that person acts in a reasonably prudent manner under the circumstances. In addition, in 2009, California adopted a so-called "Good Samaritan" statute. (The term refers to the parable in the Gospel of Luke about the "lowly" Samaritan who came to the aid of a stranger left for dead while supposedly more upstanding citizens ignored the cries of the dying man.) California's Good Samaritan statute (Section 1799.102) grants qualified immunity to any person who renders medical or non-medical aid in an emergency, so long as that person acts in good faith and not for compensation, and so long as that person's conduct is not grossly negligent or does not constitute willful or wanton misconduct.

In recent years, this Committee has heard, and the Legislature has enacted, bills providing express immunity from liability for lay people (as well as off-duty professionals) who voluntarily render medical aid in specific emergency situations. Immunities generally are provided to ensure the willingness of individuals to continue taking on certain roles that may involve some risk and to incentivize certain conduct, such as the provision of life-saving or other critical services. Examples include protections for use of CPR (Civil Code Section 1714.2); use of an automated external defibrillator (Civil Code Section 1714.21); use of opiate overdose treatment (Civil Code Section 1714.22); providing emergency care at the scene of an emergency (Sections 1799.102, 1799.106); and performing emergency rescue services (Section 1799.107). However, as indicated above, rarely is immunity absolute. These immunity provisions generally do not apply to grossly negligent conduct or intentional misconduct.

Express immunity provisions may be unnecessary given that any of these methods of administering medical or non-medical care by a lay rescuer at the scene of an emergency would most certainly qualify as rendering medical aid in an emergency by a Good Samaritan, regardless of the mechanism by which the care is administered. For example, if a person who was trained to render emergency trauma care with the contents of a trauma kit, or even an untrained lay person, voluntarily rendered aid to a victim by providing care or assistance with materials or equipment found in a trauma kit (or even with other materials, such as a t-shirt, scarf, or tie used as a tourniquet) that person would be protected from liability under the Good Samaritan statute. While providing express immunity for specific medical emergencies may be unnecessary in light of the Good Samaritan laws, one could argue that such provisions such as those in this bill are harmless and potentially useful clarifications of existing law (at least as the measure is proposed to be amended).

Author’s amendments. Despite the fact that express immunity is not required for a Good Samaritan to be shielded from liability, the bill in print provides virtually unlimited immunity to school employees who use trauma kits to provide care in an emergency:

Any employee of a local educational agency who in good faith, and not for compensation, renders emergency care or treatment by the use of a trauma kit at the scene of an emergency shall not be liable for civil damages resulting from any act or omission.

This language is inconsistent with all of the immunity statutes discussed above, including Section 1799.102, and common law. As a result, school employees would be immune from liability for all injuries caused by their use of a trauma kit, even if, for example, they intentionally misused a tourniquet and caused the amputation of a limb. In order to address the overbreadth of the immunity provided by the bill in print, the author proposes the following amendments:

(b) (1) Any employee of a local educational agency who in good faith, and not for compensation, renders emergency care or treatment by the use of a trauma kit at the scene of an emergency shall not be liable for civil damages resulting from any act or omission. Subdivision (b) of Section 1799.102 of the Health and Safety Code, the “Good Samaritan Law,” applies to any lay rescuer or person who, in good faith and not for compensation, renders emergency care or treatment by the use of a trauma kit at the scene of an emergency.

By cross-referencing Section 1799.102 of the Health and Safety Code, this language exempts from immunity “an act or omission constituting gross negligence or willful or wanton misconduct.” (Section 1799.102.) While the language is limiting in that it exempts grossly negligent and wanton acts, it is also expansive in that it applies to “any lay rescuer or person” rather than just an employee of a local educational agency. In order to clarify that a lay rescuer who happens to be paid at the time they provide emergency care is not providing care “for compensation,” the proposed amendment also states the following:

(2) A person who renders emergency care or treatment by the use of a trauma kit at the scene of an emergency and who receives compensation as a result of their employment by a local educational agency, or any other private or public employer, but is not compensated to provide emergency medical care, is not providing emergency medical care “for compensation” for purposes of Section 1799.102 of the Health and Safety Code.

ARGUMENTS IN SUPPORT: The American College of Surgeons Joint Advocacy Committee, sponsor of the bill, writes the following to explain their “strongest support” for the bill:

As with any injury or medical emergency, immediate treatment provides critical time to stabilize the patient while emergency services are on their way. In the event of a traumatic bleeding injury, time is even more crucial as it can take a just a few minutes for bleeding to cause death.

As shown in national and California studies and in recent real events, providing trained persons, including high school students and prompt access to trauma kits will greatly increase the chance of survival for the injured bleeding person.

. . .A traumatic bleeding injury can happen at any moment and in any location. Stop the Bleed has been used in California in cases of motor vehicle collisions, industrial injuries, accidents at home, rural and agricultural injuries and for victims of assaults, including mass shootings and school shootings. California is especially susceptible to natural disasters, such as earthquakes, that can result in the need to treat numerous people with severe injuries. STOP THE BLEED saves lives by extending the survival of trauma patients with heavy bleeding until they can reach a trauma center, and this bill will help ensure California students, teachers and staff will have access to approved trauma kits in every classroom. Making STOP THE BLEED high school training kits and educational offerings available in school classrooms will significantly increase the number of lay providers who will help to provide precious time for severely injured patients and will save more lives.

REGISTERED SUPPORT / OPPOSITION:

Support

American College of Surgeons Joint Advocacy Committee (sponsor)

American College of Surgeons Northern California

American College of Surgeons, Southern California Chapter

Arcadia Police Officers' Association

Association of California School Administrators

Burbank Police Officers' Association

California Association of School Business Officials (CASBO)

California Chapters, The American College of Emergency Physicians

California Coalition of School Safety Professionals

Claremont Police Officers Association

Corona Police Officers Association

Culver City Police Officers' Association

Deputy Sheriffs' Association of Monterey County

Emergency Nurses Association, California State Council

Fullerton Police Officers' Association

Los Angeles School Police Officers Association

Murrieta Police Officers' Association

Newport Beach Police Association

Palos Verdes Police Officers Association

Placer County Deputy Sheriffs' Association

Pomona Police Officers' Association

Riverside Police Officers Association

Riverside Sheriffs' Association

San Bernardino County Sheriff's Department

San Diego - Imperial Chapter, American College of Surgeons

Santa Ana Police Officers Association

Upland Police Officers Association

Opposition

None on file

Analysis Prepared by: Alison Merrilees / JUD. / (916) 319-2334

Date of Hearing: July 11, 2023

ASSEMBLY COMMITTEE ON JUDICIARY

Brian Maienschein, Chair

SBPCA Bill Id:SB 868

Author:(Wilk) – As Amended Ver:June 14, 2023

PROPOSED CONSENT (As Proposed to be Amended)

SENATE VOTE: 40-0

SUBJECT: PUPIL SAFETY: TRAUMA KITS

KEY ISSUES:

1. IF EACH CLASSROOM AT EACH SCHOOLSITE IN THE STATE WERE EQUIPPED WITH A TRAUMA KIT, SHOULD ANY LAY RESCUER USING SUCH A KIT HAVE QUALIFIED IMMUNITY FROM LIABILITY FOR ANY INJURY RESULTING FROM USE OF THE KIT IN AN EMERGENCY?
2. SHOULD THE LAW BE CLARIFIED SO THAT A LAY RESCUER WHO HAPPENS TO BE PAID WHEN PROVIDING EMERGENCY CARE VIA A SCHOOL-SUPPLIED TRAUMA KIT NOT BE CONSIDERED TO BE PROVIDING EMERGENCY CARE “FOR COMPENSATION”?

SYNOPSIS

This author-sponsored bill is one of several in recent years that have sought to make emergency supplies and equipment, including AEDs, epinephrine, and “trauma kits,” more widely available in the community in case of an emergency. It follows AB 2260 (Rodriguez), Chap. 586. Stats. 2022, which requires trauma kits to be installed in public buildings of certain sizes. This bill seeks to make trauma kits available in schools, provide qualified immunity to any lay rescuer who acts as a Good Samaritan by using such a trauma kit to provide care in an emergency; and clarify that a lay rescuer who happens to be paid at the time they provide emergency care via a school-supplied trauma kit is not providing emergency care “for compensation.”

Under existing common law tort rules, a person who voluntarily comes to the aid of another person suffering a medical emergency is immune from liability for injuries and even death, so long as that person acts in a reasonably prudent manner under the circumstances. In addition, in 2009, California adopted a so-called "Good Samaritan" statute, which grants qualified immunity to any person who renders medical or non-medical aid in an emergency, so long as that person acts in good faith and not for compensation, and so long as that person's conduct is not grossly negligent or does not constitute willful or wanton misconduct. In recent years, this Committee has heard, and the Legislature has enacted, bills providing express immunity from liability for lay people (as well as off-duty professionals) who voluntarily render medical aid in specific emergency situations. These provisions may be unnecessary given that any of these methods of administering medical or non-medical care by a lay rescuer at the scene of an emergency would most certainly qualify as rendering medical aid in an emergency by a Good Samaritan, regardless of the mechanism by which care is administered.

The bill in print, however, provides virtually unlimited immunity to school employees, providing that, “Any employee of a local educational agency who in good faith, and not for compensation, renders emergency care or treatment by the use of a trauma kit at the scene of an emergency shall not be liable for civil damages resulting from any act or omission.” This language is inconsistent with virtually all other immunity statutes – such as Section 1799.102—as well as with common law. As a result, school employees would be immune from liability for all injuries caused by their use of a trauma kit, even if, for example, they intentionally misused a tourniquet and caused the amputation of a limb. In order to address the overbreadth of the immunity provided under the bill, the author proposes amendments to limit immunity in a manner consistent with existing law. The author’s amendments also clarify that a lay rescuer who happens to be paid at the time they provide emergency care is not providing care “for compensation.” The amendments are incorporated in the SUMMARY, below, and explained in the analysis. The bill is supported by a large number of health and public safety advocacy organizations. It has no opposition on file.

