Article 2 - Employment of Medical Personnel

California Education Code — §§ 49422-49429.5

Sections (18)

Amended by Stats. 1996, Ch. 661, Sec. 1. Effective January 1, 1997.

(a)No physician, psychiatrist, oculist, dentist, dental hygienist, optometrist, otologist, podiatrist, audiologist, or nurse not employed in that capacity by the State Department of Health Services, shall be, nor shall any other person be, employed or permitted to supervise the health and physical development of pupils unless he or she holds a services credential with a specialization in health or a valid credential issued prior to the operative date of Section 25 of Chapter 557 of the Statutes of 1990.

(b)Any psychologist employed pursuant to Section 49400 and this article shall hold a school psychologist credential, a general pupil personnel services credential authorizing service as a school psychologist, a standard designated services credential with a specialization in pupil personnel services authorizing service as a psychologist, or a services credential issued by the State Board of Education or Commission on Teacher Credentialing.

(c)The services credential with a specialization in health authorizing service as a school nurse shall not authorize teaching services unless the holder also completes the requirements for a special class authorization in health in a program that is approved by the commission.

(d)No physician employed by a district to perform medical services pursuant to Section 44873, who meets the requirements of that section, shall be required to hold a credential issued by the State Board of Education or commission.

(e)(1) Notwithstanding Section 2910 of the Business and Professions Code, no person who is an employee of a school district shall administer psychological tests or engage in other psychological activities involving the application of psychological principles, methods, or procedures unless at least one of the following applies:

(A) The person holds a valid and current credential as a school psychologist issued by the Commission on Teacher Credentialing that permits the holder to administer psychological testing to, or engage in psychological activities with, pupils.

(B) Psychological assistants or school psychology interns perform the testing or activities under the supervision of a person who holds a credential described in subparagraph (A).

(C) This section does not preclude appropriately credentialed school personnel including, but not limited to, holders of a pupil personnel services credential, health services credential, or special education personnel, from performing the duties consistent with the training standards established by the Commission on Teacher Credentialing for the credential held.

(2)The application of these principles and methods includes, but is not restricted to, procedures on interviewing, psychoeducational assessment, diagnosis of specific learning and behavioral disabilities, and amelioration of learning and behavioral problems of individuals or groups.

(3)The person conducting a test or other assessment shall be qualified in accordance with the requirements established by the producer of the assessment instrument and shall follow all ethical requirements for the use of the test or assessment as prescribed by the appropriate professional organization.

(f)This section shall not be construed to affect any lawfully contracted mental health professional licensed pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code from performing services within the scope of his or her employment.

§ 49423

Amended by Stats. 2025, Ch. 322, Sec. 3. (SB 568) Effective January 1, 2026.

(a)Notwithstanding Section 49422, any pupil who is required to take, during the regular schoolday, medication prescribed for the pupil by a physician and surgeon or ordered for the pupil by a physician assistant practicing in compliance with Chapter 7.7 (commencing with Section 3500) of Division 2 of the Business and Professions Code, may be assisted by the school nurse or other designated school personnel, or may carry and self-administer a prescription epinephrine delivery system, if the local educational agency receives the appropriate written statements identified in subdivision (b).

(b)(1) In order for a pupil to be assisted by a school nurse or other

designated school personnel pursuant to subdivision (a), the local educational agency shall obtain both a written statement from the physician and surgeon or physician assistant 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 indicating the desire that the local educational agency assist the pupil in the matters set forth in the statement of the physician and surgeon or physician assistant.

(2)In order for a pupil to carry and self-administer a prescription

epinephrine delivery system pursuant to subdivision (a), the local educational agency shall obtain both a written statement from the physician and surgeon or physician assistant detailing the name of the medication, method, amount, and time schedules by which the medication is to be taken, and confirming that the pupil is able to self-administer the epinephrine delivery system, and a written statement from the parent, foster parent, or guardian of the pupil consenting to the self-administration, providing a release for the school nurse or other designated school personnel to consult with the health care provider of the pupil regarding any questions that may arise with regard to the medication, and releasing the local educational agency and school personnel from civil liability if the self-administering pupil suffers an adverse reaction as a result of self-administering medication pursuant

to this paragraph.

(3)The written statements specified in this subdivision shall be provided at least annually and more frequently if the medication, dosage, frequency of administration, or reason for administration changes.

(c)A pupil may be subject to disciplinary action pursuant to Section 48900 if that pupil uses an epinephrine delivery system in a manner other than as prescribed.

(d)For purposes of this section, “local educational agency” means a school district, county office of education, or charter school.

§ 49423.1

Amended by Stats. 2019, Ch. 101, Sec. 2. (AB 743) Effective January 1, 2020.

(a)Notwithstanding Section 49422, a pupil who is required to take, during the regular schoolday, medication prescribed for the pupil by a physician or surgeon, may 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 statements specified in subdivision (b).

(b)(1) In order for a pupil to be assisted by a school nurse or other designated school personnel pursuant to subdivision (a), the school district shall obtain both a 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.

