Senate File 368 - Introduced SENATE FILE 368 BY COMMITTEE ON EDUCATION (SUCCESSOR TO SF 111) A BILL FOR An Act relating to school personnel training, including by 1 implementing provisions related to emergency care planning, 2 authorizations for assisting, and limitations of liability 3 concerning students with epilepsy or seizure disorder, and 4 requiring the department of education to convene a health 5 care-related training for school personnel work group. 6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 7 TLSB 2188SV (2) 91 jda/jh

S.F. 368 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 para-educators. 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 2025, 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 2188SV (2) 91 jda/jh 1/ 10

S.F. 368 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, 2026, 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 2188SV (2) 91 jda/jh 2/ 10

S.F. 368 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 10A.711, 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 2188SV (2) 91 jda/jh 3/ 10

S.F. 368 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 school 9 acting reasonably, in good faith, and in compliance with a 10 student’s individual health plan and seizure action plan shall 11 not be liable for any claim for injuries or damages arising 12 from actions taken to assist a student with the student’s needs 13 related to epilepsy or a seizure disorder. 14 Sec. 2. DEPARTMENT OF EDUCATION —— HEALTH CARE-RELATED 15 TRAINING FOR SCHOOL PERSONNEL WORK GROUP. 16 1. The department of education shall convene and provide 17 administrative support to a health care-related training 18 for school personnel work group. The work group shall 19 review and develop a plan to ensure Iowa educators have the 20 health care training necessary to perform their duties and 21 responsibilities, and shall consider and submit recommendations 22 for delivery and implementation of training required under 23 state law or rule. 24 2. The work group shall include all of the following: 25 a. (1) Two members who are staff members from the 26 department of education, one of whom shall be an administrative 27 consultant in the bureau of nutrition and health services. 28 A member appointed under this subparagraph shall coordinate 29 the work group and act as chairperson for the organizational 30 meeting. 31 (2) One member who is a staff member from the Iowa 32 department of health and human services. 33 b. Members who shall represent each of the following: 34 (1) One member from a statewide organization representing 35 -4- LSB 2188SV (2) 91 jda/jh 4/ 10

S.F. 368 teachers. 1 (2) One member from a statewide organization representing 2 school board members. 3 (3) One member from a statewide organization representing 4 school administrators. 5 (4) One member from a statewide organization representing 6 authorities in charge of accredited nonpublic schools. 7 (5) One member representing the area education agencies. 8 (6) One member from a statewide organization representing 9 physicians. 10 (7) One member from a statewide organization representing 11 athletic trainers. 12 (8) One member from a statewide organization representing 13 emergency management services. 14 (9) One member from a statewide organization representing 15 health care organizations. 16 (10) One member from a statewide organization representing 17 school nurses. 18 3. Any expenses incurred by a member of the work group 19 shall be the responsibility of the individual member or the 20 respective entity represented by the member. 21 4. The director of the department of education or the 22 director’s designee shall compile and provide to the work group 23 a list of, and the purposes for, the health care training 24 programs that school personnel are required to complete, as 25 well as any requirements school personnel must meet following 26 such training, in order be in compliance with state law or 27 administrative rule. 28 5. The work group shall do all of the following: 29 a. Identify which trainings can be best provided over the 30 internet, and how such training can be rotated on a five-year 31 basis for school personnel. 32 b. Develop a plan for a regular cycle of health care-related 33 training for school personnel review, with the goal of removing 34 or modifying training or training programs that are no longer 35 -5- LSB 2188SV (2) 91 jda/jh 5/ 10

S.F. 368 relevant, and identifying less costly and more efficient 1 options that still provide the appropriate level of training to 2 school personnel. 3 c. Standardize the process of establishing new training 4 requirements in state law or rule to manage stakeholder 5 expectations relating to the timeline for establishing the 6 requirements. 7 d. Create an ongoing review process to find efficiencies, 8 identify training options that better utilize time and 9 financial resources, and offer a continuous improvement model 10 for the system moving forward. 11 e. Study and make any recommended changes on rules adopted 12 by the state board of education under 281 IAC ch. 14, relating 13 to individual health plans prepared for students with various 14 health conditions. 15 f. Ensure a public comment process for patient advocacy 16 groups and parents to provide input on the recommendations of 17 the work group. 18 6. If the work group recommends elimination or significant 19 modification of certain health care-related training for 20 school personnel, the department of education shall identify 21 stakeholders who would potentially be affected by such 22 change, and shall invite representatives from organizations 23 representing such stakeholders to submit comments before or 24 at an upcoming work group meeting before the work group makes 25 final recommendations. 26 7. The department of education shall compile the work 27 group’s findings and recommendations and shall submit the 28 compilation, including any proposal for legislation, in a 29 report to the general assembly, the governor, and the state 30 board of education by December 1, 2025. 31 EXPLANATION 32 The inclusion of this explanation does not constitute agreement with 33 the explanation’s substance by the members of the general assembly. 34 This bill relates to school personnel training, including 35 -6- LSB 2188SV (2) 91 jda/jh 6/ 10