SUMMARY: Requires each local educational agency (LEA) to equip each classroom at each schoolsite with a trauma kit; provides qualified immunity to any lay rescuer who acts as a Good Samaritan by using such a trauma kit to provide care in an emergency; and clarifies that a lay rescuer who happens to be paid at the time they provide emergency care via a school-supplied trauma kit is not providing emergency care “for compensation.” Specifically, this bill:

1. Requires LEAs to equip each classroom at each of its schoolsites with a trauma kit by the beginning of the 2024-25 school year, and to inspect and replace or replenish each trauma kit, as necessary to maintain the required contents, upon each use and at least once every three years.
2. Requires LEAs at least once each school year, to notify all employees of the location of the trauma kits and provide them with contact information for at least one potential source of training in the use of the trauma kit, including, but not limited to the following:
3. The Stop the Bleed national awareness campaign of the United States Department of Homeland Security;
4. The American College of Surgeons Committee on Trauma;
5. The American Red Cross;
6. The Committee for Tactical Emergency Casualty Care;
7. Any other partner of the United States Department of Defense;
8. A level 1 trauma center or other hospital that provides community-based education regarding trauma care or similar first aid care; or
9. Other reputable providers of first aid or trauma care training.
10. Specifies that subdivision (b) of Section 1799.102 of the Health and Safety Code, the “Good Samaritan Law,” applies to any lay rescuer or person who, in good faith and not for compensation, renders emergency care or treatment by the use of a trauma kit at the scene of an emergency.
11. Clarifies that a person who renders emergency care or treatment by the use of a trauma kit at the scene of an emergency and who receives compensation as a result of their employment by a local educational agency, or any other private or public employer, but is not compensated to provide emergency medical care, is not providing emergency medical care “for compensation.”
12. Defines “local educational agency” as a school district, county office of education (COE), or charter school.
13. Defines “trauma kit” as a first aid response kit that contains at least all of the following:
14. One tourniquet endorsed by the Committee on Tactical Combat Casualty Care.
15. One bleeding control bandage;
16. One pair of nonlatex protective gloves and a marker;
17. One pair of scissors;
18. Instructional documents developed by the Stop the Bleed national awareness campaign of the United States Department of Homeland Security or the American College of Surgeons Committee on Trauma, the American Red Cross, the Committee for Tactical Emergency Casualty Care, or any other partner of the United States Department of Defense; and
19. Medical materials and equipment approved by the medical director of the local emergency medical services agency may be included as supplements in addition to the items described if they adequately treat a traumatic injury and can be stored in a readily available kit.
20. Specifies that the trauma kit may also include: one or more additional tourniquets in sizes that are suitable for younger students; gauze, including a clotting agent or similar properties to control bleeding; and a protective capsule to hold the contents of the trauma kit.
21. Prohibits anything in this section from being construed to create a private right of action against an LEA.
22. Specifies that the implementation of these provisions is contingent upon an appropriation for these purposes in the annual Budget Act or another statute.

EXISTING LAW:

1. Provides that no local agency, entity of state or local government, private business or nonprofit organization included on the statewide registry that voluntarily and without expectation and receipt of compensation donates services, goods, labor, equipment, resources, or other public or private organization which sponsors, authorizes, supports, finances, or supervises the training of people, or certifies those people, excluding physicians and surgeons, registered nurses, and licensed vocational nurses in emergency medical services, shall be liable for any civil damages alleged to result from those training programs. (Health and Safety Code Section 1799.100. All further statutory references are to this code, unless otherwise indicated.)
2. Provides that a “Good Samaritan” who in good faith, and not for compensation, renders medical or nonmedical care at the scene of an emergency 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 or wanton misconduct. (Section 1799.102.)
3. Requires certain buildings and structures that are occupied to have an Automated External Defibrillator (AED) installed on their premises. (Section 19300.)
4. Provides that a person or entity that acquires an AED for emergency use is not liable for any civil damages resulting from any acts or omissions when the AED is used to render emergency care, provided that the person or entity has complied with all of the following specified maintenance, training, and notice requirements:
   1. Comply with all regulations governing the placement of an AED.
   2. Notify an agent of the local EMS agency of the existence, location, and type of AED acquired.
   3. Ensure that the AED is maintained and tested according to the operation and maintenance guidelines set forth by the manufacturer.
   4. Ensure that the AED is tested at least biannually and after each use.
   5. Ensure that an inspection is made of all AEDs on the premises at least every 90 days for potential issues related to operability of the device, including a blinking light or other obvious defect that may suggest tampering or that another problem has arisen with the functionality of the AED.
   6. Ensure that records of the maintenance and testing required pursuant to this paragraph are maintained. (Section 1797.196 (b)(1).)
5. Requires, when an AED is placed in a building, the building owner to do all of the following:
   1. At least once a year, notify the tenants as to the location of the AED units and provide information to tenants about who they can contact if they want to voluntarily take AED or CPR training.
   2. At least once a year, offer a demonstration to at least one person associated with the building so that the person can be walked through how to use an AED properly in an emergency. The building owner may arrange for the demonstration or partner with a nonprofit organization to do so.
   3. Next to the AED, post instructions, in no less than 14-point type, on how to use the AED. (Section 1797.196 (b)(2).)
6. Applies the immunities of the “Good Samaritan” law codified in Section 1799.102 to persons who, in good faith and not for compensation, render emergency care or treatment by the use of a trauma kit at the scene of an emergency. (Civil Code Section 1714.29 (c).)
7. Provides that a person who renders emergency care or treatment by the use of a trauma kit at the scene of an emergency and who receives compensation as a result of their employment by a property managing entity, a tenant of a building, or any other private or public employer, but is not compensated to provide emergency medical care, is not providing emergency medical care “for compensation” for purposes of Section 1799.102 of the Health and Safety Code. (Civil Code Section 1714.29 (d).)
8. Applies the immunities of Section 1799.100 to a person or entity that voluntarily, and without expectation or receipt of compensation, does the following:
   1. Provides training in the use of trauma kits, as specified; or
   2. Certifies persons, as specified, who are trained in the use of a trauma kit to provide emergency medical treatment to victims of trauma. (Civil Code Section 1714.29 (e).)

FISCAL EFFECT: As currently in print this bill is keyed fiscal.

COMMENTS: This bill, sponsored by the three California Chapters of the American College of Surgeons, is one of several in recent years that have sought to make emergency supplies and equipment, including AEDs, epinephrine, and “trauma kits,” more widely available in the community in case of an emergency. It follows AB 2260 (Rodriguez), Chap. 586. Stats. 2022, which requires trauma kits to be installed in public buildings of certain sizes. This bill seeks to make trauma kits (that include one tourniquet, among other first aid supplies) available in schools, provide qualified immunity to any lay rescuer who acts as a Good Samaritan by using such trauma kit to provide care in an emergency; and clarify that a lay rescuer who happens to be paid at the time they provide emergency care via a school-supplied trauma kit is not providing emergency care “for compensation.” According to the author:

The unfortunate reality is that schools and classrooms are ill-prepared for threats against our kids. School shootings are a terrible and devastating reality in 2023, and schools do not have the resources necessary to save children if a dangerous or life threatening emergency occurs. We must adapt our schools to be prepared for these threats against our children. While many legislative ideas work to prevent these tragedies, we must be prepared for when they do eventually occur. A lack of access to proper tools should not be the barrier faced when a life-threatening injury occurs. In order to improve student safety, this bill would place life-saving trauma kits where they are most likely to be needed in a school emergency: in the classroom.

The Assembly Committee on Education, which recently heard and passed this bill on consent, thoroughly analyzed the bill’s impact on local educational agencies. Relevant to the jurisdiction of this Committee, the bill provides qualified immunity to any lay rescuer who acts as a Good Samaritan by using such a trauma kit to provide care in an emergency; and clarifies that a lay rescuer who happens to be paid at the time they provide emergency care via a school-supplied trauma kit is not providing emergency care “for compensation.” Therefore, those issues are the focus of this analysis.

Tourniquet use by non-medical professionals. Tourniquet use, especially by untrained Good Samaritans, has been somewhat controversial over the years because of the fear that a restriction in blood supply to tissues, causing a shortage of oxygen that is needed to keep the tissue alive, could lead to amputation. (Clinical Queries: “What’s the Stop the Bleed Campaign?,” Nursing 2017, Volume 47, Number 12 (December 2017), p. 15.) If a tourniquet is left on too long or applied incorrectly, it can result in the loss of a limb. However, if the alternative is death, even the loss of a limb is a preferred outcome. For example, “in the case of massive bleeding caused by firearm or shrapnel wounds, the window of opportunity to save a life may be as little as 5 minutes.” (Ibid.) Thus, in 2015, the American Heart Association Guidelines for first aid were updated to provide that, “because the rate of complications is low and the rate of hemostasis [bleeding to death] is high, first aid providers may consider the use of a tourniquet when standard first aid hemorrhage control does not control severe external limb bleeding.” (Ibid.)

However, the 2020 American Heart Association Guidelines for first aid include the following warning about tourniquet use:

A manufactured tourniquet should be used as first-line therapy for life-threatening extremity bleeding and should be placed as soon as possible after the injury. Specifically designed tourniquets appear to be better than ones that are improvised, but tourniquets should only be used with proper training. (Jeffrey L. Pellegrino, et al. 2020 American Heart Association and American Red Cross Focused Update for First Aid (21 Oct 2020), available at https://www.ahajournals.org/doi/10.1161/CIR.0000000000000900.)

Liability and immunity in general. As a general rule, California law provides that persons are responsible not only for the result of their willful acts, but also for an injury occasioned to another by their want of ordinary care or skill in the management of their property or person, except so far as the latter has, willfully or by want of ordinary care, brought the injury upon themselves. (Civil Code Section 1714 (a).) Liability has the primary effect of ensuring that some measure of recourse exists for those persons injured by the negligent or willful acts of others; the risk of that liability has the primary effect of ensuring parties act reasonably to avoid harm to those to whom they owe a duty.

Conversely, immunity from liability disincentivizes careful planning and actions on the part of individuals and entities. Those who have immunity from civil liability are relieved of the responsibility to act with due regard and an appropriate level of care in the conduct of their activities. Immunity provisions are also disfavored because they, by their nature, preclude parties from recovering when they are injured, and force injured parties to absorb losses for which they are not responsible. Liability acts to not only allow a victim to be made whole, but also to encourage appropriate care and compliance with legal requirements.