(2)(A) In order for a pupil to carry and self-administer prescription inhaled asthma medication pursuant to subdivision (a), the school district shall obtain both a 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 confirming that the pupil is able to self-administer inhaled asthma medication, and a written statement from the parent, foster parent, or guardian of the pupil consenting to the self-administration,

providing a release for the school nurse or other designated school personnel to consult with the health care provider of the pupil regarding any questions that may arise with regard to the medication, and releasing the school district and school personnel from civil liability if the self-administering pupil suffers an adverse reaction by taking medication pursuant to this section.

(B)(i) A school district shall accept the written statement from a physician or surgeon, as specified in this paragraph, from a physician or surgeon who is contracted with a health plan licensed pursuant to Section 1351.2 of the Health and Safety Code.

A written statement specified in this subparagraph shall be provided in both English and Spanish, and shall include the name and contact information for the physician or surgeon.

(ii) A school nurse or other school personnel shall not be subject to professional review, be liable in a civil action, or be subject to criminal prosecution for their acts or omissions relating to a pupil self-administering inhaled asthma medication in accordance with this subparagraph. A school district shall not be subject to civil liability if a pupil self-administering inhaled asthma medication in accordance with this subparagraph suffers an adverse reaction.

(3)The written statements specified in this subdivision shall be provided at

least annually and more frequently if the medication, dosage, frequency of administration, or reason for administration changes.

(c)A pupil may be subject to disciplinary action pursuant to Section 48900 if the pupil uses inhaled asthma medication in a manner other than as prescribed.

§ 49423.5

Amended by Stats. 2025, Ch. 582, Sec. 2. (SB 389) Effective January 1, 2026.

(a)Notwithstanding Section 49422, an individual with exceptional needs who requires specialized physical health care services, during the regular schoolday, may be assisted by any of the following individuals:

(1)Qualified persons who possess an appropriate credential issued pursuant to Section 44267 or 44267.5, or hold a valid certificate of public health nursing issued by the Board of Registered Nursing.

(2)Qualified designated school personnel trained in the administration of specialized physical health care if they perform those services under the supervision, as defined by Section 3051.12 of Title 5 of the California Code of Regulations, of a credentialed school nurse, public health

nurse, or licensed physician and surgeon and the services are determined by the credentialed school nurse or licensed physician and surgeon, in consultation with the physician treating the pupil, to be all of the following:

(A)Routine for the pupil.

(B)Pose little potential harm for the pupil.

(C)Performed with predictable outcomes, as defined in the individualized education program of the pupil.

(D)Do not require a nursing assessment, interpretation, or decisionmaking by the designated school personnel.

(3)For basic respiratory services authorized by subdivision (l) of Section 3765 of the Business and

Professions Code, a vocational nurse licensed by the Board of Vocational Nursing and Psychiatric Technicians of the State of California under the supervision of a credentialed school nurse.

(b)Specialized health care or other services that require medically related training shall be provided pursuant to the procedures prescribed by Section 49423.

(c)Persons providing specialized physical health care services shall also demonstrate competence in basic cardiopulmonary resuscitation and shall be knowledgeable of the emergency medical resources available in the community in which the services are performed.

(d)“Specialized physical health care services,” as used in this section, includes catheterization, gastric tube feeding, suctioning, or other services that require medically related

training.

(e)Regulations necessary to implement this section shall be developed jointly by the State Department of Education and the State Department of Health Care Services, and adopted by the state board.

(f)This section does not diminish or weaken any federal requirement for serving individuals with exceptional needs under the Individuals with Disabilities Education Act (20 U.S.C. Sec. 1400 et seq.), and its implementing regulations, and under Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. Sec. 794) and its implementing regulations.

(g)This section does not affect current state law or regulation regarding medication administration.

(h)It is the intent of the Legislature that this section not cause individuals with exceptional needs to

be placed at schoolsites other than those they would attend but for their needs for specialized physical health care services.

§ 49423.6

Added by Stats. 2000, Ch. 281, Sec. 2. Effective January 1, 2001.

(a)On or before June 15, 2001, the State Department of Education shall develop and recommend to the State Board of Education, and the board shall adopt regulations, regarding the administration of medication in the public schools pursuant to Section 49423. These regulations shall be developed in consultation with parents, representatives of the medical and nursing professions, and other individuals jointly designated by the Superintendent of Public Instruction, the Advisory Commission on Special Education established pursuant to Section 33590, and the Department of Health Services. The Board of Registered Nursing may designate a liaison to consult with the Board of Education in the adoption of these regulations.

(b)Any regulations adopted pursuant to this section shall be limited to addressing a situation where a pupil’s parent or legal guardian has initiated a request to have a local educational agency dispense medicine to a pupil, based on the written consent of the pupil’s parent or legal guardian, for a specified medicine with a specified dosage, for a specified period of time, as prescribed by a physician or other authorized medical personnel.

