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| THE GENERAL ASSEMBLY OF PENNSYLVANIA |
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| HOUSE BILL |
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| INTRODUCED BY M. SMITH, BELFANTI, BEYER, BRENNAN, BRIGGS, CALTAGIRONE, DONATUCCI, FABRIZIO, FREEMAN, GEORGE, GRUCELA, HARHAI, HARPER, HENNESSEY, KORTZ, MANN, McGEEHAN, McILVAINE SMITH, MICOZZIE, MILLARD, MOUL, M. O'BRIEN, PALLONE, READSHAW, SAINATO, SEIP, SIPTROTH, K. SMITH AND YOUNGBLOOD, MARCH 25, 2009 |
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| REFERRED TO COMMITTEE ON EDUCATION, MARCH 25, 2009 |
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| AN ACT |
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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," in school health services, providing |
6 | for training of school employees in diabetes care and |
7 | treatment, for diabetes medical management plans, for |
8 | independent monitoring and treatment and for certain immunity |
9 | from civil liability. |
10 | The General Assembly finds and declares as follows: |
11 | (1) Diabetes is a serious, chronic disease that impairs |
12 | the body's ability to use food. Diabetes must be managed 24 |
13 | hours a day in order to avoid the potentially life- |
14 | threatening, short-term consequences of blood sugar levels |
15 | that are either too high or too low, and to avoid or delay |
16 | the serious long-term complications of high blood sugar |
17 | levels which include blindness, amputation, heart disease and |
18 | kidney failure. In order to manage their disease, students |
19 | with diabetes must have access to the means to balance food, |
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1 | medications and physical activity level while at school and |
2 | at school-related activities. |
3 | (2) The school nurse is the most appropriate person in |
4 | the school setting to provide care for a student with |
5 | diabetes. Many schools in Pennsylvania, however, do not have |
6 | a full-time nurse. Moreover, even when a nurse is assigned to |
7 | a school full time, he or she will not always be available |
8 | during the school day, during extracurricular activities or |
9 | on field trips. Because diabetes management is needed at all |
10 | times, additional school personnel need to be prepared to |
11 | provide diabetes care at school and all school-related |
12 | activities in order for students with diabetes to be |
13 | medically safe and to have the same access to educational |
14 | opportunities as do all students in Pennsylvania. |
15 | (3) There is a significant number of students with |
16 | diabetes, the effects of which may impact a student's ability |
17 | to learn and cause serious long-term and short-term medical |
18 | complications. |
19 | The General Assembly of the Commonwealth of Pennsylvania |
20 | hereby enacts as follows: |
21 | Section 1. The act of March 10, 1949 (P.L.30, No.14), known |
22 | as the Public School Code of 1949, is amended by adding sections |
23 | to read: |
24 | Section 1414.2. Training of School Employes in Diabetes Care |
25 | and Treatment.--(a) Within ninety days (90) of the effective |
26 | date of this act, the Department of Education, in cooperation |
27 | from at least the Department of Health, the American Diabetes |
28 | Association and the American Association of Diabetes Educators, |
29 | shall develop and make available to schools guidelines for the |
30 | training of school employes in diabetes care and treatment. At |
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1 | the minimum, the training guidelines shall include instruction |
2 | in: |
3 | (1) recognition and treatment of hypoglycemia and |
4 | hyperglycemia; |
5 | (2) understanding the appropriate actions to take when blood |
6 | glucose levels are outside of target ranges; |
7 | (3) understanding physician instructions concerning diabetes |
8 | medication drug dosage, frequency and the manner of |
9 | administration; |
10 | (4) performance of finger-stick blood glucose checking, |
11 | ketone checking and recording the results; |
12 | (5) the administration of glucagon and insulin and the |
13 | recording of results; |
14 | (6) recommended schedules and food intake for meals and |
15 | snacks, the effect of physical activity upon blood glucose |
16 | levels and actions to be implemented in the case of schedule |
17 | disruption; |
18 | (7) understanding how to perform basic insulin pump |
19 | functions; and |
20 | (8) recognizing complications that require emergency |
21 | assistance. |
22 | (b) The governing board of each school entity shall direct |
23 | the school nurse or school physician to select at least three |
24 | (3) school employes from each school in which a diabetic student |
25 | is enrolled to receive the training as described in subsection |
26 | (a) and determine by whom the training is to be provided. School |
27 | employes may not be subject to any penalty or disciplinary |
28 | action for refusing to serve as trained diabetes personnel. |
29 | Training required under this section may be provided by a school |
30 | nurse, school physician or other health care professional with |
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1 | expertise in diabetes. |
2 | (c) Training shall take place prior to the commencement of |
3 | each school year or as needed when a diabetic student is newly |
4 | enrolled or a student is newly diagnosed with diabetes. Training |
5 | shall be coordinated by a school nurse. |
6 | (d) For the purposes of this section, "school" means any |
7 | elementary or secondary public charter or nonpublic school, |
8 | intermediate unit or area vocational-technical school. "School |
9 | entity" means any school district, intermediate unit, area |