The "Good Samaritan" Law. Under existing common law tort rules, a person who voluntarily comes to the aid of another person suffering a medical emergency is immune from liability for injuries and even death, so long as that person acts in a reasonably prudent manner under the circumstances. In addition, in 2009, California adopted a so-called "Good Samaritan" statute. (The term refers to the parable in the Gospel of Luke about the "lowly" Samaritan who came to the aid of a stranger left for dead while supposedly more upstanding citizens ignored the cries of the dying man.) California's Good Samaritan statute (Section 1799.102) grants qualified immunity to any person who renders medical or non-medical aid in an emergency, so long as that person acts in good faith and not for compensation, and so long as that person's conduct is not grossly negligent or does not constitute willful or wanton misconduct.

In recent years, this Committee has heard, and the Legislature has enacted, bills providing express immunity from liability for lay people (as well as off-duty professionals) who voluntarily render medical aid in specific emergency situations. Immunities generally are provided to ensure the willingness of individuals to continue taking on certain roles that may involve some risk and to incentivize certain conduct, such as the provision of life-saving or other critical services. Examples include protections for use of CPR (Civil Code Section 1714.2); use of an automated external defibrillator (Civil Code Section 1714.21); use of opiate overdose treatment (Civil Code Section 1714.22); providing emergency care at the scene of an emergency (Sections 1799.102, 1799.106); and performing emergency rescue services (Section 1799.107). However, as indicated above, rarely is immunity absolute. These immunity provisions generally do not apply to grossly negligent conduct or intentional misconduct.

Express immunity provisions may be unnecessary given that any of these methods of administering medical or non-medical care by a lay rescuer at the scene of an emergency would most certainly qualify as rendering medical aid in an emergency by a Good Samaritan, regardless of the mechanism by which the care is administered. For example, if a person who was trained to render emergency trauma care with the contents of a trauma kit, or even an untrained lay person, voluntarily rendered aid to a victim by providing care or assistance with materials or equipment found in a trauma kit (or even with other materials, such as a t-shirt, scarf, or tie used as a tourniquet) that person would be protected from liability under the Good Samaritan statute. While providing express immunity for specific medical emergencies may be unnecessary in light of the Good Samaritan laws, one could argue that such provisions such as those in this bill are harmless and potentially useful clarifications of existing law (at least as the measure is proposed to be amended).

Author’s amendments. Despite the fact that express immunity is not required for a Good Samaritan to be shielded from liability, the bill in print provides virtually unlimited immunity to school employees who use trauma kits to provide care in an emergency:

Any employee of a local educational agency who in good faith, and not for compensation, renders emergency care or treatment by the use of a trauma kit at the scene of an emergency shall not be liable for civil damages resulting from any act or omission.

This language is inconsistent with all of the immunity statutes discussed above, including Section 1799.102, and common law. As a result, school employees would be immune from liability for all injuries caused by their use of a trauma kit, even if, for example, they intentionally misused a tourniquet and caused the amputation of a limb. In order to address the overbreadth of the immunity provided by the bill in print, the author proposes the following amendments:

(b) (1) Any employee of a local educational agency who in good faith, and not for compensation, renders emergency care or treatment by the use of a trauma kit at the scene of an emergency shall not be liable for civil damages resulting from any act or omission. Subdivision (b) of Section 1799.102 of the Health and Safety Code, the “Good Samaritan Law,” applies to any lay rescuer or person who, in good faith and not for compensation, renders emergency care or treatment by the use of a trauma kit at the scene of an emergency.

By cross-referencing Section 1799.102 of the Health and Safety Code, this language exempts from immunity “an act or omission constituting gross negligence or willful or wanton misconduct.” (Section 1799.102.) While the language is limiting in that it exempts grossly negligent and wanton acts, it is also expansive in that it applies to “any lay rescuer or person” rather than just an employee of a local educational agency. In order to clarify that a lay rescuer who happens to be paid at the time they provide emergency care is not providing care “for compensation,” the proposed amendment also states the following:

(2) A person who renders emergency care or treatment by the use of a trauma kit at the scene of an emergency and who receives compensation as a result of their employment by a local educational agency, or any other private or public employer, but is not compensated to provide emergency medical care, is not providing emergency medical care “for compensation” for purposes of Section 1799.102 of the Health and Safety Code.

ARGUMENTS IN SUPPORT: The three California Chapters of the American College of Surgeons, sponsors of the bill, write the following to explain their “strongest support” for the bill:

As with any injury or medical emergency, immediate treatment provides critical time to stabilize the patient while emergency services are on their way. In the event of a traumatic bleeding injury, time is even more crucial as it can take a just a few minutes for bleeding to cause death.

As shown in national and California studies and in recent real events, providing trained persons, including high school students and prompt access to trauma kits will greatly increase the chance of survival for the injured bleeding person.

. . .A traumatic bleeding injury can happen at any moment and in any location. Stop the Bleed has been used in California in cases of motor vehicle collisions, industrial injuries, accidents at home, rural and agricultural injuries and for victims of assaults, including mass shootings and school shootings. California is especially susceptible to natural disasters, such as earthquakes, that can result in the need to treat numerous people with severe injuries. STOP THE BLEED saves lives by extending the survival of trauma patients with heavy bleeding until they can reach a trauma center, and this bill will help ensure California students, teachers and staff will have access to approved trauma kits in every classroom. Making STOP THE BLEED high school training kits and educational offerings available in school classrooms will significantly increase the number of lay providers who will help to provide precious time for severely injured patients and will save more lives.

REGISTERED SUPPORT / OPPOSITION:

Support

California Chapters, The American College of Emergency Physicians (sponsor)

American College of Surgeons Joint Advocacy Committee

American College of Surgeons Northern California

American College of Surgeons, Southern California Chapter

Arcadia Police Officers' Association

Association of California School Administrators

Burbank Police Officers' Association

California Association of School Business Officials (CASBO)

California Coalition of School Safety Professionals

Claremont Police Officers Association

Corona Police Officers Association

Culver City Police Officers' Association

Deputy Sheriffs' Association of Monterey County

Emergency Nurses Association, California State Council

Fullerton Police Officers' Association

Los Angeles School Police Officers Association

Murrieta Police Officers' Association

Newport Beach Police Association

Palos Verdes Police Officers Association

Placer County Deputy Sheriffs' Association

Pomona Police Officers' Association

Riverside Police Officers Association

Riverside Sheriffs' Association

San Bernardino County Sheriff's Department

San Diego - Imperial Chapter, American College of Surgeons

Santa Ana Police Officers Association

Upland Police Officers Association

Opposition

None on file

Analysis Prepared by: Alison Merrilees / JUD. / (916) 319-2334

Date of Hearing: June 28, 2023

ASSEMBLY COMMITTEE ON EDUCATION

Al Muratsuchi, Chair

SBPCA Bill Id:SB 868

Author:(Wilk) – As Amended Ver:June 14, 2023

SENATE VOTE: 40-0

[Note: This bill is double referred to the Assembly Judiciary Committee and will be heard by that Committee as it relates to issues under its jurisdiction.]

SUBJECT: Pupil safety: trauma kits

SUMMARY: Requires each local educational agency (LEA) to equip each classroom at each schoolsite with a trauma kit by the 2024-25 school year, and to notify all employees of the location of the trauma kits as well as contact information for potential sources of training in the use of the trauma kits, subject to an appropriation for these purposes. Specifically, this bill:

1. Requires LEAs to equip each classroom at each of its schoolsites with a trauma kit by the beginning of the 2024-25 school year, and to inspect and replace or replenish each trauma kit, as necessary to maintain the required contents, upon each use and at least once every three years.
2. Requires LEAs at least once each school year, to notify all employees of the location of the trauma kits and provide them with contact information for at least one potential source of training in the use of the trauma kit, including, but not limited to the following:
3. The Stop the Bleed national awareness campaign of the United States Department of Homeland Security;
4. The American College of Surgeons Committee on Trauma;
5. The American Red Cross;
6. The Committee for Tactical Emergency Casualty Care;
7. Any other partner of the United States Department of Defense;
8. A level 1 trauma center or other hospital that provides community-based education regarding trauma care or similar first aid care; or
9. Other reputable providers of first aid or trauma care training.
10. Provides LEA employees with protection from civil damages resulting from any act or omission relating to the use of the trauma kits.
11. Defines “local educational agency” as a school district, county office of education (COE), or charter school.
12. Defines “trauma kit” as a first aid response kit that contains at least all of the following:
13. One tourniquet endorsed by the Committee on Tactical Combat Casualty Care;
14. One bleeding control bandage;
15. One pair of nonlatex protective gloves and a marker;
16. One pair of scissors;
17. Instructional documents developed by the Stop the Bleed national awareness campaign of the United States Department of Homeland Security or the American College of Surgeons Committee on Trauma, the American Red Cross, the Committee for Tactical Emergency Casualty Care, or any other partner of the United States Department of Defense; and
18. Medical materials and equipment approved by the medical director of the local emergency medical services agency may be included as supplements in addition to the items described if they adequately treat a traumatic injury and can be stored in a readily available kit.
19. Specifies that the trauma kit may also include: one or more additional tourniquets in sizes that are suitable for younger students; gauze, including a clotting agent or similar properties to control bleeding; and a protective capsule to hold the contents of the trauma kit.
20. Prohibits anything in this section from being construed to create a private right of action against an LEA.
21. Specifies that the implementation of these provisions is contingent upon an appropriation for these purposes in the annual Budget Act or another statute.

