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                                                        PRINTER'S NO. 53

THE GENERAL ASSEMBLY OF PENNSYLVANIA


SENATE BILL

No. 42 Session of 2003


        INTRODUCED BY ORIE, KUKOVICH, KITCHEN, TARTAGLIONE, COSTA,
           WOZNIAK, LEMMOND, RHOADES AND O'PAKE, JANUARY 24, 2003

        REFERRED TO EDUCATION, JANUARY 24, 2003

                                     AN ACT

     1  Providing for diabetes training of designated school employees;
     2     requiring diabetes health care plans for students with
     3     diabetes; and providing for required care and for independent
     4     monitoring and treatment.

     5     The General Assembly of the Commonwealth of Pennsylvania
     6  hereby enacts as follows:
     7  Section 1.  Short title.
     8     This act shall be known and may be cited as the Students with
     9  Diabetes Act.
    10  Section 2.  Definitions.
    11     The following words and phrases when used in this act shall
    12  have the meanings given to them in this section unless the
    13  context clearly indicates otherwise:
    14     "Diabetes care provider."  A school employee trained in
    15  accordance with section 3.
    16     "School."  A primary or secondary public or private school
    17  located in this Commonwealth.
    18     "School employee."  A person employed by a public school


     1  district or private school, a person employed by a local health
     2  department who is assigned to a public or private school or a
     3  subcontractor designated for this function, regardless of
     4  whether the employee is a medical professional.
     5  Section 3.  Training of designated school employees.
     6     (a)  Guidelines to be developed.--The State Board of Nursing,
     7  working in cooperation with the Department of Health, Department
     8  of Education, American Diabetes Association and American
     9  Association of Diabetes Educators, shall develop guidelines for
    10  the training of school employees in the care needed for students
    11  with diabetes. Training guidelines shall include instruction in:
    12         (1)  The administration of glucagon and insulin and the
    13     recording of results.
    14         (2)  Understanding physician instructions concerning drug
    15     dosage, frequency and the manner of administration.
    16         (3)  Recognition and treatment of hypoglycemia and
    17     hyperglycemia.
    18         (4)  Recommended schedules and food intake for meals and
    19     snacks, the effect of exercise upon blood glucose levels and
    20     actions to be implemented in the case of schedule disruption.
    21         (5)  Performance of finger-stick blood glucose testing,
    22     ketone testing and recording of results therefrom.
    23         (6)  Understanding the appropriate actions to take when
    24     blood glucose levels are outside the target ranges indicated
    25     by a physician's order for or health care plan of a student.
    26         (7)  Understanding that individual accommodations must be
    27     made for a student with diabetes to be medically safe at
    28     school and have the same access to educational opportunities
    29     as available to other students.
    30     (b)  Duties of schools.--
    20030S0042B0053                  - 2 -     

     1         (1)  Each school district or private school shall provide
     2     the training outlined in subsection (a) to a minimum of three
     3     school employees at each school attended by a student with
     4     diabetes.
     5         (2)  Each school district and private school shall
     6     provide training in the recognition and treatment of
     7     hypoglycemia and hyperglycemia to all bus drivers responsible
     8     for the transportation of a student with diabetes when a
     9     diabetes care provider is not present.
    10         (3)  The training outlined in subsection (a) shall be
    11     provided by a health care professional with expertise in
    12     diabetes. Such training shall take place prior to the
    13     commencement of each school year at every school attended by
    14     one or more students with diabetes or as needed when a
    15     student with diabetes is newly enrolled at a school or a
    16     student is newly diagnosed with diabetes.
    17  Section 4.  Diabetes health care plan.
    18     Each student with diabetes who seeks diabetes care while at
    19  school shall submit to the school a diabetes health care plan
    20  developed by the student's family and personal health care team
    21  that sets out the health services needed by the students and is
    22  signed by the student's health care team. This plan should be
    23  submitted and reviewed by the school prior to the beginning of
    24  each school year or upon the enrollment of a student with
    25  diabetes or the diagnosis of a student with diabetes. When
    26  developing or updating a diabetes health care plan or at the
    27  time of the student's participation, the student's family shall
    28  notify the school of the student's participation in school-
    29  sponsored before-school and after-school care programs, field
    30  trips or extracurricular activities.
    20030S0042B0053                  - 3 -     

     1  Section 5.  Required care.
     2     (a)  General duties.--In accordance with the student's
     3  diabetes health care plan, diabetes care providers shall be able
     4  to perform functions, including, but not limited to:
     5         (1)  Responding to blood glucose levels that are outside
     6     of the student's target range.
     7         (2)  Administering glucagon.
     8         (3)  Administering insulin or assisting a student in
     9     administering insulin through the insulin delivery system the
    10     student uses.
    11         (4)  Performing and recording blood glucose testing and
    12     ketone testing or assisting a student with such testing.
    13         (5)  Following instructions regarding meals, snacks and
    14     physical education.
    15  Students with diabetes shall have the right of access to
    16  diabetes supplies and equipment at all times while at school.
    17     (b)  Periods when duties are to be performed.--A diabetes
    18  care provider shall be onsite and available to provide care to
    19  each student with diabetes as set forth in subsection (a) during
    20  regular school hours, school-sponsored before-school and after-
    21  school care programs, field trips and extracurricular activities
    22  and on buses when the bus driver has not completed the necessary
    23  training.
    24     (c)  School choice.--A diabetes care provider shall be
    25  provided at each school where a student with diabetes is
    26  enrolled and a student's school choice shall in no way be
    27  restricted because the student has diabetes.
    28     (d)  Construction.--The activities set forth in subsection
    29  (a) shall not be construed to constitute the practice of nursing
    30  and shall be exempted from all applicable statutory and/or
    20030S0042B0053                  - 4 -     

     1  regulatory provisions that restrict what activities can be
     2  delegated to a person who is not a licensed medical
     3  professional.
     4  Section 6.  Independent monitoring and treatment.
     5     Upon written request of the parent or guardian and
     6  authorization by the student's health care team in the diabetes
     7  health care plan, a student with diabetes shall be permitted to
     8  perform blood glucose tests, administer insulin through the
     9  insulin delivery system the student uses, treat hypoglycemia and
    10  hyperglycemia and otherwise attend to the care and management of
    11  the student's diabetes in the classroom, in any area of the
    12  school or school grounds and at any school-related activity and
    13  to possess on his person at all time all necessary supplies and
    14  equipment to perform these monitoring and treatment functions.
    15  Section 7.  Effective date.
    16     This act shall take effect in 60 days.










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