The Alabama Senate Health Committee gave a favorable report to legislation from the Alabama Epilepsy Foundation to train teachers, school administrators and support staff to administer medication to students suffering from seizures.
House Bill 76, the Seizure Safe Schools Act, is sponsored by state Rep. Thomas Jackson, D-Thomasville.
The Senate Health Committee held a public hearing on HB76 prior to the vote. Chairman Jim McClendon, R-Springville, gave both sides 10 minutes to present their case for and against the proposed legislation.
This legislation was passed out of the Alabama House of Representatives last year, but the session was interrupted by the COVID-19 shutdown before the legislation could pass the Alabama Senate.
“Today we just want to bring forth this bill and let you know that there is a need in the community,” Jackson said. “I am a retired teacher working with special ed.”
Jackson said that in his career students had episodes “where people did not know what to do.”
HB76 authorizes schools to provide training to school personnel who can administer medication to stop the seizures.
According to the Alabama Epilepsy Foundation, the Seizure Safe Schools Act has three components included in the bill: Provide school personnel and school nurses with seizure detection and first aid response training; Mandate Seizure Action Plans be included into a student’s individual health plan and on file for every student diagnosed with epilepsy or a seizure disorder, and require those plans be available to all personnel responsible for the student; and Ensure the administration of medications approved by the U.S. Food & Drug Administration.
Sara Franklin is the executive director of the Alabama Epilepsy Foundation.
“I developed seizures myself after I turned thirty and had my first child,” Franklin said. “There are more than 54,000 people in the state of Alabama with epilepsy and 7,500 children. They spend a third of their daily lives in school.”
This trains people at the school so that they know what to do and how to respond to a student during a seizure. This has passed in six states so far. It passed unanimously in the House.
“The training is available online, or the Foundation can come out to the school to provide training,” Franklin said.
Dr. Kathryn Lalor is a pediatric neurologist from Children’s of Alabama.
“I suffered from epilepsy as a child,” Lalor said. “Many schools do not have a school nurse.”
“Prolonged seizures can cause loss of respiratory function, prolonged hospitalizations, and even death,” Lalor said. “We hope this bill can help smaller school systems where nurses are not always widely available as well as during sports practices, and on school buses.”
Lalor explained how the medication works.
“You put this in the child’s nose and push this button,” Lalor demonstrated. “We really must do something to address seizures in schools.”
“Frankly, I am more concerned about the loss of respiratory function from untreated seizures than I am about side effects,” Lalor told the committee.
Nancy Tindell, the lead school nurse with the Geneva County School System, said that there are only one or two school nurses in many Alabama school systems, especially in rural schools.
While it would be ideal to have this administered “by a school nurse, often we are not available,” Tindell said.
“This is a nasally administered medication,” Tindell said. “It greatly helps students experiencing seizures. We delegate epipen injections and diabetes medication including insulin and glucagon mixing. That is more complicated than this is. Nurses are not always on hand and it is not always feasible to wait on EMS services.”
Tindell said that passage of this legislation “will ensure that students are safer on campus.”
Alabama State Superintendent of Education Dr. Eric Mackey announced his support for the legislation in a press release from the Alabama Epilepsy Foundation.
“For students living with epilepsy, it is important that schools are well-equipped with the tools necessary to provide a safe and enriching environment,” said Dr. Mackey. “Seizure Safe Schools will raise awareness and implement a uniform standard of care and response across the state so that students have access to the care they need and reach their full academic potential.”
Kristine McClary spoke in opposition to the legislation. She is representing the Alabama Association of School Nurses.
“These are controlled substances that need to be kept locked up,” McClary said. “The side effects are very dangerous.”
“Why should we delegate this medication to non-licensed medication assistants,” McClary said. “Who are we talking about ? Teachers, bus drivers, and aids who do not even have to have a high school diploma?”
“Someone else will be doing the administering, but I am responsible for the outcomes?” McClary said. “Every child is different, every situation is different. Who is making the judgement call on when that medication is administered? What is happening to the child’s vital signs? We are talking about a bus driver who has forty other kids to monitor. This is a task that should not be delegated.”
“Not all children who have seizures have this medication,” McClary said. “If there is an issue with not having a school nurse, then that is a different issue and go get a nurse.”
Liberty Duke said, “There is a difference between medical personnel and persons assigned to administer medication.”
Duke played a video of a child in Georgia having a seizure and a school bus driver trying to assist the child to no good effect.
“You don’t do CPR to a child with a seizure,” Franklin said in response. “Georgia does not have seizure safe training. Thank you for showing that. It proves my point.”
Sen. Larry Stutts, R-Sheffield, asked, “Who would be liable?”
Jackson said, “The school system would be liable because the school administered the medication.”
Sen. Will Barfoot, R-Pike Road, said that he had a son with diabetes and the possibility of diabetic reactions, ”And I have had experience with Narcan and training law enforcement to use it. That has saved lives.”
Dr. Lalor said, “A five to ten minute seizure can express
Sen. Linda Coleman Madison, D-Birmingham, said, “I used to be a special ed teacher and there was all kinds of medication that I was given to administer. The school does not prescribe medication the children’s doctor does.”
“It comes with a prescribed dose,” Coleman-Madison said. “We know that there are areas out there not just in rural areas but also in urban areas where there is not a school nurse present.”
Franklin said that this medication would only be used in an emergency and only for children where it has been prescribed by their doctors.
“Even if we did have a nurse in every school we would still want this bill passed,” Franklin said.
“Everyone should be trained, even school bus drivers,” Sen. Coleman-Madison said. “I think it is a great bill.”
Sen. Donnie Chesteen, R-Geneva, said, “Being a former coach and an educator I do understand that you are fortunate to have a school nurse or two in a school system. They are spread very thin.”
Sen. Garlan Gudger, R-Cullman, said, “I don’t think this replaces the needs for school nurses. I wish Mr Chairman that there was a bill coming up funding more school nurses.”
The committee voted to give the HB76 a favorable report on an 8 to 3 vote. It can now be considered by the full Alabama Senate. It has already passed the House of Representatives on a 102 to 0 vote.
Thursday will be day 18 of the 2021 Alabama regular legislative session.