EXISTING LAW:

1. Requires each school district or COE to be responsible for the overall development of all comprehensive school safety plans for its schools operating kindergarten or any of grades 1 through 12. (Education Code (EC) 32281)
2. Specifies that the comprehensive school safety plan must include an assessment of the current status of school crime committed on school campuses and at school-related functions and identification of appropriate strategies and programs to provide or maintain a high level of school safety and address the school’s procedures for complying with existing laws related to school safety, including, but not limited to, disaster procedures; an earthquake emergency procedure system; policies regarding pupils who commit specified acts that would lead to suspension or expulsion; procedures to notify teachers of dangerous pupils; procedures for safe ingress and egress of pupils, parents, and school employees to and from school; a safe and orderly environment conducive to learning; and procedures for conducting tactical responses to criminal incidents, including procedures related to individuals with guns on school campuses and at school-related functions. (EC 32282)
3. Authorizes the portions of a school safety plan that include tactical responses to criminal incidents to be developed by school district or COE administrators in consultation with law enforcement officials and with a representative of an exclusive bargaining unit of school district or COE employees, if they choose to participate. Authorizes the school district or COE to elect not to disclose those portions of the comprehensive school safety plan that include tactical responses to criminal incidents. (EC 32281)
4. Defines “tactical responses to criminal incidents” as steps taken to safeguard pupils and staff, to secure the affected school premises, and to apprehend the criminal perpetrators. (EC 32281)
5. Requires the petition to establish a charter school to include the development of a school safety plan with specified safety topics, including procedures for conducting tactical responses to criminal incidents. (EC 47605 and 47605.5)
6. Defines “trauma kit” as a first aid response kit that contains at least all of the following:
7. One tourniquet endorsed by the Committee on Tactical Combat Casualty Care;
8. One bleeding control bandage;
9. One pair of nonlatex protective gloves and a marker;
10. One pair of scissors;
11. Instructional documents developed by the Stop the Bleed national awareness campaign of the United States Department of Homeland Security or the American College of Surgeons Committee on Trauma, the American Red Cross, the Committee for Tactical Emergency Casualty Care, or any other partner of the United States Department of Defense; and
12. Medical materials and equipment approved by the medical director of the local emergency medical services agency may be included as supplements in addition to the items described if they adequately treat a traumatic injury and can be stored in a readily available kit. (Health and Safety Code (HSC) 19305)
13. Requires certain public buildings with occupancy of 200 or more to provide a trauma kit, including education through 12^th grade and daycare facilities. (HSC 19310)

FISCAL EFFECT: According to the Senate Appropriations Committee:

While the bill’s provisions would be contingent upon an appropriation, it could lead to one-time Proposition 98 General Fund cost pressure ranging from $9.8 million to $23.4 million statewide. This estimate assumes a cost of between $50 and $100 for each trauma kit for each individual classroom in the state. However, the bill’s costs could be higher to the extent that LEAs would need to train their employees on using the trauma kit, particularly on the use of tourniquets and controlling bleeding in emergency situations. Currently, the bill only requires LEAs to notify employees and teachers of contact information for training; it does not require the actual training. Further, while not explicitly required, this bill could lead to one-time General Fund cost pressure in the tens of thousands to low hundreds of thousands of dollars for the CDE to develop minimum training standards and best practices on the use of trauma kits.

COMMENTS:

Need for the bill. According to the author, “The unfortunate reality is that schools and classrooms are ill-prepared for threats against our kids. School shootings are a terrible and devastating reality in 2023, and schools do not have the resources necessary to save children if a dangerous or life-threatening emergency occurs. We must adapt our schools to be prepared for these threats against our children. While many legislative ideas work to prevent these tragedies, we must be prepared for when they do eventually occur. A lack of access to proper tools should not be the barrier faced when a life-threatening injury occurs. In order to improve student safety, this bill would place life-saving trauma kits where they are most likely to be needed in a school emergency: in the classroom.”

Polls indicate fear of school shootings. A 2018 Public Policy Institute of California (PPIC) survey found that 73% of adults and 82% of public school parents say they are “very” or “somewhat concerned” about school shootings. Similarly, a 2018 Pew Research Center survey of parents and teenagers found 57% of teenagers aged 13-17 “very worried” or “somewhat worried” about a shooting in their schools and 63% of parents saying they at least somewhat worried about the possibility of a shooting happening at their child’s school.

K-12 Violent Incidents. The U.S. Secret Service and the U.S. Federal Bureau of Investigation (FBI) define a targeted attack or targeted violence as an attack that was planned for days, weeks, or months, serves a purpose and seeks to accomplish objectives set by the attacker. Prior to 1998, targeted attacks were rare within the U.S. During the most recent 20 years, almost all targeted attacks at schools were perpetrated by students or former students. (Marjorie Stoneman Douglas High School Public Safety Commission Report, 2019)

Since April 20, 1999, when two high school students killed 12 students and one teacher and wounded 23 others before committing suicide at Columbine High School in Colorado, school safety has been a major concern in schools across the country. Since then, more shootings have taken place at schoolsites, including Sandy Hook Elementary School in Newtown Connecticut in December 2012 where 26 students and educators were killed, and the February 14, 2018 shooting at Marjory Stoneman Douglas High School in Parkland, Florida with 17 casualties.

The K-12 School Shooting Database documents when a gun is brandished, is fired, or a bullet hits school property for any reason. The database tracks incidents at K-12 schools since 1970. They have documented 2,437 school shootings nationally resulting in 985 deaths and 2,068 injuries. The number of incidents has grown substantially from less than 25 incidents annually in 1970 to approximately 304 incidents in 2022. 43% of the shooters involved in these incidents were students. This database also illustrates the locations of these shootings (see figure below) showing that 214 of the identified shootings, or 10%, occurred in classrooms.

Source: K-12 School Shooting Database

School violence prevention audit. An audit by the California State Auditor, released in 2017, cites FBI data showing that active shooter incidents became more common between 2000 and 2015, and kindergarten through grade 12 facilities and higher education institutions have been the second most common location for these shootings to occur, both nationally and within California. Their survey of public school districts and COEs in California suggested that the number of active shooter threats and incidents in and around the State's schools had increased since academic year 2012–13.

The report noted that state law does not require schools to include procedures for responding to active shooter events in their school safety plans and that state law could improve these plans by requiring the inclusion of procedures to respond to active shooter incidents. The audit also found deficiencies in oversight and guidance by district and COEs as well as at the state level by CDE, and that some schools have failed to meet the requirement to review safety plans annually.

Since the release of this report, legislation has been enacted in California requiring schools to expand the required elements of school safety plans, including procedures to respond to active shooter situations, requires schools to conduct annual active shooter drills, and requires the CDE to provide additional guidance and oversight of safety plans.

Stop the Bleed campaign. According to its website, Stop The Bleed is the result of a collaborative effort led by the American College of Surgeons Committee on Trauma (ACS COT) to bring bleeding control to the public. After the wide adoption of tourniquets and tourniquet training by the military during the Iraq and Afghanistan conflicts, their use was reviewed and a clear survival benefit was identified. A follow-up study in 2014, led by the ACS COT emergency medical services subcommittee, showed similar benefits related to tourniquet use among civilians and further introduced direct pressure and wound packing to the list of simple but effective skills that could be used to control active bleeding in an emergency situation. It also became clear that time was a critical factor, and outcomes were directly related to how quickly bleeding control was achieved, and these findings helped establish the bystander as playing a critical role in saving lives due to severe bleeding. Curriculum was developed into what is known as the Bleeding Control Basic course (B-CON), released to the public in 2014, which is the foundation of today's Stop the Bleed course.

Tourniquet use by non-medical professionals. Tourniquet use, especially by untrained Good Samaritans, has been controversial over the years because of the fear that a restriction in blood supply to tissues, causing a shortage of oxygen that is needed to keep the tissue alive, could lead to amputation. If a tourniquet is left on too long or applied incorrectly, it can result in the loss of a limb. However, this does not appear to be the case for most civilian tourniquet applications, as having a tourniquet in place for two or fewer hours, until the patient can get to the hospital, should not have any ill effects. It typically takes at least 4-6 hours for tourniquets to cause harm. (Sztajnkrycer, 2022)

The American Heart Association Guidelines for first aid includes the following:

Because the rate of complications is low and the rate of hemostasis [bleeding to death] is high, first aid providers may consider the use of a tourniquet when standard first aid hemorrhage control does not control severe external limb bleeding. A manufactured tourniquet should be used as first-line therapy for life-threatening extremity bleeding and should be placed as soon as possible after the injury. Specifically designed tourniquets appear to be better than ones that are improvised, but tourniquets should only be used with proper training.

Arguments in support. The American College of Emergency Physicians writes, “One-third of people who die from trauma do so from bleeding. Trauma kits are intended to provide potential first responders with the tools that they need for bleeding control. Training programs like Stop the Bleed have been used since 2015 to train non-medical providers and reduce the number of deaths due to uncontrolled bleeding and have been associated with increased confidence in trauma response.

Including trauma kits in classrooms and providing school employees with opportunities for trauma kit training increases the likelihood that they will be able to appropriately respond in the event of an emergency. Expanding access to trauma tools and training will enable school employees to save lives.”

Related legislation. AB 71 (Rodriguez) of the 2023-24 Session would require, when the Health Framework for California Public Schools is next revised after January 1, 2024, the Instructional Quality Commission (IQC) to consider including information on bleeding control in the framework. Specifically, the bill would require the IQC to consider including information developed by the Stop the Bleed national awareness campaign of the United States Department of Homeland Security or the American College of Surgeons Committee on Trauma, the American Red Cross, the Committee for Tactical Emergency Casualty Care, or any other partner of the United States Department of Defense. In addition, the bill would require the CDE to make available on its website to LEAs, a list of resources and instructional materials on bleeding control.

AB 70 (Rodriguez) of the 2023-24 Session would extend a recently enacted law that requires certain buildings constructed after January 1, 2023 to have at least six trauma kits on the premises, to also require buildings that were constructed prior to that date to have the trauma kits if the buildings were renovated or improved.

SB 643 (Wilk) of the 2023-24 Session would establish the School Safety Division within the CDE and require the division to administer the Safe-To-Tell Program to receive anonymous reports of dangerous, violent, or unlawful activity. Would also require LEAs to establish school-based teams of at least three members of the administrative staff at each of its schools to receive notice of reports, and requires the Safe-to-Tell advisory committee to provide an annual report to the Governor and Legislature.

AB 960 (Mathis) of the 2023-24 Session would require each public school with 100 or more pupils to implement a web-based or app-based school safety program by July 1, 2030.

AB 2260 (Rodriguez) Chapter 586, Statutes of 2022, requires certain public and private buildings with an occupancy of 200 persons or greater, including K-12 educational facilities and daycare facilities, to maintain a trauma kit on the building’s premises. The bill provides specified immunity to persons supplying trauma kits, training others on their use, and using them in emergency situations.

