S.F. 483 Section 1. NEW SECTION . 280.13D Seizure action plan and 1 training requirements. 2 1. For the purposes of this section, unless the context 3 otherwise requires: 4 a. “Individual health plan” means the confidential, written, 5 preplanned, and ongoing special health service developed for a 6 student who requires such service to be incorporated with the 7 student’s educational program. 8 b. “School nurse” means a registered nurse holding current 9 licensure recognized by the board of nursing who practices in 10 the school setting to promote and protect the health of the 11 school population by using knowledge from the nursing, social, 12 and public health sciences. 13 c. “School personnel” means principals, guidance counselors, 14 teachers, and other relevant employees who have direct contact 15 with and supervise children, including school bus drivers and 16 paraeducators. 17 d. “Seizure action plan” means a written set of instructions 18 designed to direct caregivers and staff to intervene in the 19 event of a seizure occurrence and is considered a plan for 20 emergencies as a part of an individual health plan. 21 2. a. Starting with the school year beginning July 1, 22 2024, the board of directors of each school district and the 23 authorities in charge of each accredited nonpublic school shall 24 have at least one school employee at each school who has met 25 the training requirements necessary to administer or assist 26 with the self-administration of all of the following: 27 (1) A medication approved by the United States food and 28 drug administration to treat seizure disorder symptoms or 29 a medication approved by the United States food and drug 30 administration as a seizure rescue medication. 31 (2) A manual dose of prescribed electrical stimulation 32 using a vagus nerve stimulator magnet approved by the United 33 States food and drug administration. 34 b. The presence of a school nurse employed full-time by 35 -1- LSB 2015SV (1) 90 dg/jh 1/ 7

S.F. 483 a school district or accredited nonpublic school who assumes 1 responsibility for the administration of seizure medications 2 and the administration oversight of vagus nerve stimulation 3 shall fulfill the requirements of paragraph “a” . This section 4 shall not be construed to require school personnel, other than 5 a school nurse, to administer a suppository to a student. 6 3. a. On or before December 31, 2025, each public school 7 and each accredited nonpublic school shall provide training to 8 all school personnel on how to recognize the signs and symptoms 9 of seizures and the appropriate steps for seizure first aid. 10 b. Each public school and each accredited nonpublic school 11 shall require school personnel responsible for the supervision 12 or care of students to undergo seizure recognition and first 13 aid training on a biennial basis. 14 4. Any training programs or guidelines adopted by a state 15 agency for the training of school personnel in the health care 16 needs of students diagnosed with a seizure disorder shall be 17 consistent with training programs and guidelines developed 18 by the epilepsy foundation of America or any successor 19 organization. 20 5. This section shall not be construed to limit the 21 authority of a school district, an accredited nonpublic school, 22 or the department of education to require additional seizure 23 disorder training. 24 6. a. Prior to school personnel administering medication 25 prescribed to treat a student’s seizure disorder symptoms, a 26 school or accredited nonpublic school shall obtain a signed and 27 dated authorization from the student’s parent or guardian that 28 authorizes a person who meets the requirements of subsection 2 29 to administer medication in accordance with the school’s policy 30 and procedures. 31 b. Authorizations required pursuant to paragraph “a” shall 32 be effective for the school year in which the authorization is 33 granted and must be renewed each school year. 34 7. Upon the request of a student’s parent or guardian, 35 -2- LSB 2015SV (1) 90 dg/jh 2/ 7

S.F. 483 a school district or accredited nonpublic school shall 1 collaborate with the parent or guardian and relevant licensed 2 health care professionals, including the school nurse or 3 education team, in the development of an individual health 4 plan, and a seizure action plan if appropriate, consistent 5 with rules adopted by the state board of education. The 6 individual health plan or seizure action plan shall be based 7 on the student’s needs and may include but is not limited 8 to assessment, nursing diagnosis, outcomes, planning, 9 interventions, student goals, and a plan for emergencies to 10 provide direction in managing the student’s health needs. The 11 plan shall be updated consistent with timelines for individual 12 health plans and with rules adopted by the state board of 13 education. 14 8. a. Each school district and each accredited nonpublic 15 school shall maintain all authorizations pursuant to subsection 16 6, individual health plans, and seizure action plans for 17 enrolled students on file in the office of the school nurse or 18 school administrator. 19 b. Each school district and each accredited nonpublic 20 school shall distribute information regarding a student’s 21 seizure action plan to any school personnel responsible for the 22 supervision or care of the student. 23 9. The requirements of subsections 6, 7, and 8 shall only 24 apply to a school district or accredited nonpublic school that 25 has either of the following: 26 a. An enrolled student with a known diagnosis of epilepsy or 27 seizure disorder. 28 b. An enrolled student who is known to currently be taking 29 medication prescribed by a health care provider as that term 30 is defined in section 135.61, and approved by the United 31 States food and drug administration to treat seizure disorder 32 symptoms. 33 10. The state board of education shall adopt rules to 34 establish a seizure education program for the purpose of 35 -3- LSB 2015SV (1) 90 dg/jh 3/ 7

