[First Reprint]

 

ASSEMBLY COMMITTEE SUBSTITUTE FOR

ASSEMBLY, No. 267

STATE OF NEW JERSEY

213th LEGISLATURE

ADOPTED JUNE 12, 2008

 


 

Sponsored by:

Assemblywoman CHARLOTTE VANDERVALK

District 39 (Bergen)

Assemblyman JACK CONNERS

District 7 (Burlington and Camden)

Assemblywoman JOAN M. VOSS

District 38 (Bergen)

Assemblywoman CLEOPATRA G. TUCKER

District 28 (Essex)

 

Co-Sponsored by:

Assemblymen Diegnan, McKeon, Assemblywomen Evans, Greenstein, Senators Turner, Kyrillos and Bucco

 

 

 

 

SYNOPSIS

†††† Authorizes parent or guardian to request use of individualized health care plan for student with diabetes and provides for the emergency administration of glucagon for certain students.

 

CURRENT VERSION OF TEXT

†††† As reported by the Senate Budget and Appropriations Committee on June 22, 2009, with amendments.

††

 

 

 


An Act concerning the care of students with diabetes and supplementing chapter 40 of 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 levels 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, because the school nurse is in a position to coordinate care and educate school staff in the monitoring and treatment of symptoms, develop an individualized health care plan and an individualized emergency health care plan, and consult and coordinate with a student's parents or guardians and health care provider to establish a safe, therapeutic environment;

†††† d.† Because of the significant number of students with diabetes, the effect of diabetes upon a student's ability to learn, and the risk of serious long and short-term medical complications, the Legislature deems it in the public interest to enact legislation that addresses the care of students with diabetes within the public school system.

 

†††† 2.† As used in this act:

†††† ďIndividualized emergency health care plan" means a document developed by the school nurse, in consultation with the parent or guardian of a student with diabetes and other appropriate medical professionals, which is consistent with the recommendations of the studentís health care providers and which outlines a set of procedural guidelines that provide specific directions about what to do in a particular emergency situation and is signed by the parent or guardian and the school nurse.

†††† "Individualized health care plan" means a document developed by the school nurse, in consultation with the parent or guardian of a student with diabetes and other appropriate medical professionals who may be providing diabetes care to the student, which is consistent with the recommendations of the studentís health care providers and which sets out the health services needed by the student at school and is signed by the parent or guardian and the school nurse.

†††† "School" means an elementary or secondary public school located within this State.

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

 

†††† 3.† a.† The parent of guardian of a student with diabetes who seeks diabetes care while at school shall inform the school nurse who shall develop an individualized health care plan and an individualized emergency health care plan for the student provided that:

†††† (1)† the parents or guardians of the student annually provide to the board of education written authorization for the provision of diabetes care as may be outlined in the individualized plans including authorization for the emergency administration of glucagon and, if requested by the studentís parents or guardians pursuant to section 5 of this act, authorization for the studentís self-management and care of his diabetes; 1and1;

†††† (2)† 1[the parents or guardians of the student annually provide to the board of education written certification from the studentís physician that the student has diabetes and, if requested by the studentís parents or guardians pursuant to section 5 of this act, that the student is capable of, and has been instructed in, the management and care of his diabetes;

†††† (3)† the board of education annually informs the parents or guardians of the student in writing that the district and its employees or agents shall incur no liability as a result of any injury arising from the implementation of the individualized plans including the emergency administration of glucagon, or a studentís self-management and care of his diabetes; and

†††† (4)† the parents or guardians of the student annually sign a statement acknowledging that the district shall incur no liability as a result of any injury arising from the implementation of the individualized plans including the emergency administration of glucagon, or a studentís self-management and care of his diabetes, and the parents or guardians shall indemnify and hold harmless the district and its employees or agents against any claims arising from the implementation of the individualized plans including the emergency administration of glucagon, or a studentís self-management and care of his diabetes] if a request is made by a studentís parent or guardian pursuant to section 5 of this act, the studentís physician or advanced practice nurse provides written certification to the board of education that the student is capable of, and has been instructed in, the management and care of his diabetes1 .

†††† b.† The individualized health care plan and individualized emergency health care plan developed in accordance with subsection a. of this section shall be updated by the school nurse prior to the beginning of each school year and as necessary in the event that there is a change in the health status of the student.

