ASSEMBLY, No. 3663

 

STATE OF NEW JERSEY

 

210th LEGISLATURE

 

INTRODUCED MAY 19, 2003

 

 

Sponsored by:

Assemblywoman CHARLOTTE VANDERVALK

District 39 (Bergen)

Assemblywoman LORETTA WEINBERG

District 37 (Bergen)

Assemblywoman ROSE MARIE HECK

District 38 (Bergen)

 

Co-Sponsored by:

Assemblymen Ahearn, Conners, Guear, Chivukula, McKeon, Arnone, Blee, Conover and Munoz

 

 

 

 

SYNOPSIS

    Requires training in diabetes care for certain school employees and use of medical management plans in schools for students with diabetes.

 

CURRENT VERSION OF TEXT

    As introduced.

 

(Sponsorship Updated As Of: 12/12/2003)


An Act concerning the care of students with diabetes and supplementing Title 18A of the New Jersey Statutes.

 

    Be It Enacted by the Senate and General Assembly of the State of New Jersey:

 

    1. The Legislature finds and declares that:

    a. Diabetes is a serious chronic disease that impairs the body's ability to use food, and must be managed 24 hours a day in order to: avoid the potentially life-threatening short-term consequences of blood sugar levels that are either too high or too low; and avoid or delay the serious long-term complications of high blood sugar level that include blindness, amputation, heart disease and kidney failure;

    b. In order to manage their disease, students with diabetes must have access to the means to balance food, medications, and physical activity level while at school and at school-related activities;

    c. The school nurse is the most appropriate person in the school setting to provide care for a student with diabetes; however, even a nurse who is assigned to a school on a full-time basis will not always be available during the school day, during extracurricular activities or on field trips;

    d. Because diabetes management is needed at all times, additional school personnel need to be prepared to provide diabetes care at school and all school-related activities in order for students with diabetes to be medically safe and have the same access to educational opportunities as all other students in New Jersey; and

    e. 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 Legislature deems it in the public interest to enact the provisions of this act into law.

 

    2. As used in this act:

    "Medical management plan" means a document developed by the parent or guardian of a student with diabetes and the trained diabetes personnel who will be providing diabetes care to the student, which sets out the health services needed by the student at school and is signed by the parent or guardian and the trained diabetes personnel.

    "School" means a primary or secondary public school located within this State.

    "School employee" means a person employed by a public school district.

    "Trained diabetes personnel" means a school employee who is trained in accordance with the provisions of section 3 of this act, but need not be a licensed or certified health care professional.


    3. a. The State Board of Education, in consultation with the Commissioner of Health and Senior Services, shall develop guidelines for the training of school employees in the care needed for students with diabetes, for which purpose the board shall solicit recommendations from at least the following: the American Diabetes Association, the American Association of Diabetes Educators, the Medical Society of New Jersey; the American Academy of Pediatrics-New Jersey Chapter, the New Jersey State Nurses Association, and the New Jersey State School Nurses Association.

    The training guidelines shall be fully developed no later than one year after the effective date of this act and shall include instruction in the following:

    (1) recognition and treatment of hypoglycemia and hyperglycemia;

    (2) understanding the appropriate actions to take when a student's blood glucose levels are outside of the target ranges indicated by the student's medical management plan;

    (3) understanding physician instructions concerning diabetes medication drug dosage, frequency, and the manner of administration;

    (4) performance of finger-stick blood glucose checking, ketone checking, and recording the results;

    (5) the administration of glucagon and insulin and the recording of results; and

    (6) recommended schedules and food intake for meals and snacks, the effect of physical activity upon blood glucose levels, and actions to be implemented in the case of schedule disruption.

    b. Each public school district shall ensure that the training outlined in subsection a. of this section is provided, at a minimum, to the registered school nurse and two other school employees at each school that is attended by a student with diabetes.

    c. The training outlined in subsection a. of this section shall be provided annually by a health care professional with expertise in diabetes, and shall take place prior to the commencement of each school year or as needed when a student with diabetes is newly enrolled at a school or a student is newly diagnosed with diabetes.

    d. Each public school district shall provide training in the recognition of hypoglycemia and hyperglycemia and actions to take in response to emergency situations to all bus drivers responsible for the transportation of a student with diabetes, unless cell phone contact between bus drivers and trained diabetes personnel can be arranged.

 

    4. a. The parent or guardian of each student with diabetes who seeks diabetes care while at school shall submit a medical management plan to the school. The plan shall be 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.

    b. In accordance with the request of a parent or guardian of a student with diabetes and the student's medical management plan, trained diabetes personnel shall perform the following functions: responding to blood glucose levels that are outside of the student's target range; administering glucagon; administering insulin or assisting a student in administering insulin through the insulin delivery system that the student uses; providing oral diabetes medications; checking and recording blood glucose levels and ketone levels or assisting a student with such checking and recording; and following instructions regarding meals, snacks and physical activity.

    c. The school nurse assigned to a particular school shall coordinate the provision of diabetes care at that school and serve as the lead person among the trained diabetes personnel at the school. At least one of the trained diabetes personnel shall be on site and available to provide care to each student with diabetes as set forth in subsection b. of this section during: regular school hours; school-sponsored, before and after-school care programs; field trips; extracurricular activities; and on buses when the bus driver has not completed the necessary training, unless cell phone contact between the bus driver and trained diabetes personnel can be arranged.

    d. There shall be trained diabetes personnel at each school in which a student with diabetes is enrolled, and a student's school choice shall in no way be restricted because the student has diabetes.

    e. The activities set fourth in subsection b. of this section shall not constitute the practice of nursing and shall be exempted from all applicable statutory or regulatory provisions that restrict the activities that may be delegated to a person who is not a licensed health care professional.