§ 49424

Enacted by Stats. 1976, Ch. 1010.

A school psychologist is a credentialed professional whose primary objective is the application of scientific principles of learning and behavior to ameliorate school-related problems and to facilitate the learning and development of children in the public schools of California.

To accomplish this objective the school psychologist provides services to children, teachers, parents, community agencies, and the school system itself. These services include:

(a)Consultation with school administrators concerning appropriate learning objectives for children, planning of developmental and remedial programs for pupils in regular and special school programs, and the development of educational experimentation and evaluation.

(b)Consultation with teachers in the development and implementation of classroom methods and procedures designed to facilitate pupil learning and to overcome learning and behavior disorders.

(c)Consultation with parents to assist in understanding the learning and adjustment processes of children.

(d)Consultation with community agencies, such as probation departments, mental health clinics, and welfare departments, concerning pupils who are being served by such community agencies.

(e)Consultation and supervision of pupil personnel services workers.

(f)Psychoeducational assessment and diagnosis of specific learning and behavioral disabilities, including, but not limited to, case study evaluation, recommendations for remediation or placement, and periodic reevaluation of such children.

(g)Psychological counseling of and other therapeutic techniques with children and parents, including parent education.

§ 49425

Enacted by Stats. 1976, Ch. 1010.

Notwithstanding the provisions of Section 49422, a licensed physician need not hold a credential if his sole service for a school district or county superintendent of schools is service as a member of a committee whose function is to consider written and oral information and reports concerning the pupil that are available to the committee and, upon the basis of such information and reports, to recommend the admission of the pupil to, or his discharge from, special schools and classes for exceptional children.

§ 49426

Amended by Stats. 1994, Ch. 172, Sec. 4. Effective January 1, 1995.

A school nurse is a registered nurse currently licensed under Chapter 6 (commencing with Section 2700) of Division 2 of the Business and Professions Code, and who has completed the additional educational requirements for, and possesses a current credential in, school nursing pursuant to Section 44877.

School nurses strengthen and facilitate the educational process by improving and protecting the health status of children and by identification and assistance in the removal or modification of health-related barriers to learning in individual children. The major focus of school health services is the prevention of illness and disability, and the early detection and correction of health problems. The school nurse is especially prepared and uniquely qualified in preventive health, health assessment, and referral procedures.

Nothing in this section shall be construed to limit the scope of professional practice or otherwise to change the legal scope of practice for any registered nurse or other licensed healing arts practitioner. Rather, it is the intent of the Legislature to provide positively for the health services, many of which may be performed in the public schools only by physicians and school nurses. School nurses may perform, if authorized by the local governing board, the following services:

(a)Conduct immunization programs pursuant to Section 49403 and assure that every pupil’s immunization status is in compliance with the law, including parental or guardian consent, and good health practice.

(b)Assess and evaluate the health and developmental status of pupils to identify specific physical disorders and other factors relating to the learning process, communicate with the primary care provider, and contribute significant information in order to modify the pupils’ educational plans.

(c)Interpret the health and developmental assessment to parents, teachers, administrators, and other professionals directly concerned with the pupil.

(d)Design and implement a health maintenance plan to meet the individual health needs of the students, incorporating plans directed by a physician.

(e)Refer the pupil and his or her parent or guardian to appropriate community resources for necessary services.

(f)Maintain communication with parents and all involved community practitioners and agencies to promote needed treatment and secure reports of findings pertinent to educational planning.

(g)Interpret medical and nursing findings appropriate to the student’s individual educational plan and make recommendations to professional personnel directly involved.

(h)Consult with, conduct in-service training to, and serve as a resource person to teachers and administrators, and act as a participant in implementing any section or sections of a comprehensive health instruction curriculum for students by providing current scientific information regarding nutrition, preventive dentistry, mental health, genetics, prevention of communicable diseases, self-health care, consumer education, and other areas of health.

(i)Counsel pupils and parents by:

(1)Assisting children and youth, parents, and school personnel in identifying and utilizing appropriate and mutually acceptable private and community health delivery services for professional care and remediation of defects.

(2)Counseling with parents, pupils and school staff regarding health-related attendance problems.

(3)Helping parents, school personnel and pupils understand and adjust to physical, mental and social limitations.

(4)Exploring with families and pupils, attitudes, information and values which affect their health behavior.

(j)Assist parents and pupils to solve financial, transportation and other barriers to needed health services.

The holder of a services credential with a specialization in health for a school nurse who also completes the requirements for a special class authorization in health in a program that is approved by the commission is authorized to teach classes on health in a preschool, kindergarten, grades 1 to 12, inclusive, and classes organized primarily for adults.

§ 49426.5

Added by Stats. 2023, Ch. 853, Sec. 1. (AB 1722) Effective January 1, 2024. Repealed as of January 1, 2029, by its own provisions.

(a)A licensed vocational nurse hired pursuant to this section shall be supervised by a credentialed school nurse who is employed as a school nurse at the same local educational agency or at another local educational agency.

