S T A T E O F N E W Y O R K
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3739
2013-2014 Regular Sessions
I N A S S E M B L Y
January 29, 2013
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Introduced by M. of A. BOYLAND -- read once and referred to the Commit-
tee on Education
AN ACT to amend the education law, in relation to providing for the care
of students with diabetes in elementary and secondary school and
providing for the training of designated school personnel to assist in
a student's diabetes care
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Legislative intent. The legislature finds that:
(1) Diabetes is a serious, chronic disease that impairs the body's
ability to use food. Diabetes must be managed 24 hours a day in order to
avoid the potentially life-threatening consequences of blood glucose
levels that are either too high (hyperglycemia) or too low (hypoglyce-
mia), and to avoid or delay the serious long-term complications of high
blood glucose levels which include blindness, amputation, heart disease,
and kidney failure;
(2) In order to manage their disease, students with diabetes must have
access to the means to balance food, medications, and physical activity
levels while at school and at school related activities;
(3) Diabetes is generally a self-managed disease, and many students
with diabetes are able to perform most of their own diabetes care tasks.
Such students should be permitted to do so in the school setting.
However, some students, because of age, inexperience, or other factors,
need help with some or all of diabetes care tasks, and all students will
need help in the event of a diabetes emergency;
(4) The school nurse is the preferred person in the school setting to
provide or facilitate care for a student with diabetes. However, a
school nurse may not always be available on site and even when a nurse
is assigned to a school full time, he or she may not always be available
to provide direct care during the school day;
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD06947-01-3
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(5) Diabetes management is needed at all times. Additional school
personnel, who have completed training coordinated by the school nurse
or other health care professional and who provide care under the super-
vision of the school nurse or other health care professional, need to be
prepared to perform diabetes care tasks at school when a school nurse or
other health care professional is not available. Preparations are needed
to ensure that students with diabetes will be medically safe and have
the same access to educational opportunities as all students in New
York; and
(6) Due to the significant number of students with diabetes, the
effect of diabetes upon a student's ability to learn, and the risk for
serious long-term and short-term medical complications, legislation in
this state is necessary to address this issue.
S 2. The education law is amended by adding a new section 921 to read
as follows:
S 921. DIABETES MANAGEMENT FOR PUPILS AFFLICTED WITH DIABETES. 1. AS
USED IN THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEAN-
INGS:
A. "DIABETES MEDICAL MANAGEMENT PLAN" MEANS A DOCUMENT DEVELOPED BY
THE STUDENT'S PHYSICIAN OR OTHER HEALTH CARE PROVIDER THAT SETS OUT THE
HEALTH SERVICES, INCLUDING THE STUDENT'S TARGET RANGE FOR BLOOD GLUCOSE
LEVELS, NEEDED BY THE STUDENT AT SCHOOL AND IS SIGNED BY THE STUDENT'S
PARENT OR GUARDIAN.
B. "SCHOOL" MEANS ANY PRIMARY OR SECONDARY PUBLIC SCHOOL LOCATED WITH-
IN THIS STATE.
C. "SCHOOL EMPLOYEE" MEANS ANY PERSON EMPLOYED BY A LOCAL SCHOOL BOARD
OR STATE CHARTERED SPECIAL SCHOOL OR ANY PERSON EMPLOYED BY A LOCAL
HEALTH DEPARTMENT WHO IS ASSIGNED TO A PUBLIC SCHOOL.
D. "TRAINED DIABETES PERSONNEL" MEANS A SCHOOL EMPLOYEE WHO VOLUNTEERS
TO BE TRAINED IN ACCORDANCE WITH THIS SECTION. SUCH EMPLOYEE SHALL NOT
BE REQUIRED TO BE A HEALTH CARE PROFESSIONAL.