†††† c.† Each individualized health care plan shall include, and each individualized emergency health care plan may include, the following information:

†††† (1) †the 1[definition] symptoms1 of hypoglycemia for that particular student and the recommended treatment;

†††† (2) †the 1[definition] symptoms1 of hyperglycemia for that particular student and the recommended treatment;

†††† (3) †the frequency of blood glucose testing;

†††† (4) written orders from the student's physician or advanced practice nurse outlining the dosage and indications for insulin administration and the administration of glucagon, if needed;

†††† (5) †times of meals and snacks and indications for additional snacks for exercise;

†††† (6) full participation in exercise and sports, and any contraindications to exercise, or accommodations that must be made for that particular student;

†††† (7) †accommodations for school trips, after-school activities, class parties, and other school-related activities;

†††† (8) education of all school personnel who may come in contact with the student about diabetes, how to recognize and treat hypoglycemia, how to recognize hyperglycemia, and when to call for assistance;

†††† (9) medical and treatment issues that may affect the educational process of the student with diabetes; and

†††† (10) how to maintain communications with the student, the student's parent or guardian and health care team, the school nurse, and the educational staff.

†††† d.† The school nurse assigned to a particular school shall coordinate the provision of diabetes care at that school and ensure that appropriate staff are trained in the care of students with diabetes, including staff working with school-sponsored programs outside of the regular school day, as provided in the individualized health care plan and the individualized emergency health care plan.† 1[Non-medical staff shall not be trained to treat hyperglycemia.]1

 

†††† 4.† a.† The school nurse shall have the primary responsibility for the emergency administration of glucagon to a student with diabetes who is experiencing severe hypoglycemia.† The school nurse shall designate, in consultation with the board of education, additional employees of the school district who volunteer to administer glucagon to a student with diabetes who is experiencing severe hypoglycemia.† The designated employees shall only be authorized to administer glucagon, following training by the school nurse or other qualified health care professional, when a school nurse is not physically present at the scene.

†††† b.† The activities set forth in subsection a. 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.

†††† c.† In the event that a licensed athletic trainer volunteers to administer glucagon to a student with diabetes pursuant to subsection a. of this section, it shall not constitute a violation of the ďAthletic Training Licensure Act,Ē P.L.1984, c.203 (C.45:9-37.35 et seq.).

 

†††† 5.† Upon the written request of the parent or guardian and as provided in a studentís individualized health care plan, a school district shall allow the student to attend to the management and care of the studentís diabetes as needed in the classroom, in any area of the school or school grounds, or at any school-related activity if the student has been evaluated and determined to be capable of doing so as reflected in the studentís individualized health care plan.† The studentís management and care of his diabetes shall include the following:

†††† a.† performing blood glucose level checks;

†††† b.† administering insulin through the insulin delivery system the student uses;

†††† c. †treating hypoglycemia and hyperglycemia;

†††† d.† possessing on the studentís person at any time the supplies or equipment necessary to monitor and care for the studentís diabetes;

†††† e.† compliance with required procedures for medical waste disposal in accordance with district policies and as set forth in the individualized health care plan; and

†††† f. †otherwise attending to the management and care of the studentís diabetes.

 

†††† 6.† A school district shall, for each pupil with diabetes whom a school bus driver transports, provide the driver with a notice of the pupilís condition 1, how to treat hypoglycemia, who to contact in an emergency,1 and parent contact information.

 

†††† 7.† Designated areas of the school building shall have posted, in plain view, a reference sheet identifying signs and symptoms of hypoglycemia in students with diabetes.


†††† 8.† The school nurse shall obtain a release from the parent or guardian of a diabetic student to authorize the sharing of medical information between the studentís physician or advanced practice nurse and other health care providers.† The release shall also authorize the school nurse to share medical information with other staff members of the school district as necessary.

 

†††† 9.† No school employee, including a school nurse, a school bus driver, a school bus aide, or any other officer or agent of a board of education, shall be held liable for any good faith act or omission consistent with the provisions of this act, nor shall an action before the New Jersey State Board of Nursing lie against a school nurse for any such action taken by a person trained in good faith by the school nurse pursuant to this act.† Good faith shall not include willful misconduct, gross negligence, or recklessness.

 

†††† 10.† The possession and use of syringes consistent with the purposes of this act shall not be considered a violation of applicable statutory or regulatory provisions that may otherwise restrict or prohibit such possession and use.

 

†††† 11.† A studentís school choice shall not be restricted due to the fact that the student has diabetes.

 

†††† 12.† This act shall take effect on the 120th day after the date of enactment.