AB 1499 (Flora) of the 2019-20 Session would have required the California Office of Emergency Services (Cal OES) to create a new grant program for communication interoperability systems – systems that allow emergency responders and schools to better communicate with each other – on the campuses of K-12 schools, community colleges, and public colleges and universities. This bill was held in the Assembly Appropriations Committee.

SB 541 (Bates) Chapter 786, Statutes of 2019, requires the CDE to collect, and LEAs to provide, data pertaining to lockdown or multi-option response drills conducted at school sites within school districts, county offices of education and charter schools providing instructional services to pupils in kindergarten or in any of grades 1 to 12, and requires the CDE to submit a report to the Legislature relative to that data.

AB 1747 (Rodriguez) Chapter 806, Statutes of 2018, expands the required elements of school safety plans, including procedures to respond to active shooter situations, requires schools to conduct annual active shooter drills, and requires the CDE to provide additional guidance and oversight of safety plans.

REGISTERED SUPPORT / OPPOSITION:

Support

Arcadia Police Officers' Association

Association of California School Administrators

Burbank Police Officers' Association

California Association of School Business Officials

California Chapter of the American College of Emergency Physicians

California Coalition of School Safety Professionals

Claremont Police Officers’ Association

Corona Police Officers’ Association

Culver City Police Officers' Association

Deputy Sheriffs' Association of Monterey County

Emergency Nurses Association, California State Council

Fullerton Police Officers' Association

Los Angeles School Police Officers’ Association

Murrieta Police Officers' Association

Newport Beach Police Association

Palos Verdes Police Officers’ Association

Placer County Deputy Sheriffs' Association

Pomona Police Officers' Association

Riverside Police Officers’ Association

Riverside Sheriffs' Association

Santa Ana Police Officers’ Association

Upland Police Officers’ Association

Opposition

None on file

Analysis Prepared by: Debbie Look / ED. / (916) 319-2087

 THIRD READING  

Bill No: SB 868

Author: Wilk (R), et al.

Amended: 3/20/23

Vote: 21

SENATE EDUCATION COMMITTEE: 7-0, 3/29/23

AYES: Newman, Ochoa Bogh, Cortese, Glazer, McGuire, Smallwood-Cuevas, Wilk

SENATE JUDICIARY COMMITTEE: 11-0, 4/18/23

AYES: Umberg, Wilk, Allen, Ashby, Caballero, Durazo, Laird, McGuire, Min, Niello, Wiener

SENATE APPROPRIATIONS COMMITTEE: 7-0, 5/18/23

AYES: Portantino, Jones, Ashby, Bradford, Seyarto, Wahab, Wiener

SUBJECT: Pupil safety: trauma kits

SOURCE: Author

DIGEST:

This bill requires, upon an appropriation, commencing with the 2024–25 school year, each LEA, COE, and charter school to equip each classroom at each of its schoolsites with a trauma kit.

ANALYSIS:

Existing law:

1. Requires each LEA and COE to be responsible for the overall development of all comprehensive school safety plans for its schools operating kindergarten or any of grades 1 through 12. (EC § 32281(a))
2. Specifies that the schoolsite council or a school safety planning committee is responsible for developing the comprehensive school safety plan. (EC § 32281(b))
3. Specifies that the comprehensive school safety plan must include an assessment of the current status of school crime committed on school campuses and at school-related functions and identification of appropriate strategies and programs to provide or maintain a high level of school safety and address the school’s procedures for complying with existing laws related to school safety, including child abuse reporting procedures; disaster procedures; an earthquake emergency procedure system; policies regarding pupils who commit specified acts that would lead to suspension or expulsion; procedures to notify teachers of dangerous pupils; a discrimination and harassment policy; the provisions of any schoolwide dress code; procedures for safe ingress and egress of pupils, parents, and school employees to and from school; a safe and orderly environment conducive to learning; and rules and procedures on school discipline. (EC § 32282(a))
4. Requires the comprehensive school safety plan to be evaluated at least once a year. (EC § 32282(d))
5. Requires the comprehensive school safety plan to include, but not be limited to, procedures for conducting tactical responses to criminal incidents, including procedures related to individuals with guns on school campuses and at school-related functions. (EC § 32282(a)(2)(J))
6. Permits a school nurse or trained personnel who have volunteered to provide emergency naloxone hydrochloride or another opioid antagonist, by nasal spray or by auto-injector, to persons suffering, or reasonably believed to be suffering, from an opioid overdose. (EC § 49414.3(a))
7. Permits each public and private school to designate one or more volunteers to receive initial and annual refresher training, based on specified standards, regarding the storage and emergency use of an epinephrine auto-injector from the school nurse or other qualified person designated by an authorizing physician or surgeon. (EC § 49414(d))
8. Authorizes a pupil who is required to take, during the regular schoolday, medication prescribed for the pupil by a physician or surgeon, to be assisted by the school nurse or other designated school personnel or may carry and self-administer inhaled asthma medication if the school district receives the appropriate written statement from the physician or surgeon detailing the name of the medication, method, amount, and time schedules by which the medication is to be taken and a written statement from the parent, foster parent, or guardian of the pupil requesting that the school district assist the pupil in the matters set forth in the statement of the physician or surgeon. (EC § 49423.1)

This bill:

1. Requires, upon an appropriation, each LEA, COE, and charter school, commencing the 2024-25 school year, to equip each classroom with a trauma kit and to notify administrative employees, classified employees, pupil services employees, and teachers of its location and contact information for training, as specified.
2. Specifies that any administrative employees, classified employees, pupil services employees, and teachers of a LEA who in good faith and not for compensation, renders emergency care of treatment by the use of a trauma kit at the scene of an emergency shall not be liable for civil damages resulting from any act or omission, other than an act or omission constituting gross negligence or willful or wanton misconduct. The scene of an emergency shall not include emergency departments and other places where medical care is usually offered.
3. Defines “Trauma kit” as a first aid response kit that contains at least all of the following:
   1. One or more tourniquets in sizes that are suitable for younger or smaller pupils.
   2. Gauze, including a clotting agent or similar properties to control bleeding.
   3. A protective capsule to hold the trauma kit’s contents.

Comments

1. Need for the bill. According to the author, “The unfortunate reality is that schools and classrooms are ill-prepared for threats against our kids. School shootings are a terrible and devastating reality in 2023, and schools do not have the resources necessary to save children if a dangerous or life threatening emergency occurs. We must adapt our schools to be prepared for these threats against our children. While many legislative ideas work to prevent these tragedies, we must be prepared for when they do eventually occur. A lack of access to proper tools should not be the barrier faced when a life-threatening injury occurs. In order to improve student safety, this bill would place life-saving trauma kits where they are most likely to be needed in a school emergency: in the classroom.”
2. Traumatic Events. According to a 2018 study by the Pew Research Center, the majority of U.S. teens fear a shooting could happen at their school, and most parents share their concerns. Firearms are a leading cause of morbidity and mortality in the United States and accounted for more than 36,000 deaths and nearly 85,000 injuries in 2015. In 2020, California saw a troubling rise of more than 500 homicides, the largest jump in state history since record-keeping began in 1960. Gun homicides drive the rise. California saw 1,658 homicides in 2019; the number climbed to 2,161 in 2020—an increase of 503 homicides (or 30.3%). Of the 503 additional homicides, 460, or 91%, were gun related deaths. While the 2020 homicide rate is far lower than past peaks, the past year deviates from historically low rates of the last decade. Over the past few years, gun violence has risen to the forefront of public consciousness. The consequences of gun violence are more pervasive and affect entire communities, families, and children. With more than 25% of children witnessing an act of violence in their homes, schools, or community over the past year, and more than 5% witnessing a shooting. A 2004 report by the United States Secret Service and United States Department of Education found that over two-thirds of school shooters acquired the gun (or guns) used in their attacks from their own home or that of a relative (68 percent).
3. School Safety Plans. Existing law requires each school site to review and update its school safety plan, which must be developed and written by a School Site Council or its designated Safety Planning Committee in collaboration with teachers, classified staff, parents, and first responders to ensure they are up-to-date and complete. The plans must have policies and procedures addressing critical issues, including disaster preparedness; crisis response; mental and physical health; earthquake emergencies; school learning environment; discipline, suspension and expulsion; hate crime reporting; child abuse reporting; release of a pesticide or toxic substance; and procedures related to individuals with guns on school campuses and at school-related functions.
4. Stop The Bleed Campaign. According to its website, Stop The Beed is the result of a collaborative effort led by the American College of Surgeons Committee on Trauma (ACS COT) to bring bleeding control to the public. After the broad adoption of tourniquets and tourniquet training by the military during the Iraq and Afghanistan conflicts, their use was reviewed a clear survival benefit was identified. A follow-up study in 2014, led by the ACS COT emergency medical services subcommittee, showed similar benefits related to tourniquet use among civilians and introduced direct pressure and wound packing to the list of simple but effective skills that could be used to control active bleeding in an emergency. It also became clear that time was a critical factor, and outcomes were directly related to how quickly bleeding control was achieved. These findings helped establish the bystander as necessary in saving lives due to severe bleeding. The curriculum was developed into what is known as the Bleeding Control Basic course (B-CON), released to the public in 2014, which is the foundation of today’s Stop The Bleed course. 

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: Yes

According to the Senate Appropriations Committee, “While the bill’s provisions would be contingent upon an appropriation, it could lead to one-time Proposition 98 General Fund cost pressure ranging from $9.8 million to $23.4 million statewide. This estimate assumes a cost of between $50 and $100 for each trauma kit for each individual classroom in the state. However, the bill’s costs could be higher to the extent that LEAs would need to train their employees on using the trauma kit, particularly on the use of tourniquets and controlling bleeding in emergency situations. Currently, the bill only requires LEAs to notify employees and teachers of contact information for training; it does not require the actual training. Further, while not explicitly required, this bill could lead to one-time General Fund cost pressure in the tens of thousands to low hundreds of thousands of dollars for the California Department of Education (CDE) to develop minimum training standards and best practices on the use of trauma kits.”

