PRINTER'S NO. 552
No. 509 Session of 2007
INTRODUCED BY ORIE, ERICKSON, KITCHEN, STACK, FONTANA, BOSCOLA, COSTA, RAFFERTY, LOGAN, WASHINGTON, M. WHITE, O'PAKE, WOZNIAK AND STOUT, MARCH 19, 2007
REFERRED TO EDUCATION, MARCH 19, 2007
AN ACT 1 Amending the act of March 10, 1949 (P.L.30, No.14), entitled "An 2 act relating to the public school system, including certain 3 provisions applicable as well to private and parochial 4 schools; amending, revising, consolidating and changing the 5 laws relating thereto," further providing for school health 6 services. 7 The General Assembly finds and declares as follows: 8 (1) Diabetes is a serious, chronic disease that impairs 9 the body's ability to use food. Diabetes must be managed 24 10 hours a day in order to avoid the potentially life- 11 threatening, short-term consequences of blood sugar levels 12 that are either too high or too low, and to avoid or delay 13 the serious long-term complications of high blood sugar 14 levels which include blindness, amputation, heart disease and 15 kidney failure. In order to manage their disease, students 16 with diabetes must have access to the means to balance food, 17 medications and physical activity level while at school and 18 at school-related activities. 19 (2) The school nurse is the most appropriate person in
1 the school setting to provide care for a student with 2 diabetes. Many schools in Pennsylvania, however, do not have 3 a full-time nurse. Moreover, even when a nurse is assigned to 4 a school full time, he or she will not always be available 5 during the school day, during extracurricular activities or 6 on field trips. Because diabetes management is needed at all 7 times, additional school personnel need to be prepared to 8 provide diabetes care at school and all school-related 9 activities in order for students with diabetes to be 10 medically safe and to have the same access to educational 11 opportunities as do all students in Pennsylvania. 12 (3) There is a significant number of students with 13 diabetes, the effects of which may impact a student's ability 14 to learn and cause serious long-term and short-term medical 15 complications. 16 The General Assembly of the Commonwealth of Pennsylvania 17 hereby enacts as follows: 18 Section 1. The act of March 10, 1949 (P.L.30, No.14), known 19 as the Public School Code of 1949, is amended by adding sections 20 to read: 21 Section 1414.2. Training of School Employes in Diabetes Care 22 and Treatment.--(a) Within ninety days (90) of the effective 23 date of this act, the Department of Education, in cooperation 24 from at least the Department of Health, the American Diabetes 25 Association and the American Association of Diabetes Educators, 26 shall develop and make available to schools guidelines for the 27 training of school employes in diabetes care and treatment. At 28 the minimum, the training guidelines shall include instruction 29 in: 30 (1) recognition and treatment of hypoglycemia and 20070S0509B0552 - 2 -
1 hyperglycemia; 2 (2) understanding the appropriate actions to take when blood 3 glucose levels are outside of target ranges; 4 (3) understanding physician instructions concerning diabetes 5 medication drug dosage, frequency and the manner of 6 administration; 7 (4) performance of finger-stick blood glucose checking, 8 ketone checking and recording the results; 9 (5) the administration of glucagon and insulin and the 10 recording of results; and 11 (6) recommended schedules and food intake for meals and 12 snacks, the effect of physical activity upon blood glucose 13 levels and actions to be implemented in the case of schedule 14 disruption. 15 (b) The governing board of each school entity shall direct 16 the school nurse or school physician to select at least three 17 (3) school employes from each school in which a diabetic student 18 is enrolled to receive the training as described in subsection 19 (a) and determine by whom the training is to be provided. School 20 employes may not be subject to any penalty or disciplinary 21 action for refusing to serve as trained diabetes personnel. 22 Training required under this section may be provided by a local 23 health agency, subcontractor, school nurse, school physician or 24 any other person skilled in providing diabetes care and 25 treatment training required under this section. 26 (c) Training shall take place prior to the commencement of 27 each school year or as needed when a diabetic student is newly 28 enrolled or a student is newly diagnosed with diabetes. 29 (d) For the purposes of this section, "school" means any 30 elementary or secondary public charter or nonpublic school, 20070S0509B0552 - 3 -