S.F. 483 providing school districts and accredited nonpublic schools an 1 age-appropriate program on seizures and seizure disorders. The 2 seizure education program shall be consistent with guidelines 3 published by the epilepsy foundation of America or any 4 successor organization, and participation in the program shall 5 be optional. 6 11. A school district or accredited nonpublic school, an 7 employee of a school district or accredited nonpublic school, 8 or an agent of a school district or accredited nonpublic 9 school acting in good faith and in compliance with a student’s 10 individual health plan and seizure action plan shall not be 11 liable for any claim for injuries or damages arising from 12 actions taken to assist a student with the student’s needs 13 related to epilepsy or a seizure disorder. 14 EXPLANATION 15 The inclusion of this explanation does not constitute agreement with 16 the explanation’s substance by the members of the general assembly. 17 This bill relates to school personnel training, emergency 18 care planning, authorizations for assisting, and limitations 19 of liability concerning students with epilepsy or a seizure 20 disorder. 21 The bill creates definitions for “individual health plan”, 22 “school nurse”, “school personnel”, and “seizure action plan”. 23 The bill requires by the start of the school year beginning 24 July 1, 2024, for the board of directors of each school 25 district and the authorities in charge of each accredited 26 nonpublic school to have at least one school employee at each 27 school who has met the training requirements necessary to 28 administer or assist with the self-administration of a seizure 29 rescue medication or medication prescribed to treat seizure 30 disorder symptoms and approved by the United States food and 31 drug administration and a manual dose of prescribed electrical 32 stimulation using a vagus nerve stimulator magnet approved by 33 the United States food and drug administration. The presence 34 of a school nurse employed full-time by a school who assumes 35 -4- LSB 2015SV (1) 90 dg/jh 4/ 7

S.F. 483 responsibility for the administration of seizure medications 1 and the administration oversight of vagus nerve stimulation 2 fulfills such requirements. These requirements do not require 3 school personnel, other than a school nurse, to administer a 4 suppository to a student. 5 The bill requires by December 31, 2025, each public school 6 and each accredited nonpublic school to provide training to all 7 school personnel on how to recognize the signs and symptoms of 8 seizures and the appropriate steps for seizure first aid. 9 The bill requires each public school and each accredited 10 nonpublic school to have school personnel responsible for the 11 supervision or care of students to undergo seizure recognition 12 and first aid training on a biennial basis. 13 The bill requires any training programs or guidelines 14 adopted by a state agency for the training of school personnel 15 in the health care needs of students diagnosed with a seizure 16 disorder to be consistent with training programs and guidelines 17 developed by the epilepsy foundation of America or any 18 successor organization. 19 The bill authorizes schools and the department of education 20 to require additional seizure disorder training. 21 The bill requires, prior to school personnel administering 22 medication prescribed to treat a student’s seizure disorder 23 symptoms, a school, or accredited nonpublic school to obtain 24 signed and dated authorization from the student’s parent or 25 guardian that authorizes a person trained to administer or 26 assist with the self-administration of a medication approved by 27 the United States food and drug administration to treat seizure 28 disorder symptoms and a manual dose of prescribed electrical 29 stimulation using a vagus nerve stimulator magnet approved by 30 the United States food and drug administration in accordance 31 with the school’s policy and procedures. Such authorizations 32 are effective for the school year in which the authorization is 33 granted and must be renewed each school year. 34 The bill requires, upon the request of a student’s parent or 35 -5- LSB 2015SV (1) 90 dg/jh 5/ 7

S.F. 483 guardian, a school to collaborate with the parent or guardian 1 and relevant licensed health care professionals, including 2 the school nurse or education team, in the development of 3 an individual health plan, and a seizure action plan if 4 appropriate, consistent with rules adopted by the state 5 board of education. The individual health plan or seizure 6 action plan must be based on the student’s needs and may 7 include but is not limited to assessment, nursing diagnosis, 8 outcomes, planning, interventions, student goals, and a plan 9 for emergencies to provide direction in managing the student’s 10 health needs. The plan must be updated consistent with 11 timelines for individual health plans and with rules adopted by 12 the state board of education. 13 The bill requires each school to maintain all authorizations 14 to allow seizure assistance, individual health plans, and 15 seizure action plans for enrolled students on file in the 16 office of the school nurse or school administrator. 17 The bill requires each school to distribute information 18 regarding a student’s seizure action plan to any school 19 personnel responsible for the supervision or care of the 20 student. 21 The bill limits the requirements relating to authorizations, 22 individual health plans, and seizure action plans for students 23 to schools that either have an enrolled student with a known 24 diagnosis of epilepsy or seizure disorder or an enrolled 25 student who is known to currently be taking medication 26 prescribed by a health care provider and approved by the United 27 States food and drug administration to treat seizure disorder 28 symptoms. 29 The bill directs the state board of education to adopt rules 30 to establish a seizure education program for the purpose of 31 providing school districts and accredited nonpublic schools an 32 age-appropriate program on seizures and seizure disorders. The 33 seizure education program shall be consistent with guidelines 34 published by the epilepsy foundation of America or any 35 -6- LSB 2015SV (1) 90 dg/jh 6/ 7

S.F. 483 successor organization, and participation in the program shall 1 be optional. 2 The bill makes a school, a school employee, or an agent of a 3 school acting in good faith and in compliance with a student’s 4 individual health plan and seizure action plan immune from 5 liability for any claim for injuries or damages arising from 6 actions taken to assist a student with the student’s needs 7 related to epilepsy or a seizure disorder. 8 -7- LSB 2015SV (1) 90 dg/jh 7/ 7