10 | vocational-technical school, charter school or nonpublic school |
11 | located in this Commonwealth. |
12 | Section 1414.3. Diabetes Medical Management Plan.--(a) At |
13 | the beginning of each school year, upon enrollment or diagnosis, |
14 | a diabetic student who seeks diabetes care in school shall |
15 | submit to the school nurse or school physician a diabetes |
16 | medical management plan, which outlines the health services |
17 | needed by the student while at school. All diabetes care |
18 | provided to a student shall be consistent with the diabetes |
19 | medical management plan of the student. The diabetes medical |
20 | management plan shall be developed by the student's parent or |
21 | guardian along with the student's physician, certified |
22 | registered nurse practitioner or physician assistant and may |
23 | include written authorization allowing: |
24 | (1) trained diabetes personnel to perform diabetes care and |
25 | treatment upon the child if the parent or guardian so requests, |
26 | including, but not limited to, responding to blood glucose |
27 | levels that are outside of the student's target range; |
28 | administering glucagon; administering insulin or assisting a |
29 | student in administering insulin through the insulin delivery |
30 | system the student uses; providing oral diabetes medications, |
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1 | checking and recording blood glucose levels and ketone levels or |
2 | assisting a student with such checking and recording; and |
3 | following instructions regarding meals, snacks and physical |
4 | activity; and |
5 | (2) the child to conduct independent monitoring and |
6 | treatment in school, if the parent or guardian so requests. If |
7 | this request is made, the physician, certified registered nurse |
8 | practitioner or physician assistant shall provide a written |
9 | statement in the plan indicating the student has successfully |
10 | demonstrated capability of independent monitoring and |
11 | responsible behavior in self-administering treatment or |
12 | prescribed medication. |
13 | (b) Notwithstanding any authorization granted pursuant to |
14 | subsection (a)(1), a school nurse shall be the primary provider |
15 | of diabetes care and treatment and responsible for any |
16 | delegation of care. |
17 | (c) Any diabetic student unable to or prevented from |
18 | submitting a diabetes medical management plan to his or her |
19 | school nurse or school physician shall not be precluded from |
20 | receiving school nurse services, including the care and |
21 | treatment of diabetes. |
22 | (d) For purposes of this section, "trained diabetes |
23 | personnel" means a school employe, other than a school nurse or |
24 | school physician, or a nonhealth care professional trained in |
25 | accordance with section 1414.2. Functions performed by these |
26 | professionals shall not constitute the practice of nursing and |
27 | shall be exempted from all applicable statutory and/or |
28 | regulatory provisions that restrict what functions can be |
29 | performed by a person who is not a licensed health care |
30 | professional or that can be delegated by a licensed health care |
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1 | professional. |
2 | Section 1414.4. Independent Monitoring and Treatment.--(a) |
3 | The governing board of each school entity shall develop a |
4 | written policy allowing diabetic students to possess on their |
5 | person at all times all necessary supplies, equipment and |
6 | prescribed medication to perform self-monitoring and treatment. |
7 | (b) The student with diabetes shall be permitted to perform |
8 | blood glucose checks, treat hypoglycemia and hyperglycemia and |
9 | otherwise attend to the care and management of his or her |
10 | diabetes in the classroom in any area of the school or school |
11 | grounds and at any school-related activity if requested by the |
12 | parent or guardian. |
13 | (c) The policy may revoke or restrict a student's |
14 | independent monitoring and treatment privileges if school |
15 | policies are abused or ignored. |
16 | Section 1414.5. Required Care.--(a) At least one trained |
17 | diabetes personnel shall be on site and available to provide |
18 | treatment and care to diabetic students during regular school |
19 | hours and at all school-sponsored activities, including, but not |
20 | limited to, extracurricular activities and field trips, where a |
21 | student with diabetes is a direct participant. No student shall |
22 | be required to attend another school solely because she or he |
23 | has diabetes. |
24 | (b) The governing board of each school entity shall develop |
25 | a written policy that requires the distribution of information |
26 | to school bus drivers that identifies diabetic students, the |
27 | potential emergencies that may occur as a result of the |
28 | student's diabetes and the appropriate responses to such |
29 | emergencies and emergency contact information for students with |
30 | diabetes. |
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1 | Section 1414.6. Immunity from Civil Liability.--No |
2 | physician, nurse, school employe, trained diabetes personnel or |
3 | school entity shall be liable for civil damages as a result of |
4 | the activities authorized by this legislation when such acts are |
5 | performed as an ordinary reasonably prudent person would have |
6 | acted under the same or similar circumstances. |
7 | Section 2. This act shall take effect as follows: |
8 | (1) The addition of section 1414.5 of the act shall take |
9 | effect in 150 days. |
10 | (2) The remainder of this act shall take effect |
11 | immediately. |
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