(b)(1) If a local educational agency elects to hire a licensed vocational nurse to be supervised by a credentialed school nurse employed by another local educational agency, both local educational agencies shall enter into a written agreement containing all of the following:

(A) The duties of the credentialed school nurse and the licensed vocational nurse.

(B) A

communication policy delineating how the licensed vocational nurse and the credentialed school nurse are to communicate.

(D) The financial arrangement between the local educational agencies.

(E) The additional compensation for the credentialed school nurse to act as a supervisor.

(2)A local educational agency is only authorized to hire a licensed vocational nurse pursuant to this subdivision if a written agreement with another local educational agency is in place.

(c)(1) A local educational agency shall only hire a licensed vocational nurse pursuant to this section if a diligent search has been

conducted for a suitable credentialed school nurse each school year. A diligent search shall include, but is not limited to, distributing job announcements, contacting college and university placement centers, and advertising in print or electronic media. Copies of all recruitment efforts and the salary or salary range advertised as part of the recruitment efforts shall be retained by the employing agency.

(2)A local educational agency shall seek approval from its governing board or body before hiring a licensed vocational nurse pursuant to this section, including by submitting a declaration to its governing board or body containing all of the following:

(A)That the local educational agency made a diligent effort to recruit a credentialed school nurse with the proper qualifications for the opening.

(B)That the

effort to recruit a credentialed school nurse was not successful.

(C)That hiring a licensed vocational nurse is necessary to fulfill a critical need.

(3)A local educational agency electing to hire a licensed vocational nurse pursuant to this section shall certify to the department, upon penalty of perjury, that a diligent recruitment effort to hire a credentialed school nurse was made.

(d)Subdivision (a) shall not be interpreted to allow a licensed vocational nurse to go beyond the approved scope of practice pursuant to the Vocational Nursing Practice Act (Chapter 6.5 (commencing with Section 2840) of Division 2 of the Business and Professions Code).

(e)A licensed vocational nurse hired pursuant to this section shall only operate under the

supervision of a credentialed school nurse based on levels of supervision described in Section 3051.12 of Title 5 of the California Code of Regulations.

(f)County offices of education are encouraged to establish networks of credentialed school nurses for employment by local educational agencies that are not able to hire a credentialed school nurse. County offices of education are encouraged to provide mentoring opportunities for licensed vocational nurses.

(g)A local educational agency employing a credentialed school nurse who is supervising a licensed vocational nurse at another local educational agency pursuant to this section shall have indemnification for the supervisorial liability from the local educational agency employing the licensed vocational nurse.

(h)A credentialed school nurse who is supervising a

licensed vocational nurse at another local educational agency pursuant to this section shall have indemnification for the supervisorial liability from the local educational agency employing the licensed vocational nurse.

(i)If a local educational agency uses its authority pursuant to this section, the local educational agency shall report its use of that authority to the department.

(j)(1) On or before January 1, 2028, the department shall submit a report to the Legislature containing a list of the local educational agencies that have used their authority pursuant to this section.

(2)The report submitted pursuant to paragraph (1) shall be submitted in compliance with Section 9795 of the Government Code.

(k)As used in this

section, the following terms have the following meanings:

(1)“Credentialed school nurse” means only qualified persons who possess an appropriate credential issued pursuant to Section 44267.5.

(2)“Licensed vocational nurse” means a person licensed pursuant to the provisions of Chapter 6.5 (commencing with Section 2840) of Division 2 of the Business and Professions Code.

(3)“Local educational agency” means a school district, county office of education, or charter school.

(l)This section shall remain in effect only until January 1, 2029, and as of that date is repealed.

§ 49427

Amended by Stats. 1994, Ch. 922, Sec. 107. Effective January 1, 1995.

(a)It is the intent of the Legislature that the governing board of each school district and each county superintendent of schools maintain fundamental school health services at a level that is adequate to accomplish all of the following:

(1)Preserve pupils’ ability to learn.

(2)Fulfill existing state requirements and policies regarding pupils’ health.

(3)Contain health care costs through preventive programs and education.

(b)The Legislature finds and declares that the provision of these services may be in jeopardy due to the current caseloads in the public schools, and that failure to maintain adequate health services and standards will result in pupils’ poorer health and ability to learn.

§ 49428

Added by Stats. 2018, Ch. 484, Sec. 1. (AB 2022) Effective January 1, 2019.

(a)A school of a school district or county office of education and a charter school shall notify pupils and parents or guardians of pupils no less than twice during the school year on how to initiate access to available pupil mental health services on campus or in the community, or both, as follows:

(1)A school shall use at least two of the following methods to notify parents or guardians:

(A)Distributing the information in a letter electronically or in

hardcopy, including, but not limited to, through the postal service.

(B)Including the information in the parent handbook at the beginning of the school year in accordance with Section 48980.

(C)Posting the information on the school’s Internet Web site or social media Internet Web page.