1 intermediate unit or area vocational-technical school. "School 2 entity" means any school district, intermediate unit, area 3 vocational-technical school, charter school or nonpublic school 4 located in this Commonwealth. 5 Section 1414.3. Diabetes Medical Management Plan.--(a) At 6 the beginning of each school year, upon enrollment or diagnosis, 7 a diabetic student who seeks diabetes care in school shall 8 submit to the school nurse or school physician a diabetes 9 medical management plan, which outlines the health services 10 needed by the student while at school. This plan shall be 11 developed by the student's parent or guardian along with the 12 student's physician, certified registered nurse practitioner or 13 physician assistant and include, at the minimum, written 14 authorization allowing: 15 (1) trained diabetes personnel to perform diabetes care and 16 treatment upon the child, including, but not limited to, 17 responding to blood glucose levels that are outside of the 18 student's target range; administering glucagon; administering 19 insulin or assisting a student in administering insulin through 20 the insulin delivery system the student uses; providing oral 21 diabetes medications, checking and recording blood glucose 22 levels and ketone levels or assisting a student with such 23 checking and recording; and following instructions regarding 24 meals, snacks and physical activity; and 25 (2) the child to conduct independent monitoring and 26 treatment in school, if the parent or guardian so requests. If 27 this request is made, the physician, certified registered nurse 28 practitioner or physician assistant shall provide a written 29 statement in the plan indicating the student has successfully 30 demonstrated capability of independent monitoring and 20070S0509B0552 - 4 -
1 responsible behavior in self-administering treatment or 2 prescribed medication. 3 (b) Notwithstanding any authorization granted pursuant to 4 subsection (a)(1), a school nurse shall be the primary provider 5 of diabetes care and treatment and responsible for any 6 delegation of care. 7 (c) Any diabetic student unable to or prevented from 8 submitting a diabetes medical management plan to his or her 9 school nurse or school physician shall not be precluded from 10 receiving school nurse services, including the care and 11 treatment of diabetes. 12 (d) For purposes of this section, "trained diabetes 13 personnel" means a school employe, other than a school nurse or 14 school physician, or a nonhealth care professional trained in 15 accordance with section 1414.2. Functions performed by these 16 professionals shall not constitute the practice of nursing and 17 shall be exempted from all applicable statutory and/or 18 regulatory provisions that restrict what functions can be 19 performed by a person who is not a licensed health care 20 professional. 21 Section 1414.4. Independent Monitoring and Treatment.--The 22 governing board of each school entity shall develop a written 23 policy allowing diabetic students to possess on their person at 24 all times all necessary supplies, equipment and prescribed 25 medication to perform self-monitoring and treatment. The policy 26 may revoke or restrict a student's independent monitoring and 27 treatment privileges if school policies are abused or ignored. 28 Section 1414.5. Required Care.--(a) At least one trained 29 diabetes personnel shall be on site and available to provide 30 treatment and care to diabetic students during regular school 20070S0509B0552 - 5 -
1 hours and at all school-sponsored activities, including, but not 2 limited to, extracurricular activities and field trips, where a 3 student with diabetes is a direct participant. No student shall 4 be required to attend another school solely because she or he 5 has diabetes. 6 (b) The governing board of each school entity shall develop 7 a written policy that requires the distribution of information 8 to school bus drivers that identifies diabetic students, the 9 potential emergencies that may occur as a result of the 10 student's diabetes and the appropriate responses to such 11 emergencies and emergency contact information for students with 12 diabetes. 13 Section 1414.6. Immunity from Civil Liability.--No 14 physician, nurse, school employe, trained diabetes personnel or 15 school entity shall be liable for civil damages as a result of 16 the activities authorized by this legislation when such acts are 17 performed as an ordinary reasonably prudent person would have 18 acted under the same or similar circumstances. 19 Section 2. This act shall take effect as follows: 20 (1) The addition of section 1414.5 of the act shall take 21 effect in 150 days. 22 (2) The remainder of this act shall take effect 23 immediately. L28L24JS/20070S0509B0552 - 6 -