 

    5. Upon the written request of the parent or guardian and authorization by the student's medical management plan, a student with diabetes shall be permitted to: perform blood glucose checks; administer insulin through the insulin delivery system that the student uses; treat hypoglycemia and hyperglycemia, and otherwise attend to the care and management of his diabetes in the classroom, in any area of the school or school grounds, and at any school-related activity; and possess on his person at all times such supplies and equipment as are necessary to perform these monitoring and treatment functions.

 

    6. A physician, nurse, school employee or public school district shall not be liable for civil damages as a result of the actions authorized by this act when those actions are taken in the same manner as a reasonably prudent person would have acted under the same or similar circumstances.

 

    7. This act shall take effect immediately.


STATEMENT

 

    This bill requires training in diabetes care for certain school employees and the use of medical management plans in schools for students with diabetes.

    Specifically, the bill provides as follows:

   The State Board of Education, in consultation with the Commissioner of Health and Senior Services, is to develop guidelines for the training of public school employees in the care needed for students with diabetes, for which purpose the board will solicit recommendations from at least the following: the American Diabetes Association, the American Association of Diabetes Educators, the Medical Society of New Jersey; the American Academy of Pediatrics-New Jersey Chapter, the New Jersey State Nurses Association, and the New Jersey State School Nurses Association.

   The training guidelines are to be fully developed no later than one year after the effective date of the bill and include instruction in the following:

    -- recognition and treatment of hypoglycemia and hyperglycemia;

    -- understanding the appropriate actions to take when a student's blood glucose levels are outside of the target ranges indicated by the student's medical management plan;

    -- understanding physician instructions concerning diabetes medication drug dosage, frequency, and the manner of administration;

    -- performance of finger-stick blood glucose checking, ketone checking, and recording the results;

    -- the administration of glucagon and insulin and the recording of results; and

    -- recommended schedules and food intake for meals and snacks, the effect of physical activity upon blood glucose levels, and actions to be implemented in the case of schedule disruption.

   Each public school district is to ensure that the training is provided, at a minimum, to the registered school nurse and two other school employees at each school that is attended by a student with diabetes.

   The training is to be provided annually by a health care professional with expertise in diabetes and take place prior to the commencement of each school year or as needed when a student with diabetes is newly enrolled at a school or a student is newly diagnosed with diabetes.

   Each public school district is to provide training in the recognition of hypoglycemia and hyperglycemia and actions to take in response to emergency situations to all bus drivers responsible for the transportation of a student with diabetes unless cell phone contact between bus drivers and trained diabetes personnel can be arranged.

   The parent or guardian of each student with diabetes who seeks diabetes care while at school is to submit a medical management plan to the school, which will be 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.

   In accordance with the request of a parent or guardian of a student with diabetes and the student's medical management plan, trained diabetes personnel are to perform the following functions: responding to blood glucose levels that are outside of the student's target range; administering glucagon; administering insulin or assisting a student in administering insulin through the insulin delivery system that the student uses; providing oral diabetes medications; checking and recording blood glucose levels and ketone levels or assisting a student with such checking and recording; and following instructions regarding meals, snacks and physical activity.

   The school nurse assigned to a particular school is to coordinate the provision of diabetes care at that school and serve as the lead person among the trained diabetes personnel at the school. At least one of the trained diabetes personnel is to be on site and available to provide care to each student with diabetes during: regular school hours; school-sponsored, before and after-school care programs; field trips; extracurricular activities; and on buses when the bus driver has not completed the necessary training, unless cell phone contact between the bus driver and trained diabetes personnel can be arranged.

   There are to be trained diabetes personnel at each school in which a student with diabetes is enrolled, and a student's school choice must in no way be restricted because the student has diabetes.

   Upon the written request of the parent or guardian and authorization by the student's medical management plan, a student with diabetes will be permitted to: perform blood glucose checks; administer insulin through the insulin delivery system that the student uses; treat hypoglycemia and hyperglycemia, and otherwise attend to the care and management of his diabetes in the classroom, in any area of the school or school grounds, and at any school-related activity; and possess on his person at all times such supplies and equipment as are necessary to perform these monitoring and treatment functions.

   A physician, nurse, school employee or public school district will not be liable for civil damages as a result of the actions authorized by this bill when those actions are taken in the same manner as a reasonably prudent person would have acted under the same or similar circumstances.