Gretchen Cararie RD, LDN, CDE
A new session of the Pennsylvania Legislature will begin this month; this means that Jane Orie’s bill related to diabetes programs in schools will have to be reintroduced and will have a new number. We will keep you posted as to its progress.
What you can do at this time, to assist with the progress of this bill:
1. Contact Jane Orie’s office in a few weeks to get the new bill number and a copy of the legislation. This is especially important if you are a constituent of Jane’s Address: 2525 Rochester Road, Cranberry Twp Phone: 724-776-3500
2. Make a list of all the school nurses whom you know personally. Call each one, once you have a copy of the bill, and ask if they are aware of the proposed legislation, do they support it, and would they be willing to make a phone call or write a letter to Jane stating their support.
3. If you find peopel who object to the proposed legislation, it is important to find out exactly why and send that information to one of the WPADE officers. We may be able to answer those objections, or to pass them along to the committee, which is working on the bill.
4. Below is a draft of the legislation:
Care of Students with Diabetes
Section Background
Diabetes is a serious, chronic disease that impairs the body’s ability to use food. Diabetes must be managed twenty-four hours a day in order to avoid the potentiality life-threatening short-term consequences of blood sugar levels that are either too high or too low, and to avoid or delay the serious long-term complications of high blood sugar levels which include blindness, amputation, heart disease and kidney failure. In order to manage their disease, students with diabetes must have access to the means to balance food, medications, and activity level while at school and at school-related activities.
Because of the significant number of students with diabetes, the effect of diabetes upon a student’s ability to learn, and the risk for serious long and short-term medical complications, the Pennsylvania Legislature enacts the following provisions:
Section 2 Definitions
2.1 The term “school” in this Act shall refer to any primary or secondary public or private school located within the state of Pennsylvania.
2.2 The term “school employee” in this Act shall include any person employed by a public school district or private school, any person employed by a local health department who is assigned to a public or private school, or any subcontractor designated for this function. Such an employee need not be a medical professional.
2.3 The term “Diabetes Care Provider” in this Act shall refer to a school employee trained in accordance with section 3.1 of this Act.
Section 3 Training of Designated School Employees
3.1 The Pennsylvania Board of Nursing working in cooperation with the Pennsylvania Department of Health, Pennsylvania Department of Education, American Diabetes Association, and American Association of Diabetes Educators shall develop guidelines for the training of school employees in the care needed for students with diabetes. Training guidelines shall include instruction in:
a. the administration of glucagon and insulin and the recording results;
b. understanding physician instructions concerning drug dosage, frequency, and the manner of administration;
c. recognition and treatment of hypoglycemia and hyperglycemia;
d. recommended schedules and food intake for meals and snacks, the effect of exercise upon blood glucose levels, and actions to be implemented in the case of schedule disruption;
e. performance of finger-stick blood glucose testing, ketone testing, and recording the results
f. understanding the appropriate actions to take when blood glucose levels are outside of the target ranges indicated by student’s physician’s order and/or Health Care Plan; and
g. understanding that individual accommodations must be made for the student with diabetes to be medically safe at school and have the same access to educational opportunities as do other students
3.2 Each public school district or private school shall provide the training outlined in Section 3.1 to a minimum of three school employees at each school attended by a student with diabetes.
3.3 Each public school district and private school shall provide training in the recognition and treatment of hypoglycemia and hyperglycemia to all bus drivers responsible for the transportation of a student with diabetes when a Diabetes Care Provider is not present
3.4 The training outlined in Section 3.1 shall be provided by a health care professional with expertise in diabetes. Such training shall take place prior to the commencement of each school year at every school attended by one or more students with diabetes, or as needed when a student with diabetes is newly enrolled at a school or a student is newly diagnosed with diabetes.
Section 4 Diabetes Health Care Plan
4.1 Each student with diabetes who seeks diabetes care while at school shall submit to the school of a Diabetes Health Care Plan developed by ehte student’s family and personal health care team that sets out the health services needed by eht students and is signed by the student’s health care team. This plan should be submitted and reviewed by the school prior to the beginning of each school year or upon the enrollment of a student with diabetes or the diagnosis of a student with diabetes.
Section 5 Required Care
5.1 In accordance with the student’s Diabetes Health Care Plan, Diabetes Care Providers shall perform functions including, but not limited to, responding to blood glucose levels that are outside of the student’s target range; administering glucagon; administering insulin through the insulin delivery system the student uses; performing and recording blood glucose testing and ketone testing or assisting a student with such testing; and following instructions regarding meals, snacks, and physical education. Students must have access to diabetes supplies and equipment at all times.
5.2 A Diabetes Care Provider shall be on site and available to provide care to each student with diabetes as set forth in seciont 5.1 during regular school hours, school-sponsored before school and after school care programs, field trips, and extracurricular activities, and on buses when the bus driver has not completed the necessary training. When developing and/or updating the Health Care Plan, it is the parent’s/caregiver’s responsibility to notify the school of their child’s participation in school-sponsored before and after school care programs, field trip, or extracurricular activities.
5.3 Diabetes Care Providers shall be provided at each school where a student with diabetes is enrolled and a student’s school choice shall in no way be restricted because the student has diabetes.
5.4 The activities set forth in Section 5.1 shall not constitute the practice of nursing and shall be exempted from all applicable statutory and/or regulatory provisions that restrict what activities can be delegated to a person who is not a licensed medical professional.
Section 6 Independent Monitoring and Treatment
6.1 Upon written request of the parent or guardian and authorization by the student’s health care team in the Diabetes Health Care Plan, a student with diabetes shall be permitted to perform blood glucose tests, administer insulin through the insulin delivery stystem the student uses, treat hypoglycemia and hyperglycemia, and otherwise attend to the care and management of his or her diabetes in the classroom, in any area of the school or school gournds, and at any school-related activity, and to possess on his or her person at all time all necessary supplies and equipment to perform these monitoring and treatment functions.
Section 7 Effective Date
7.1 This Act shall become effective on ____________.