2. A. NO LATER THAN AUGUST FIRST, TWO THOUSAND THIRTEEN, THE DEPART-
MENT, IN CONJUNCTION WITH THE NEW YORK STATE ASSOCIATION OF SCHOOL NURS-
ES, SHALL DEVELOP GUIDELINES FOR THE TRAINING OF SCHOOL EMPLOYEES IN THE
CARE NEEDED FOR STUDENTS WITH DIABETES. THE TRAINING GUIDELINES SHALL
INCLUDE INSTRUCTION IN:
(1) RECOGNITION AND TREATMENT OF HYPOGLYCEMIA AND HYPERGLYCEMIA;
(2) UNDERSTANDING THE APPROPRIATE ACTIONS TO TAKE WHEN BLOOD GLUCOSE
LEVELS ARE OUTSIDE OF THE TARGET RANGES INDICATED BY A STUDENT'S
DIABETES MEDICAL MANAGEMENT PLAN;
(3) UNDERSTANDING PHYSICIAN INSTRUCTIONS CONCERNING DIABETES MEDICA-
TION DOSAGE, FREQUENCY, AND THE MANNER OF ADMINISTRATION;
(4) PERFORMANCE OF FINGER-STICK BLOOD GLUCOSE CHECKING, KETONE CHECK-
ING, AND RECORDING THE RESULTS;
(5) ADMINISTRATION OF INSULIN AND GLUCAGON, AN INJECTABLE USED TO
RAISE BLOOD GLUCOSE LEVELS IMMEDIATELY FOR SEVERE HYPOGLYCEMIA, AND THE
RECORDING OF RESULTS;
(6) PERFORMANCE OF BASIC INSULIN PUMP FUNCTIONS;
(7) RECOGNIZING COMPLICATIONS THAT REQUIRE EMERGENCY ASSISTANCE; AND
(8) 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 LOCAL SCHOOL BOARD AND STATE CHARTERED SPECIAL SCHOOL SHALL
INSURE THAT THE TRAINING OUTLINED IN PARAGRAPH A OF THIS SUBDIVISION IS
PROVIDED TO A MINIMUM OF TWO SCHOOL EMPLOYEES AT EACH SCHOOL ATTENDED BY
A STUDENT WITH DIABETES.
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C. A SCHOOL EMPLOYEE SHALL NOT BE SUBJECT TO ANY PENALTY OR DISCIPLI-
NARY ACTION FOR REFUSING TO SERVE AS TRAINED DIABETES PERSONNEL.
D. THE TRAINING OUTLINED IN PARAGRAPH A OF THIS SUBDIVISION SHALL BE
COORDINATED AND PROVIDED BY A SCHOOL NURSE OR MAY BE CONTRACTED OUT TO
BE PROVIDED BY ANOTHER HEALTH CARE PROFESSIONAL WITH EXPERTISE IN
DIABETES. SUCH TRAINING 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. THE
SCHOOL NURSE OR OTHER CONTRACTED HEALTH CARE PROFESSIONAL SHALL PROVIDE
FOLLOW-UP TRAINING AND SUPERVISION.
E. EACH LOCAL SCHOOL BOARD AND STATE CHARTERED SPECIAL SCHOOL SHALL
PROVIDE INFORMATION IN THE RECOGNITION OF DIABETES RELATED EMERGENCY
SITUATIONS TO ALL BUS DRIVERS RESPONSIBLE FOR THE TRANSPORTATION OF A
STUDENT WITH DIABETES.
3. THE PARENT OR GUARDIAN OF EACH STUDENT WITH DIABETES WHO SEEKS
DIABETES CARE WHILE AT SCHOOL SHALL SUBMIT TO THE SCHOOL A DIABETES
MEDICAL MANAGEMENT PLAN WHICH UPON RECEIPT SHALL BE REVIEWED AND IMPLE-
MENTED BY THE SCHOOL.
4. A. IN ACCORDANCE WITH THE REQUEST OF A PARENT OR GUARDIAN OF A
STUDENT WITH DIABETES AND THE STUDENT'S DIABETES MEDICAL MANAGEMENT
PLAN, THE SCHOOL NURSE OR, IN THE ABSENCE OF THE SCHOOL NURSE, TRAINED
DIABETES PERSONNEL SHALL PERFORM FUNCTIONS INCLUDING, BUT NOT LIMITED
TO, RESPONDING TO BLOOD GLUCOSE LEVELS THAT ARE OUTSIDE OF THE STUDENT'S
TARGET RANGE; ADMINISTERING GLUCAGON; ADMINISTERING INSULIN, OR ASSIST-
ING A STUDENT IN ADMINISTERING INSULIN THROUGH THE INSULIN DELIVERY
SYSTEM 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.