SUPPORT: (Verified 5/19/23)

Arcadia Police Officers' Association

Burbank Police Officers' Association

California Association of School Business Officials

California Chapter Of The American College Of Emergency Physicians

California Coalition of School Safety Professionals

Claremont Police Officers Association

Corona Police Officers Association

Culver City Police Officers' Association

Deputy Sheriffs' Association of Monterey County

Emergency Nurses Association, California State Council

Fullerton Police Officers' Association

Los Angeles School Police Officers Association

Murrieta Police Officers' Association

Newport Beach Police Association

Palos Verdes Police Officers Association

Placer County Deputy Sheriffs' Association

Pomona Police Officers' Association

Riverside Police Officers Association

Riverside Sheriffs' Association

Santa Ana Police Officers Association

Upland Police Officers Association

OPPOSITION: (Verified 5/19/23)

None received.

ARGUMENTS IN SUPPORT: According to the California Association of School Business Officials “CASBO supports student safety, and SB 868 ensures that by placing trauma kits in K-12 classrooms, students and staff will have access to the supplies they need to treat injuries and save lives. While not all wounds are fatal, uncontrolled bleeding is extremely deadly. By placing trauma kits where they are most needed, the risk of further unnecessary loss of life may be reduced.

Prepared by: Kordell Hampton / ED. / (916) 651-4105

5/22/23 8:55:45

**** END ****

SENATE COMMITTEE ON

Senator Anthony Portantino, Chair

2023 - 2024 Regular Session

SB 868 (Wilk) - Pupil safety: trauma kits

Bill Summary:

This bill, commencing with the 2024-25 school year, would require local educational agencies (LEAs) to equip each classroom at its school sites with a trauma kit.

Fiscal Impact:

While the bill’s provisions would be contingent upon an appropriation, it could lead to one-time Proposition 98 General Fund cost pressure ranging from $9.8 million to $23.4 million statewide. This estimate assumes a cost of between $50 and $100 for each trauma kit for each individual classroom in the state. However, the bill’s costs could be higher to the extent that LEAs would need to train their employees on using the trauma kit, particularly on the use of tourniquets and controlling bleeding in emergency situations. Currently, the bill only requires LEAs to notify employees and teachers of contact information for training; it does not require the actual training. Further, while not explicitly required, this bill could lead to one-time General Fund cost pressure in the tens of thousands to low hundreds of thousands of dollars for the California Department of Education (CDE) to develop minimum training standards and best practices on the use of trauma kits.

Background:

Existing law establishes the School/Law Enforcement Partnership (Partnership), comprised of the Superintendent of Public Instruction and the Attorney General, and specifies that the Partnership shall develop programs and policies necessary to help implement the creation of school safety plans, the administration of safe school programs and all training, procedures, and activities, and cooperation with other states and state and federal agencies on matters relating to school safety.

Existing law requires the Partnership to establish a statewide school safety cadre for the purpose of facilitating interagency coordination and collaboration among school districts, COEs, agencies serving youth, allied agencies, community-based organizations, and law enforcement agencies to improve school attendance, encourage good citizenship, and to reduce school violence, school crime, including hate crimes, vandalism, drug and alcohol abuse, gang membership and gang violence, truancy rates, bullying, including acts that are committed personally or by means of an electronic act, teen relationship violence, and discrimination and harassment, including, but not limited to, sexual harassment.

Existing law requires each school district or county office of education to be responsible for the overall development of all comprehensive school safety plans for its schools operating kindergarten or any of grades 1 through 12. The law specifies that the schoolsite council or a school safety planning committee is responsible for developing the comprehensive school safety plan and also establishes detailed requirements for its contents. Specifically, the comprehensive school safety plans are required to include disaster procedures, routine and emergency, including adaptations for pupils with disabilities in accordance with the federal IDEA. Additionally, the plans are to include an assessment of the current status of school crime committed on school campuses and at school-related functions and the identification of appropriate strategies and programs that will provide or maintain a high level of school safety and address the school’s procedures for complying with existing laws related to school safety, as specified.

Proposed Law:

This bill requires, upon an appropriation, each LEA, including charter schools, commencing the 2024-25 school year, to equip each classroom with a trauma kit and to notify administrative employees, classified employees, pupil services employees, and teachers of its location and contact information for training, as specified.

This bill provides that any administrative employees, classified employees, pupil services employees, and teachers of a LEA who in good faith and not for compensation, renders emergency care of treatment by the use of a trauma kit at the scene of an emergency shall not be liable for civil damages resulting from any act or omission, other than an act or omission constituting gross negligence or willful or wanton misconduct. The scene of an emergency shall not include emergency departments and other places where medical care is usually offered.

This bill defines “Trauma kit” as a first aid response kit that contains at least all of the following: one or more tourniquets in sizes that are suitable for younger or smaller pupils; gauze, including a clotting agent or similar properties to control bleeding; and a protective capsule to hold the trauma kit’s contents.

Related Legislation:

SB 671 (Portantino, 2023) would require LEAs to add, as part of their comprehensive school safety plans, a procedure to assess and respond to reports of any dangerous, violent, or unlawful activity that is being conducted or threatened to be conducted on their property, at a school-sponsored event, or on a school bus. This bill will be heard in this Committee on May 1, 2023.

Staff Comments:

This bill requires LEAs to provide school personnel, at least once a year, contact information for training in the use of the trauma kit by certain entities. It does not require actual training nor does it specify if school personnel would be required to use the trauma kits in emergency situations and provide medical assistance. To the extent that LEAs elect to require training for staff, particularly on how to properly use the tourniquets during emergency situations, they could incur additional, unknown costs. The bill could also lead to one-time cost pressure for CDE to develop minimum training standards and best practices for LEAs.

-- END --

SENATE JUDICIARY COMMITTEE

Senator Thomas Umberg, Chair

2023-2024 Regular Session

Bill No: SB 868 (Author:Wilk)

Version: March 20, 2023

Hearing Date: April 18, 2023

Fiscal: Yes

Urgency: No

Consultant: CK

SUBJECT

Pupil safety: trauma kits

DIGEST

This bill requires local educational agencies to equip each classroom with a trauma kit and to offer training to employees on the use of such kits. Employees who render emergency care with such kits are granted qualified immunity from civil damages, as provided.

EXECUTIVE SUMMARY

According to the Stop the Bleed campaign: “Uncontrolled bleeding is a major cause of preventable deaths. Approximately 40 [percent] of trauma-related deaths worldwide are due to bleeding or its consequences, establishing hemorrhage as the most common cause of preventable death in trauma.” The Stop the Bleed Coalition seeks to raise awareness of this threat and how proper training and materials can prevent bleeding deaths in the wake of a trauma event.

This bill carries out this purpose by requiring “trauma kits,” first aid response kits that contain certain materials, including tourniquets, pressure dressings, chest seals, and instructional documents to be placed in each classroom in California by the local educational agency (LEA), commencing with the 2024–25 school year. Each LEA is required to provide training to employees on the use of the kits, as specified. The bill immunizes those actually using the kits to render emergency care at the scene of an emergency, except for acts constituting gross negligence or willful or wanton misconduct.

This bill is author sponsored. It is supported by a wide coalition of law enforcement groups and the Emergency Nurses Association, California State Council. There is no registered opposition. The bill passed out of the Senate Education Committee on a 7 to 0 vote.

PROPOSED CHANGES TO THE LAW

Existing law:

1. Provides that no person who, in good faith, and not for compensation, renders emergency medical or nonmedical care at the scene of an emergency shall be liable for any civil damages resulting from any act or omission. The scene of an emergency shall not include emergency departments and other places where medical care is usually offered. This applies only to medical, law enforcement, and emergency personnel, as specified. (Health & Saf. Code § 1799.102(a).)
2. Extends to all other persons not covered by the above who are rendering medical or nonmedical care or other assistance in such situations immunity from civil damages resulting from any act or omission other than acts or omissions constituting gross negligence or willful or wanton misconduct. (Health & Saf. Code § 1799.102(b).)
3. Provides that, in order to encourage local agencies and other organizations to train people in emergency medical services, no local agency, entity of state or local government, private business, or nonprofit organization included on the statewide registry that voluntarily and without expectation and receipt of compensation donates services, goods, labor, equipment, resources, or dispensaries or other facilities, in compliance with Section 8588.2 of the Government Code, or other public or private organization which sponsors, authorizes, supports, finances, or supervises the training of people, or certifies those people, excluding physicians and surgeons, registered nurses, and licensed vocational nurses, as defined, in emergency medical services, shall be liable for any civil damages alleged to result from those training programs. (Health & Saf. Code § 1799.100.)
4. Requires the person or entity responsible for managing the building, facility, and tenants of specified structures do all of the following:
   1. acquire and place a trauma kit on the premises of the building or facility;
   2. inspect all trauma kits acquired and placed on the premises of a building or structure every three years from the date of installation to ensure that all materials, supplies, and equipment contained in the trauma kit are not expired, and replace any expired materials, supplies, and equipment as necessary;
   3. if a property managing entity or person is aware, or reasonably should be aware, that a trauma kit has been used, restock the trauma kit after each use and replace any materials, supplies, and equipment as necessary to ensure that all materials, supplies, and equipment required to be contained in the trauma kit are contained in the trauma kit; and
   4. at least once per year, notify tenants of the building or structure of the location of the trauma kit and provide information to tenants regarding contact information for training in the use of the trauma kit. (Health and Saf. Code § 19310.)
5. Provides civil immunity to those persons or entities that comply with the trauma kit requirements in connection with any damages that result from acts or omissions in the rendering of emergency care by use of a trauma kit. A property managing entity is also civilly immune from damages resulting from the failure, improper operation, or malfunction of equipment or materials within a properly stocked trauma kit. (Health and Saf. Code § 19310.)
6. Applies the immunities of the “Good Samaritan” law codified in Section 1799.102 to persons who, in good faith and not for compensation, render emergency care or treatment by the use of a trauma kit at the scene of an emergency. (Civ. Code § 1714.29(c).)
7. Provides that a person who renders emergency care or treatment by the use of a trauma kit at the scene of an emergency and who receives compensation as a result of their employment by a property managing entity, a tenant of a building, or any other private or public employer, but is not compensated to provide emergency medical care, is not providing emergency medical care “for compensation” for purposes of Section 1799.102 of the Health and Safety Code. (Civ. Code § 1714.29(d).)
8. Applies the immunities of Section 1799.100 to a person or entity that voluntarily, and without expectation or receipt of compensation, does the following:
   1. provides training in the use of trauma kits, as specified; or
   2. certifies persons, as specified, who are trained in the use of a trauma kit to provide emergency medical treatment to victims of trauma. (Civ. Code § 1714.29(e).)
9. Provides that any person who, in good faith and not for compensation, renders emergency care or treatment by the use of an automated external defibrillator (AED) at the scene of an emergency is not liable for any civil damages resulting from any acts or omissions in rendering the emergency care. (Civ. Code § 1714.21(b).) A person or entity who provides CPR and AED training to a person who renders such emergency care is not liable for any civil damages resulting from any acts or omissions of the person rendering the emergency care. (Civ. Code § 1714.21(c).)
10. Provides that a person or entity that acquires an AED for emergency use, as specified, is not liable for any civil damages resulting from any acts or omissions in the rendering of the emergency care by use of an AED if that person or entity has complied with subdivision (b) of Section 1797.196 of the Health and Safety Code. (Civ. Code § 1714.21(d).)
11. Provides that when an AED is placed in a building, the building owner shall do all of the following:
    1. at least once a year, notify the tenants as to the location of the AED units and provide information to tenants about who they can contact if they want to voluntarily take AED or CPR training;
    2. at least once a year, offer a demonstration to at least one person associated with the building so that the person can be taught how to use an AED properly in an emergency. The building owner may arrange for the demonstration or partner with a nonprofit organization to do so; and
    3. next to the AED, post instructions, in no less than 14-point type, on how to use the AED. (Health & Saf. Code § 1797.196(b)(2).)

