"Paul's Law" Will Require School Nurses to Develop Individualized Health Care and Emergency Health Care Plans for Students with Epilepsy and Seizure Disorders
Epilepsy is a brain disorder that causes seizures of different types.1 Approximately 3.4 million people in the United States have active epilepsy, and of that number approximately 470,000 are children.2 In New Jersey, there are 12,000 reported cases of children from infancy to age 17 who have active epilepsy.3
On January 9, 2020, Governor Phil Murphy signed into law Senate Bill No. 4141, known as “Paul’s Law,” to require, among other things, training for school staff for the care of students with epilepsy.4 The law became effective immediately and, therefore, school officials will need to begin compliance. The law’s namesake is Paul St. Pierre, a boy from South Jersey with epilepsy, who met with his local state senator to advocate for a law that would require safety training in schools for students suffering from seizures.5 The bill received bi-partisan support and was unanimously approved in both the Senate and the Assembly.
Paul’s Law permits a parent or guardian of a student with epilepsy or with a seizure disorder, who would like care for his/her child while at school, to annually provide the school nurse with the student’s seizure action plan.6 A seizure action plan is a document prepared by the student’s health care provider which includes information regarding seizure triggers, seizure medications, and seizure first aid, among other things.7
If a parent or guardian submits the seizure action plan and provides written authorization for the provision of epilepsy or seizure disorder care, the school nurse must develop an individualized health care plan (IHCP) and an individualized emergency health care plan (emergency plan) for the student.8 An IHCP is a document prepared by the nurse in consultation with the parent or guardian and other medical professionals providing care for the student which is consistent with the student’s health care providers’ recommendations.9 The IHCP must be signed by the nurse and parent or guardian, and must contain the health services needed at school by the student.10 An emergency plan is a document prepared by the nurse in consultation with the parent or guardian and other medical professionals, as appropriate, and which is consistent with the recommendations of the student’s health care providers.11 The emergency plan must be signed by the school nurse and parent or guardian, and must contain specific actions for school staff to perform in an emergency situation.12 The school nurse must update each plan annually and as needed if there is a change in the student’s health status.13 The school nurse must also obtain a release from the parent or guardian to authorize the sharing of medical information between the student’s health care providers and other health care providers, and with school staff as necessary.14
Paul’s Law requires school administrators to coordinate the provision of epilepsy and seizure disorder care at schools in the district.15 School administrators must also ensure that all staff are trained in the care of students with epilepsy and seizure disorders.16 The training must include a Department of Health-approved online or in-person course provided by a nonprofit national organization.17 In addition, when a school bus driver transports a student with epilepsy or a seizure disorder, school administrators must provide the driver with notice of the student’s condition, how to provide care for the student, the student’s emergency contact and parent contact information, and first aid training for epilepsy and seizure disorders.18
Paul’s Law contains a provision protecting school employees and others from liability for acting in good faith in complying with the law.19 Specifically, the law provides immunity from liability for any school employee, school nurse, school bus driver, school bus aide, or school administrator, for any good faith act or omission consistent with the provisions of the law. It will not protect individuals for acts of willful misconduct, gross negligence, or recklessness.20
In order to ensure compliance with Paul’s Law, school administrators should ensure that student health policies are updated to incorporate the requirements of the law. School nurses should review the requirements of the law and understand how to prepare an ICHP and emergency plan. The school board attorney should review all policy updates, and should also review and/or prepare the medical release form necessary for information sharing. Procedures should be established to ensure that school bus drivers, and aides are notified whenever they transport a student with epilepsy or a seizure disorder, and the protocol they must follow in case of an emergency. Lastly, school administrators should ensure that all employees, including bus drivers and aides, receive the required training on the care of students with epilepsy and seizure disorders, and should document the provision of such training. Questions regarding compliance with Paul’s Law should be directed to the board attorney.
- See Centers for Disease Control and Prevention, Types of Seizures available on the Internet at https://www.cdc.gov/epilepsy/about/types-of-seizures.htm.
- See Centers for Disease Control and Prevention, Epilepsy Data and Statistics available on the Internet at https://www.cdc.gov/epilepsy/data/index.html.
- See id. at Data Table.
- Pub. L. 2019, ch. 290.
- Sheri Berkery, “Maple Shade Boy with Epilepsy wants NJ to Enact a 'Seizure Safety' Law for Schools,” Cherry Hill Courier-Post (Aug. 7, 2019), available on the Internet at https://www.courierpostonline.com/story/news/local/south-jersey/2019/08/07/epilepsy-pauls-law-nj-safety-training-awareness-pauls-law-cameron-boyce/1855305001/.
- See Pub. L. 2019, ch. 290, §2.a.
- See id. at §1 (defining “seizure action plan”).
- See Pub. L. 2019, ch. 290, §2.a.
- See id. at §1 (defining “individualized health care plan”).
- Id.; see id. at §2.c. (specifying the components of an individualized health care plan).
- See id. at §1 (defining “individualized emergency health care plan”).
- Id.; see id. at §2.c. (specifying the components of an individualized emergency health care plan).
- See id. at §2.b.
- Id. at §4.
- See id. at §2.d.
- See id.
- Id. The Epilepsy Foundation provides training to school personnel. Refer to the Epilepsy Foundation’s website: https://www.epilepsy.com.
- See Pub. L. 2019, ch. 290, §3.
- See id. at §5.
- See id.