B. THE SCHOOL NURSE OR AT LEAST ONE TRAINED DIABETES PERSONNEL SHALL
BE ON SITE AT EACH SCHOOL AND AVAILABLE DURING REGULAR SCHOOL HOURS TO
PROVIDE CARE TO EACH STUDENT WITH DIABETES AS IDENTIFIED PURSUANT TO
SUBDIVISION THREE OF THIS SECTION. FOR PURPOSES OF FIELD TRIPS, THE
PARENT OR GUARDIAN, OR DESIGNEE OF SUCH PARENT OR GUARDIAN, OF A STUDENT
WITH DIABETES MAY ACCOMPANY SUCH STUDENT ON A FIELD TRIP.
C. THERE SHALL BE TRAINED DIABETES PERSONNEL AT EACH SCHOOL WHERE A
STUDENT WITH DIABETES IS ENROLLED, AND A STUDENT'S SCHOOL CHOICE SHALL
IN NO WAY BE RESTRICTED BECAUSE THE STUDENT HAS DIABETES.
D. THE ACTIVITIES SET FORTH IN PARAGRAPH A OF THIS SUBDIVISION SHALL
NOT CONSTITUTE THE PRACTICE OF NURSING AND SHALL BE EXEMPTED FROM ALL
APPLICABLE STATUTORY AND REGULATORY PROVISIONS THAT RESTRICT WHAT ACTIV-
ITIES CAN BE DELEGATED TO OR PERFORMED BY A PERSON WHO IS NOT A LICENSED
HEALTH CARE PROFESSIONAL.
5. UPON WRITTEN REQUEST OF A STUDENT'S PARENT OR GUARDIAN AND IF
AUTHORIZED BY THE STUDENT'S DIABETES MEDICAL MANAGEMENT PLAN, A STUDENT
WITH DIABETES SHALL BE PERMITTED TO PERFORM BLOOD GLUCOSE CHECKS, ADMIN-
ISTER INSULIN THROUGH THE INSULIN DELIVERY SYSTEM THE STUDENT USES,
TREAT HYPOGLYCEMIA AND HYPERGLYCEMIA, AND OTHERWISE ATTEND TO THE MONI-
TORING AND TREATMENT OF HIS OR HER DIABETES IN THE CLASSROOM, IN ANY
AREA OF THE SCHOOL OR SCHOOL GROUNDS, AND AT ANY SCHOOL RELATED ACTIV-
ITY, AND HE OR SHE SHALL BE PERMITTED TO POSSESS ON HIS OR HER PERSON AT
ALL TIMES ALL NECESSARY SUPPLIES AND EQUIPMENT TO PERFORM SUCH MONITOR-
ING AND TREATMENT FUNCTIONS.
6. NO PHYSICIAN, NURSE, SCHOOL EMPLOYEE, LOCAL SCHOOL BOARD, OR STATE
CHARTERED SPECIAL SCHOOL SHALL BE LIABLE FOR CIVIL DAMAGES OR SUBJECT TO
DISCIPLINARY ACTION UNDER PROFESSIONAL LICENSING REGULATIONS OR SCHOOL
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DISCIPLINARY POLICIES AS A RESULT OF THE ACTIVITIES AUTHORIZED OR
REQUIRED BY THIS SECTION WHEN SUCH ACTS ARE COMMITTED AS AN ORDINARILY
REASONABLY PRUDENT PHYSICIAN, NURSE, SCHOOL EMPLOYEE, LOCAL SCHOOL
BOARD, OR STATE CHARTERED SPECIAL SCHOOL WOULD HAVE ACTED UNDER THE SAME
OR SIMILAR CIRCUMSTANCES.
7. A PRIVATE SCHOOL WHICH COMPLIES WITH THE REQUIREMENTS OF THIS
SECTION SHALL HAVE THE SAME LIMITED LIABILITY FOR SUCH SCHOOL AND ITS
EMPLOYEES IN THE SAME MANNER AS FOR PUBLIC SCHOOLS AS PROVIDED FOR IN
SUBDIVISION SIX OF THIS SECTION.
S 3. This act shall take effect immediately.