(2)A school shall use at least two of the following methods to notify pupils:

(A)Distributing the information in a document or school publication electronically or in hardcopy.

(B)Including the information in pupil orientation materials at the beginning of the school year or in a pupil handbook.

(C)Posting the information on the school’s Internet Web site or social media Internet Web page.

(b)(1) A county may use funds from the Mental Health Services Act, enacted by the voters at the November 2, 2004, statewide general election as Proposition 63, to provide a grant to a school district or county office of education, or to a charter school, within the county, for purposes of funding the activities required pursuant to subdivision (a).

(2)A school district or county office of education, or a charter school, may apply to its respective county for a grant pursuant to paragraph (1).

§ 49428.1

Amended by Stats. 2024, Ch. 38, Sec. 56. (SB 153) Effective June 29, 2024.

(a)On or before June 1, 2025, the department shall develop model referral protocols for addressing pupil behavioral health concerns. In developing these protocols, the department shall consult with the State Department of Health Care Services, the members of the Student Mental Health Policy Workgroup, local educational agencies that have served as state or regional leaders in state or federal pupil behavioral health initiatives, county behavioral health programs, current classroom teachers and administrators, current schoolsite classified staff, current schoolsite staff who hold pupil personnel services credentials, current school nurses, current school counselors, and other professionals involved in pupil behavioral health as the department deems appropriate. The department shall also select at least one member of each of the

following groups to consult with in developing the protocols:

(1)Current high school pupils.

(2)Parents of current high school or middle school pupils.

(3)Parents of current elementary school pupils.

(b)These protocols shall be designed for use, on a voluntary basis, by schoolsites, school districts, county offices of education, charter schools, the California School for the Deaf, and the California School for the Blind, and by teacher, administrator, school counselor, pupil personnel services, and school nurse preparation programs operated by postsecondary educational institutions. The protocols shall do all of the following:

(1)Address the appropriate and timely referral by school

staff of pupils with behavioral health concerns.

(2)Reflect a multitiered system of support process and positive behavioral interventions and supports. These protocols are encouraged to be used in lieu of disciplinary actions, and pupils who may be the subject of disciplinary action should be able to access these protocols and should not be prohibited from accessing them.

(3)Be adaptable to varied local service arrangements for behavioral health services.

(4)(A) Reflect evidence-based and culturally appropriate approaches to pupil behavioral health referral without disciplinary actions.

(B)For purposes of this paragraph, “evidence-based” means peer-reviewed, scientific research evidence, including studies based on research

methodologies that control threats to both the internal and the external validity of the research findings.

(5)Address the inclusion of parents and guardians in the referral process.

(6)Be written to ensure clarity and ease of use by certificated and classified school employees.

(7)Reflect differentiated referral processes for pupils with disabilities and other populations for whom the referral process may be distinct.

(8)Be written to ensure that school employees act only within the authorization or scope of their credential or license. This section shall not be construed as authorizing or encouraging school employees to diagnose or treat youth behavioral health disorders unless they are specifically licensed and employed to do so.

(9)Be consistent with state activities conducted by the department in the administration of federally funded behavioral health programs.

(c)The department shall consider, when developing protocols under this section, the school behavioral health referral pathways toolkit developed by the Substance Abuse and Mental Health Services Administration of the United States Department of Health and Human Services.

(d)The department shall post the model referral protocols on its internet website so that they may be accessed and used by educational institutions specified in subdivision (b).

§ 49428.15

Amended by Stats. 2025, Ch. 241, Sec. 4. (SB 857) Effective January 1, 2026.

(a)For purposes of this section, the following definitions apply:

(1)“Evidence-based” means peer-reviewed, scientific research evidence, including studies based on research methodologies that control threats to both the internal and the external validity of the research findings.

(2)“Evidence-informed” means using research that is already available and has been tested for efficacy and effectiveness. This evidence is then combined with the experiences and expertise of the training program developers to best fit the population intended to be served.

(3)“Local educational agency” means a county office of education, school district, state special school, or charter school that serves pupils in any of grades 7 to 12, inclusive.

(4)“Youth behavioral health disorders” means pupil mental health and substance use disorders.

(5)“Youth behavioral health training” means training addressing the signs and symptoms of a pupil mental health or substance use disorder.

(b)The department shall, on or before January 1, 2023, recommend best practices, and identify evidence-based and evidence-informed training programs for schools to address youth behavioral health, including, but not necessarily limited to, staff and pupil training.

(c)In identifying one or more evidence-based or evidence-informed youth behavioral health training programs for use by local educational agencies to train school staff or pupils pursuant to subdivision (b), the department shall ensure that each training program meets all of the following requirements:

(1)Provides instruction on recognizing the signs and symptoms of youth behavioral health disorders, including common psychiatric conditions and substance use disorders such as opioid and alcohol abuse.

(2)Provides instruction on how school staff can best provide referrals to youth behavioral health services or other support to individuals in the early stages of developing a youth behavioral health disorder.