S.F. 368 by implementing provisions related to emergency care planning, 1 authorizations for assisting, and limitations of liability 2 concerning students with epilepsy or seizure disorder, and 3 requires the department of education to convene a health 4 care-related training for school personnel work group. 5 The bill creates definitions for “individual health plan”, 6 “school nurse”, “school personnel”, and “seizure action plan”. 7 The bill requires by the start of the school year beginning 8 July 1, 2025, for the board of directors of each school 9 district and the authorities in charge of each accredited 10 nonpublic school to have at least one school employee at each 11 school who has met the training requirements necessary to 12 administer or assist with the self-administration of a seizure 13 rescue medication or medication prescribed to treat seizure 14 disorder symptoms and approved by the United States food and 15 drug administration and a manual dose of prescribed electrical 16 stimulation using a vagus nerve stimulator magnet approved by 17 the United States food and drug administration. The presence 18 of a school nurse employed full-time by a school who assumes 19 responsibility for the administration of seizure medications 20 and the administration oversight of vagus nerve stimulation 21 fulfills such requirements. These requirements do not require 22 school personnel, other than a school nurse, to administer a 23 suppository to a student. 24 The bill requires by December 31, 2026, each public school 25 and each accredited nonpublic school to provide training to all 26 school personnel on how to recognize the signs and symptoms of 27 seizures and the appropriate steps for seizure first aid. 28 The bill requires each public school and each accredited 29 nonpublic school to have school personnel responsible for the 30 supervision or care of students to undergo seizure recognition 31 and first aid training on a biennial basis. 32 The bill requires any training programs or guidelines 33 adopted by a state agency for the training of school personnel 34 in the health care needs of students diagnosed with a seizure 35 -7- LSB 2188SV (2) 91 jda/jh 7/ 10

S.F. 368 disorder to be consistent with training programs and guidelines 1 developed by the epilepsy foundation of America or any 2 successor organization. 3 The bill authorizes schools and the department of education 4 to require additional seizure disorder training. 5 The bill requires, prior to school personnel administering 6 medication prescribed to treat a student’s seizure disorder 7 symptoms, a school, or accredited nonpublic school to obtain 8 signed and dated authorization from the student’s parent or 9 guardian that authorizes a person trained to administer or 10 assist with the self-administration of a medication approved by 11 the United States food and drug administration to treat seizure 12 disorder symptoms and a manual dose of prescribed electrical 13 stimulation using a vagus nerve stimulator magnet approved by 14 the United States food and drug administration in accordance 15 with the school’s policy and procedures. Such authorizations 16 are effective for the school year in which the authorization is 17 granted and must be renewed each school year. 18 The bill requires, upon the request of a student’s parent or 19 guardian, a school to collaborate with the parent or guardian 20 and relevant licensed health care professionals, including 21 the school nurse or education team, in the development of 22 an individual health plan, and a seizure action plan if 23 appropriate, consistent with rules adopted by the state 24 board of education. The individual health plan or seizure 25 action plan must be based on the student’s needs and may 26 include but is not limited to assessment, nursing diagnosis, 27 outcomes, planning, interventions, student goals, and a plan 28 for emergencies to provide direction in managing the student’s 29 health needs. The plan must be updated consistent with 30 timelines for individual health plans and with rules adopted by 31 the state board of education. 32 The bill requires each school to maintain all authorizations 33 to allow seizure assistance, individual health plans, and 34 seizure action plans for enrolled students on file in the 35 -8- LSB 2188SV (2) 91 jda/jh 8/ 10

S.F. 368 office of the school nurse or school administrator. 1 The bill requires each school to distribute information 2 regarding a student’s seizure action plan to any school 3 personnel responsible for the supervision or care of the 4 student. 5 The bill limits the requirements relating to authorizations, 6 individual health plans, and seizure action plans for students 7 to schools that either have an enrolled student with a known 8 diagnosis of epilepsy or seizure disorder or an enrolled 9 student who is known to currently be taking medication 10 prescribed by a health care provider and approved by the United 11 States food and drug administration to treat seizure disorder 12 symptoms. 13 The bill directs the state board of education to adopt rules 14 to establish a seizure education program for the purpose of 15 providing school districts and accredited nonpublic schools an 16 age-appropriate program on seizures and seizure disorders. The 17 seizure education program shall be consistent with guidelines 18 published by the epilepsy foundation of America or any 19 successor organization, and participation in the program shall 20 be optional. 21 The bill makes a school, a school employee, or an agent of 22 a school acting reasonably, in good faith, and in compliance 23 with a student’s individual health plan and seizure action 24 plan immune from liability for any claim for injuries or 25 damages arising from actions taken to assist a student with the 26 student’s needs related to epilepsy or a seizure disorder. 27 The bill requires the department of education to convene 28 and provide administrative support to a health care-related 29 training for school personnel group. The bill requires 30 the group to review and develop a plan to ensure that Iowa 31 educators have the health care training necessary to perform 32 their duties and to submit recommendations for delivery 33 and implementation of training required under state law 34 or rule. The bill specifies the members the group shall 35 -9- LSB 2188SV (2) 91 jda/jh 9/ 10