This bill:

1. Requires each local educational agency to do the following, commencing with the 2024–25 school year:
   1. equip each classroom at each of its schoolsites with a trauma kit; and
   2. notify, at least once each school year, its administrative employees, classified employees, pupil services employees, and teachers of the location of the trauma kits and provide them with contact information for training in the use of the trauma kit.
2. Immunizes any administrative employee, classified employee, pupil services employee, or teacher of a local educational agency who in good faith, and not for compensation, renders emergency care or treatment by the use of a trauma kit at the scene of an emergency from civil damages resulting from any act or omission, other than an act or omission constituting gross negligence or willful or wanton misconduct. The scene of an emergency shall not include emergency departments and other places where medical care is usually offered.
3. Provides the following definitions:
   1. “local education agency” means a school district, county office of education, or charter school.
   2. “trauma kit” has the same meaning as defined in Section 19305 of the Health and Safety Code.
4. Provides that its implementation is contingent upon an appropriation for its purposes in the annual Budget Act or another statute.

COMMENTS

• • • 1. Civil liability and immunity

As a general rule, California law provides that persons are responsible, not only for the result of their willful acts, but also for an injury occasioned to another by their want of ordinary care or skill in the management of their property or person, except so far as the latter has, willfully or by want of ordinary care, brought the injury upon themselves. (Civ. Code § 1714(a).) Liability has the primary effect of ensuring that some measure of recourse exists for those persons injured by the negligent or willful acts of others; the risk of that liability has the primary effect of ensuring parties act reasonably to avoid harm to those to whom they owe a duty.

Conversely, immunity from liability disincentivizes careful planning and acting on the part of individuals and entities. When one enjoys immunity from civil liability, they are relieved of the responsibility to act with due regard and an appropriate level of care in the conduct of their activities. Immunity provisions are also disfavored because they, by their nature, preclude parties from recovering when they are injured, and force injured parties to absorb losses for which they are not responsible. Liability acts not only to allow a victim to be made whole, but to encourage appropriate compliance with legal requirements.

Although immunity provisions are rarely preferable, the Legislature has, in limited scenarios, approved measured immunity from liability (as opposed to blanket immunities) to promote other policy goals that could benefit the public. Immunities are generally afforded when needed to ensure the willingness of individuals to continue taking on certain roles that may involve some risk and to incentivize certain conduct, such as the provision of life-saving or other critical services. Examples include protections for use of CPR (Civ. Code § 1714.2); use of an automated external defibrillator (Civ. Code § 1714.21); use of opiate overdose treatment (Civ. Code § 1714.22); providing emergency care at the scene of an emergency (Health & Saf. Code §§ 1799.102, 1799.106); and performing emergency rescue services (Health & Saf. Code § 1799.107). However, as indicated above, rarely is immunity absolute, and these immunities generally do not cover grossly negligent conduct or intentional misconduct.

• • • 1. Incentivizing the deployment and proper use of trauma kits

In order to maximize the life-saving capabilities of trauma kits, this bill requires placement of trauma kits in all classrooms in California. Each school district, county office of education, or charter school is not only required to equip classrooms with these kits, but most notify, at least every year, its employees of the location of the kits and provide them with contact information for training.

A person who, in good faith, and not for compensation, renders emergency care or treatment by the use of a trauma kit at the scene of an emergency shall not be liable for civil damages resulting from any act or omission, other than an act or omission constituting gross negligence or willful or wanton misconduct. The scene of an emergency shall not include emergency departments and other places where medical care is usually offered.

These provisions track with similar laws governing the placement of automated external defibrillators (AED) and the attached immunity. (Civ. Code § 1714.21; Health & Saf. Code § 1797.196.)

The bill affords liability protections for any administrative employee, classified employee, pupil services employee, or teacher of an LEA who, in good faith and not for compensation, renders emergency care or treatment through the use of a trauma kit at the scene of an emergency.

This tracks with the immunity provisions of Section 1799.102 of the Health and Safety Code, often referred to as the “Good Samaritan Law.” That statute provides immunity for those rendering emergency medical or nonmedical care at the scene of an emergency, as specified. The Good Samaritan law applies two standards, one solely applies to specified medical, law enforcement, or emergency personnel. Subdivision (b) applies to all other persons and establishes immunity from damages resulting from the same acts or omissions, but specifically excludes those acts or omissions constituting gross negligence or willful or wanton misconduct. The latter standard is the one the bill appropriately applies here, as it specifically does not apply immunity where the act or omission constitutes gross negligence or willful or wanton misconduct.

In fact, a person who, in good faith and not for compensation, renders emergency care or treatment by the use of a trauma kit at the scene of an emergency is likely already covered by the existing Good Samaritan law. However, this provision will likely incentivize more individuals to take action when needed.

According to the author:

The unfortunate reality is that schools and classrooms are ill-prepared for threats against our kids. School shootings are a terrible and devastating reality in 2023, and schools do not have the resources necessary to save children if a dangerous or life threatening emergency occurs. We must adapt our schools to be prepared for these threats against our children. While many legislative ideas work to prevent these tragedies, we must be prepared for when they do eventually occur. A lack of access to proper tools should not be the barrier faced when a life-threatening injury occurs. In order to improve student safety, this bill would place life-saving trauma kits where they are most likely to be needed in a school emergency: in the classroom.

• • • 1. Stakeholder positions

Writing in support, a coalition of law enforcement groups, including the Riverside Sheriffs’ Association and Santa Ana Police Officers’ Association, asserts that the bill “would place life-saving trauma kits where they are most likely to be needed in a

school emergency: in the classroom. Building on previous efforts to make trauma kits more widely available, this bill will require each K-12 classroom to have a trauma kit available. SB 868 is a common sense public safety/student safety measure.”

SUPPORT

Arcadia Police Officers’ Association

Burbank Police Officers’ Association

California Coalition of School Safety Professionals

Claremont Police Officers Association

Corona Police Officers Association

Culver City Police Officers’ Association

Deputy Sheriffs’ Association of Monterey County

Emergency Nurses Association, California State Council

Fullerton Police Officers’ Association

Los Angeles School Police Officers Association

Murrieta Police Officers’ Association

Newport Beach Police Association

Palos Verdes Police Officers Association

Placer County Deputy Sheriffs’ Association

Pomona Police Officers’ Association

Riverside Police Officers Association

Riverside Sheriffs’ Association

Santa Ana Police Officers Association

Upland Police Officers Association

OPPOSITION

None known

RELATED LEGISLATION

Pending Legislation: None known.

Prior Legislation:

AB 1810 (Levine, Ch. 906, Stats. 2022) authorized schools to designate and train persons to provide anti-seizure medication in an emergency involving a pupil diagnosed with a seizure disorder. The persons must be provided defense and indemnification and are granted qualified immunity, as specified.

AB 2260 (Rodriguez, Ch. 586, Stats. 2022) required certain public and private buildings to maintain a trauma kit on the building’s premises. It provided specified immunity to persons supplying trauma kits, training others on their use, and using them in emergency situations.

SB 687 (Hueso, 2021) was substantially similar to AB 2260. However, it required the person or entity responsible for managing the building, facility, and tenants to comply with all regulations governing the placement of a trauma kit and afforded less immunity to them. This bill died in the Assembly Appropriations Committee.

AB 2053 (Rodriguez, 2020) was substantially similar to 2260. This bill died in the Assembly Appropriations Committee.

AB 1708 (Rodriguez, 2019) was substantially similar to AB 2260. This bill died in the Assembly Appropriations Committee.

SB 1305 (Glazer, Ch. 900, Stats. 2018) permitted an emergency responder to provide basic first aid, as specified, to a dog or a cat, without being in violation of the Veterinary Medicine Practice Act and ensured existing immunity laws apply.

AB 1766 (Maienschein, Ch. 270, Stats. 2018) provided that every public swimming pool that is required to provide lifeguard services and that charges a direct fee shall provide on its premises an AED that must be readily available during pool operations and applied conditional liability protections to those acquiring or using these AEDs.

PRIOR VOTES:

Senate Education Committee (Ayes 7, Noes 0)

**************

SENATE COMMITTEE ON EDUCATION

Senator Josh Newman, Chair

2023 - 2024 Regular

Bill No: Hearing Date: March 29, 2023

Subject:

NOTE: This bill has been referred to the Committees on Education. A "do pass" motion should include referral to the Committee on Rules.

SUMMARY

Upon an appropriation, commencing with the 2024–25 school year, this bill requires each school district (LEA), county office of education (COE), and charter school to equip each classroom at each of its schoolsites with a trauma kit.