(3)Provides instruction on how to maintain pupil privacy and confidentiality in a manner consistent with federal and state privacy laws.

(4)Provides instruction on the safe de-escalation of crisis situations involving individuals with a youth behavioral health disorder.

(5)Is capable of assessing trainee knowledge before and after training is provided in order to measure training outcomes.

(6)Is administered by a nationally recognized training authority in youth behavioral health disorders or by a local educational agency.

(7)(A) Includes in-person and virtual training

with certified instructors who can recommend resources available in the community for individuals with a youth behavioral health disorder.

(B)For purposes of this paragraph, “certified instructors” means individuals who obtain or have obtained a certification to provide the selected youth behavioral health training.

(d)This section shall be implemented only to the extent that an appropriation is made in the annual Budget Act or another statute for these purposes.

§ 49428.16

Added by Stats. 2023, Ch. 856, Sec. 6. (SB 10) Effective January 1, 2024.

(a)It is the intent of the Legislature to assist local educational agencies in developing strategies for preventing pupil opioid overdoses, including synthetic opioids.

(b)The Legislature encourages county offices of education to establish a County Working Group on Fentanyl Education in Schools for the purposes of outreach, building awareness, and collaborating with local health agencies regarding fentanyl overdoses. A County Working Group on Fentanyl Education in Schools is encouraged to, at a minimum, include representatives of local educational agencies within the county and the county public health department.

(c)The department shall curate and maintain on its internet

website all of the following:

(1)Informational materials containing awareness and safety advice, for school staff, pupils, and parents or guardians of pupils, on how to prevent an opioid overdose and any relevant information developed by a County Working Group on Fentanyl Education in Schools established pursuant to subdivision (b).

(2)Resource information on an entity’s application process for the statewide standing order issued by the State Public Health Officer pursuant to Section 1714.22 of the Civil Code, and resource information on an entity’s participation in the Naloxone Distribution Project administered by the State Department of Health Care Services.

(3)Resource information on the provision of emergency naloxone hydrochloride or another opioid antagonist, as described in Section 49414.3.

(d)For purposes of this section, the following definitions apply:

(1)“Local educational agency” means a county office of education, school district, state special school, or charter school that serves pupils in any of grades 7 to 12, inclusive.

(2)“Opioid antagonist” means naloxone hydrochloride or another drug approved by the federal Food and Drug Administration that, when administered, negates or neutralizes in whole or in part the pharmacological effects of an opioid in the body, and has been approved for the treatment of an opioid overdose.

§ 49428.2

Amended by Stats. 2025, Ch. 241, Sec. 3. (SB 857) Effective January 1, 2026. Inoperative July 1, 2030, by its own provisions. Repealed as of January 1, 2031, by its own provisions.

(a)For purposes of this section, the following definitions apply:

(1)“Local educational agency” means a county office of education, school district, state special school, or charter school that serves pupils in any of grades 7 to 12, inclusive.

(2)“Youth behavioral health disorders” means pupil mental health and substance use disorders.

(3)“Youth behavioral health training” means training that develops awareness of trauma and the brain’s response to stress and the protective factors for behavioral health and well-being that support healing and

resilience.

(b)(1) The governing board or body of a local educational agency shall, before January 31, 2026, adopt, at a regularly scheduled meeting, a policy on referral protocols for addressing pupil behavioral health concerns in grades 7 to 12, inclusive. The policy shall be developed in consultation with school and community stakeholders and school-linked behavioral health professionals, and shall, at a minimum, address procedures relating to referrals to behavioral health professionals and support services. Policies adopted before the date of enactment of the act that added this section may be considered to meet the requirements of this section, if they fulfill the requirements of this section.

(2)The policy adopted pursuant to paragraph (1) shall either be based

on the model policy developed by the department or be consistent with subdivision (b) of Section 49428.1.

(3)The policy adopted pursuant to paragraph (1) shall specifically address the needs of high-risk groups, including, but not limited to, all of the following:

(A)Pupils bereaved by death or loss of a close family member or friend.

(B)Pupils for whom there is concern due to behavioral health disorders, including common psychiatric conditions and substance use disorders such as opioid and alcohol abuse.

(C)Pupils with disabilities, mental illness, or substance use disorders.

(D)Pupils

experiencing homelessness or placed in out-of-home settings, such as foster care.

(E)Lesbian, gay, bisexual, transgender, or questioning pupils.

(4)(A) The policy adopted pursuant to paragraph (1) shall also address any training to be provided to teachers of pupils in grades 7 to 12, inclusive, on pupil behavioral health.

(B)Materials approved by a local educational agency for training shall include how to identify appropriate contacts for behavioral health evaluation, services, or both evaluation and services, at both the schoolsite and within the larger community, and when and how to refer pupils and their families to those services.

(C)Materials approved for training may also include programs that can be completed through self-review of materials developed pursuant to this section.

(5)The policy adopted pursuant to paragraph (1) shall be written to ensure that a school employee acts only within the authorization and scope of the employee’s credential or license. Nothing in this section shall be construed as authorizing or encouraging a school employee to diagnose or treat youth behavioral health disorders unless the employee is specifically licensed and employed to do so.

(6)To assist local educational agencies in developing policies on referral protocols, the department shall develop and maintain a model policy in accordance with Section 49428.1 to serve as a guide for local educational

agencies.

(c)Subject to subdivision (d), on or before July 1, 2029, a local educational agency shall certify to the department that 100 percent of its certificated employees and 40 percent of its classified employees, who have direct contact with pupils in any of grades 7 to 12, have received youth behavioral health training at least one time, in accordance with all of the following:

(1)The training provides instruction around the unique risk factors and warning signs of behavioral health problems in adolescents, builds understanding of the importance of early intervention, and teaches classified and certificated employees how to help an adolescent in crisis or experiencing a behavioral health challenge, including guidance on when to make referrals consistent with the policy

adopted pursuant to subdivision (b). The training may also include the following:

(A)Instruction on recognizing the signs and symptoms of youth behavioral health disorders, including, but not limited to, psychiatric conditions and substance use disorders such as opioid and alcohol abuse.

(B)Instruction on how to maintain pupil privacy and confidentiality in a manner consistent with federal and state privacy laws.

(C)Instruction on the safe de-escalation of crisis situations involving pupils with a youth behavioral health disorder.

(2)Except as provided in paragraph (3), the youth behavioral health training is provided to classified and certificated

employees during regularly scheduled work hours.

(3)If a classified or certificated employee receives the youth behavioral health training in a manner other than through an in-service training program provided by the local educational agency, the employee may present a certificate of successful completion of the training to the local educational agency for purposes of satisfying the requirements of this subdivision.

(4)The youth behavioral health training shall not be a condition of employment or hiring for classified or certificated employees.

(5)A local educational agency may use the training described in subdivision (c) of Section 49428.15 to meet the requirements of this section.

(d)A local educational agency may exclude a licensed behavioral health professional who holds a pupil personnel services credential from the youth behavioral health training required by this section.

(e)A local educational agency may meet the requirements of subdivision (c) through an alternative approach by adopting a policy that describes how this approach is consistent with the goals specified in subdivision (c) but better meets the needs of pupils.

(f)Any parts of this section that fall within the scope of representation, as that term is used in paragraph (1) of subdivision (a) of Section 3543.2 of the Government Code, are subject to bargaining with the exclusive representative pursuant to Chapter 10.7

(commencing with Section 3540) of Division 4 of Title 1 of the Government Code.

(g)It is the intent of the Legislature that the sum of thirty-five million dollars ($35,000,000), or as much of that amount as is available, be allocated to the department, for apportionments to local educational agencies in the 2025–26 fiscal year pursuant to paragraph (2) of subdivision (c) of Section 36005 of the Revenue and Taxation Code. Upon appropriation for this purpose, all of the following shall apply:

(1)The funding shall be provided on a per-pupil basis for each pupil enrolled in grades 7 to 12, inclusive, as reported in the California Longitudinal Pupil Achievement Data System for the prior year Fall 1 Submission to meet the requirements of this section.

(2)Local educational agencies shall first use the funding provided to support the youth behavioral health training described in subdivision (c).

(3)If there are remaining funds, local educational agencies shall use the funds to offer additional training consistent with this section or to increase the number of staff that hold a pupil personnel services credential within the local educational agency.

(h)This section shall become inoperative on July 1, 2030, and, as of January 1, 2031, is repealed.

§ 49428.5

Added by Stats. 2022, Ch. 431, Sec. 1. (AB 748) Effective January 1, 2023.

(a)On or before the start of the 2023–24 school year, each schoolsite in a school district, county office of education, or charter school, serving pupils in any of grades 6 to 12, inclusive, shall create a poster that identifies approaches and shares resources regarding pupil mental health.

(b)The schoolsite may partner with pupils enrolled at that schoolsite, local, state, or federal agencies, or nonprofit organizations, for purposes of the design and content of the poster.

(c)The language in the poster shall be age appropriate and culturally relevant, and the schoolsite may partner with pupils enrolled at

that schoolsite, local, state, or federal agencies, or nonprofit organizations, for these purposes.

(d)The poster shall be displayed in English and any primary language spoken by 15 percent or more of the pupils enrolled at the schoolsite as determined pursuant to Section 48985.

(e)The poster shall be no smaller than 8.5 by 11 inches and use at least 12-point font.

(f)The poster shall display, at a minimum, all of the following:

(1)Identification of common behaviors of those struggling with mental health or who are in a mental health crisis, including, but not limited to, anxiety, depression, eating disorders, emotional dysregulation, bipolar episodes, and

schizophrenic episodes.

(2)A list of, and contact information for, schoolsite-specific resources, including, but not limited to, counselors, wellness centers, and peer

counselors.

(3)A list of, and contact information for, community resources, including, but not limited to, suicide prevention, substance abuse, child crisis, nonpolice mental health hotlines, public behavioral health services, and community mental health centers.