BACKGROUND

Existing law

Education Code (EDC)

1. Requires each LEA and COE to be responsible for the overall development of all comprehensive school safety plans for its schools operating kindergarten or any of grades 1 through 12. (EDC § 32281(a))
2. Specifies that the schoolsite council or a school safety planning committee is responsible for developing the comprehensive school safety plan. (EDC § 32281(b))
3. Specifies that the comprehensive school safety plan must include an assessment of the current status of school crime committed on school campuses and at school-related functions and identification of appropriate strategies and programs to provide or maintain a high level of school safety and address the school’s procedures for complying with existing laws related to school safety, including child abuse reporting procedures; disaster procedures; an earthquake emergency procedure system; policies regarding pupils who commit specified acts that would lead to suspension or expulsion; procedures to notify teachers of dangerous pupils; a discrimination and harassment policy; the provisions of any schoolwide dress code; procedures for safe ingress and egress of pupils, parents, and school employees to and from school; a safe and orderly environment conducive to learning; and rules and procedures on school discipline. (EDC § 32282(a))
4. Requires the comprehensive school safety plan to be evaluated at least once a year. (EDC § 32282(d))
5. Requires the comprehensive school safety plan to include, but not be limited to, procedures for conducting tactical responses to criminal incidents, including procedures related to individuals with guns on school campuses and at school-related functions. (EDC § 32282(a)(2)(J))
6. Permits a school nurse or trained personnel who have volunteered to provide emergency naloxone hydrochloride or another opioid antagonist, by nasal spray or by auto-injector, to persons suffering, or reasonably believed to be suffering, from an opioid overdose. (EDC § 49414.3(a))
7. Permits each public and private school to designate one or more volunteers to receive initial and annual refresher training, based on specified standards, regarding the storage and emergency use of an epinephrine auto-injector from the school nurse or other qualified person designated by an authorizing physician or surgeon. (EC § 49414(d))
8. Authorizes a pupil who is required to take, during the regular schoolday, medication prescribed for the pupil by a physician or surgeon, to be assisted by the school nurse or other designated school personnel or may carry and self-administer inhaled asthma medication if the school district receives the appropriate written statement from the physician or surgeon detailing the name of the medication, method, amount, and time schedules by which the medication is to be taken and a written statement from the parent, foster parent, or guardian of the pupil requesting that the school district assist the pupil in the matters set forth in the statement of the physician or surgeon. (EDC § 49423.1)

Health and Safety Code (HSC)

1. Defines, “trauma kit” as a first aid response kit that contains at least all of the following:
2. One tourniquet endorsed by the Committee on Tactical Combat Casualty Care
3. One bleeding control bandage.
4. One pair of nonlatex protective gloves and a marker.
5. One pair of scissors.
6. Instructional documents developed by the Stop the Bleed national awareness campaign of the United States Department of Homeland Security or the American College of Surgeons Committee on Trauma, the American Red Cross, the Committee for Tactical Emergency Casualty Care, or any other partner of the United States Department of Defense. (HSC § 19305)

ANALYSIS

Upon an appropriation, commencing with the 2024–25 school year, this bill requires each LEA, COE, and charter school to equip each classroom at each of its schoolsites with a trauma kit. Specifically, this bill:

1. Upon an appropriation, requires each LEA, COE, and charter school, commencing the 2024-25 school year, to equip each classroom with a trauma kit and to notify administrative employees, classified employees, pupil services employees, and teachers of its location and contact information for training, as specified .
2. Specifies that any administrative employees, classified employees, pupil services employees, and teachers of a LEA who in good faith and not for compensation, renders emergency care of treatment by the use of a trauma kit at the scene of an emergency shall not be liable for civil damages resulting from any act or omission, other than an act or omission constituting gross negligence or willful or wanton misconduct. The scene of an emergency shall not include emergency departments and other places where medical care is usually offered.
3. Aligns the definition of a trauma kit with the HSC and specifies that may include any of the following:
4. Defines “Trauma kit” as a first aid response kit that contains at least all of the following:
   1. One or more tourniquets in sizes that are suitable for younger or smaller pupils.
   2. Gauze, including a clotting agent or similar properties to control bleeding.
   3. A protective capsule to hold the trauma kit’s contents

STAFF COMMENTS

1. Need for the bill. According to the author, “The unfortunate reality is that schools and classrooms are ill-prepared for threats against our kids. School shootings are a terrible and devastating reality in 2023, and schools do not have the resources necessary to save children if a dangerous or life threatening emergency occurs. We must adapt our schools to be prepared for these threats against our children. While many legislative ideas work to prevent these tragedies, we must be prepared for when they do eventually occur. A lack of access to proper tools should not be the barrier faced when a life-threatening injury occurs. In order to improve student safety, this bill would place life-saving trauma kits where they are most likely to be needed in a school emergency: in the classroom.”
2. Traumatic Events According to a 2018 study by the Pew Research Center, the majority of U.S. teens fear a shooting could happen at their school, and most parents share their concerns. Firearms are a leading cause of morbidity and mortality in the United States and accounted for more than 36,000 deaths and nearly 85,000 injuries in 2015. In 2020, California saw a troubling rise of more than 500 homicides, the largest jump in state history since record-keeping began in 1960. Gun homicides drive the rise. California saw 1,658 homicides in 2019; the number climbed to 2,161 in 2020—an increase of 503 homicides (or 30.3%). Of the 503 additional homicides, 460, or 91%, were gun related deaths. While the 2020 homicide rate is far lower than past peaks, the past year deviates from historically low rates of the last decade. Over the past few years, gun violence has risen to the forefront of public consciousness. The consequences of gun violence are more pervasive and affect entire communities, families, and children. With more than 25% of children witnessing an act of violence in their homes, schools, or community over the past year, and more than 5% witnessing a shooting. A 2004 report by the United States Secret Service and United States Department of Education found that over two-thirds of school shooters acquired the gun (or guns) used in their attacks from their own home or that of a relative (68 percent).
3. School Safety Plans. Existing law requires each school site to review and update its school safety plan, which must be developed and written by a School Site Council or its designated Safety Planning Committee in collaboration with teachers, classified staff, parents, and first responders to ensure they are up-to-date and complete. The plans must have policies and procedures addressing critical issues, including disaster preparedness; crisis response; mental and physical health; earthquake emergencies; school learning environment; discipline, suspension and expulsion; hate crime reporting; child abuse reporting; release of a pesticide or toxic substance; and procedures related to individuals with guns on school campuses and at school-related functions.

LEAs can currently provide for trauma kits and include in the provision of their school safety plans.

1. Stop The Bleed Campaign. According to its website, Stop The Beed is the result of a collaborative effort led by the American College of Surgeons Committee on Trauma (ACS COT) to bring bleeding control to the public. After the broad adoption of tourniquets and tourniquet training by the military during the Iraq and Afghanistan conflicts, their use was reviewed a clear survival benefit was identified. A follow-up study in 2014, led by the ACS COT emergency medical services subcommittee, showed similar benefits related to tourniquet use among civilians and introduced direct pressure and wound packing to the list of simple but effective skills that could be used to control active bleeding in an emergency. It also became clear that time was a critical factor, and outcomes were directly related to how quickly bleeding control was achieved. These findings helped establish the bystander as necessary in saving lives due to severe bleeding. The curriculum was developed into what is known as the Bleeding Control Basic course (B-CON), released to the public in 2014, which is the foundation of today’s Stop The Bleed course. 

This bill requires LEAs to provide school personnel, at least once a year, contact information for training in the use of the trauma kit by certain entities. Traditionally when the Legislature has permitted the administration of medication on school campuses, the CDE is tasked to develop minimum training standards and best practices in consultation with appropriate stakeholders to ensure LEAs are equipped with appropriate information designed to properly engage with students. The author may wish to consider adding language to ensure that CDE develops appropriate minimum standards of training and best practices relative to the use of trauma kits.

It should also be noted that when the Legislature permits the administration of medication on school campuses, school personnel have the option to opt- in to provide medical assistance. While the provisions of the bill require LEAs to provide training information to school personnel regarding the use of a trauma kit, it is unclear if school personnel must use the trauma kit in the event of an emergency. The author may wish to consider whether school personnel should have the ability to opt-in to use a trauma kit.

1. Related Legislation.

AB 2217 (Melendez), Chapter 812, Statutes of 2014, authorizes schools to solicit and receive non-state funds for automatic external defibrillator (AED), and clarifies those schools and school employees are not civilly liable when acting in good faith.

AB 71 (Rodriguez, 2023) would require commencing with the 2025–26 school year, the governing board of a school district or the governing body of a charter school that requires a course in health education for graduation from high school to include in that course instruction in bleeding control.

SB 643 (Wilk, 2023) would a) establishes the School Safety Division within the California Department of Education (CDE); b) requires the Division to administer the Safe-To-Tell Program to receive anonymous reports of dangerous, violent, or unlawful activity; c) requires local educational agencies (LEAs) to establish school-based teams of at least three members of the administrative staff at each of its schools to receive notice of reports; and d) establishes the Safe-To-Tell Program Advisory Committee and requires the advisory committee to provide an annual report to the Governor and Legislature. This bill is currently in Senate Education Committee.

AB 1747 (Rodriguez) Chapter 806, Statutes of 2018, expanded the required elements of school safety plans, including procedures to respond to active shooter situations, required schools to conduct annual active shooter drills, and required the CDE to provide additional guidance and oversight of safety plans.

AB 2260 (Rodriguez) Chapter 586, Statutes 2022, requires certain buildings constructed on or after January 1, 2023, with an occupancy of 200 or more to have at least six trauma kits on the premises of the building or facility.

SB 63 (Price, 2011) would have required each school with any of grades 9-12 to have an automatic external defibrillator in a centralized location on campus and at athletic events, prepare an emergency preparedness plan and require anyone expected to use a defibrillator to complete specified training. This bill was held in Senate Appropriations Committee.

SUPPORT

Arcadia Police Officers' Association
Burbank Police Officers' Association
California Coalition of School Safety Professionals
Claremont Police Officers Association
Corona Police Officers Association
Culver City Police Officers' Association
Deputy Sheriffs' Association of Monterey County
Fullerton Police Officers' Association
Los Angeles School Police Officers Association
Murrieta Police Officers' Association
Newport Beach Police Association
Palos Verdes Police Officers Association
Placer County Deputy Sheriffs' Association
Pomona Police Officers' Association
Riverside Police Officers Association
Riverside Sheriffs' Association
Santa Ana Police Officers Association
Upland Police Officers Association

OPPOSITION

None received

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