(4)A list of positive coping strategies to use when dealing with mental health, including, but not limited to, meditation, mindfulness, yoga, breathing exercises, grounding skills, journaling, acceptance, and seeking therapy.

(5)A list of negative coping strategies to avoid, including, but not limited to, substance abuse or self-medication, violence and abuse, self-harm, compulsivity, dissociation, catastrophizing, and isolating.

(g)(1) (A) Commencing with the 2023–24 school year, the poster shall be prominently and conspicuously displayed in appropriate public areas that are accessible to, and commonly frequented by, pupils at each schoolsite.

(B) The governing board of a school district, governing body of a charter school, and county board of education shall have full discretion to select additional appropriate public areas that are accessible to, and commonly frequented by, pupils to display the poster at the schoolsite. These areas may include, but are not limited to, bathrooms, locker rooms, classrooms, classroom hallways, gymnasiums, auditoriums, cafeterias, wellness centers, and offices.

(2)The poster shall be digitized and distributed online to pupils through social media, internet websites, portals, and learning

platforms at the beginning of each school year.

(3)To assist school districts, county offices of education, and charter schools in developing policies for pupil suicide prevention, the department shall develop and maintain a model poster, in collaboration with mental health experts, pupils, and administrators, in accordance with this section to serve as a guide for school districts, county offices of education, and charter schools.

(h)No basis for civil liability is created by this section for any school district, county office of education, or charter school serving pupils in any of grades 6 to 12, inclusive.

§ 49429

Amended by Stats. 2021, Ch. 252, Sec. 25. (AB 167) Effective September 23, 2021.

(a)The department, in consultation with the State Department of Health Care Services and appropriate stakeholders, including stakeholders with experience in telehealth, as defined in subdivision (d), shall develop guidelines on or before December 31, 2022, for the use of telehealth technology in public schools, including charter schools, to provide mental health and behavioral health services to pupils on school campuses.

(b)The guidelines developed pursuant to subdivision (a) shall include, but are not limited to, guidance on all of the following:

(1)Qualifications of individuals authorized to provide assistance, within their scope of practice, to pupils in accessing mental health and behavioral

health services via telehealth technology at a schoolsite.

(2)Qualifications of individuals authorized to provide mental health and behavioral health services, within their scope of practice, to pupils via telehealth technology.

(3)Potential sources of funding for the purchase of the necessary equipment and technology infrastructure by schools to allow schools to provide telehealth services.

(4)The ability of mental and behavioral health services providers to access reimbursement through the Medi-Cal program or other sources for services provided to pupils at schoolsites via telehealth technology.

(5)The legal requirements for parental consent for the provision of mental health and behavioral health treatment of minors via telehealth technology.

(6)Measures necessary to protect the security of data transmitted via telehealth technology.

(7)Measures necessary to protect the privacy of pupil data pursuant to the federal Family Educational Rights and Privacy Act of 1974 (20 U.S.C. Sec. 1232g) and medical records pursuant to the federal Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191).

(8)Potential school district, county office of education, and charter school liability associated with the provision of telehealth services.

(c)The department shall post the guidelines developed pursuant to this section on its internet website on or before December 31, 2022.

(d)For purposes of this section, “telehealth”

means the mode of delivering health care services via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a pupil’s health care while the pupil is at a schoolsite and the health care provider is at a distant site.

(e)This section shall only be implemented if sufficient funds are made available to the department pursuant to an appropriation in the annual Budget Act or another statute for that purpose.

§ 49429.5

Added by Stats. 2022, Ch. 909, Sec. 2. (AB 2072) Effective January 1, 2023.

(a)For purposes of this section, “local educational agency” means a school district, county office of education, or charter school.

(b)On or before November 1, 2024, county offices of education, in consultation with the department and other relevant state and local agencies, shall coordinate agreements between school districts and charter schools within the county in order to develop a system through which qualified mental health professionals and other key school personnel employed by individual school districts and charter schools throughout the county could be rapidly deployed on a short- or long-term basis to an area of the county that has experienced a

natural disaster or other traumatic event, in order to provide support to pupils and staff, to the extent the school district or charter school employing those professionals or personnel determines they can be deployed under the circumstances. In developing agreements for this system of sharing mental health professionals and other key school personnel, county offices of education shall consider, at a minimum, all of the following:

(1)The cost of creating and maintaining the system described in this subdivision.

(2)The criteria required for a local educational agency to request the use of mental health professionals and

other key school personnel employed by another local educational agency.

(3)Potential reimbursement between local educational agencies.

(4)Reimbursement for travel expenses incurred by mental health professionals and other key school personnel.

(c)Single school district county offices of education shall comply with subdivision (b) by entering into agreements with at least one other county office of education they share a border with.

(d)County offices of education that share a county border with a single school district county office of education shall consult with and enter into agreements with at least one single school district county office of education in

order to comply with subdivision (b).