Senate Bill S245

                                 
BILL NUMBER: S245

SPONSOR: GALLIVAN
 
TITLE OF BILL:

An act to amend the education law, in relation to when school personnel
may adjust a student's dosage of insulin

 
PURPOSE:

To clarify that licensed school personnel may adjust the dosage of
prescribed insulin under instructions of the prescriber of the insulin
with parental consent

 
SUMMARY OF PROVISIONS:

Section 1 amends subdivision 1 of section 902-a of the education law, as
added by chapter 423 of the laws of 2014, to provide that licensed nurs-
es, nurse practitioners, physician assistants, or physicians employed by
school districts or boards of cooperative educational services are
authorized to administer prescribed insulin, which may include adjusting
the dosage of the insulin under instructions from the prescriber or
              

instructions from the parent or person in parental relationship where
explicitly authorized by the prescriber.

Section 2 amends section 6909 of the education law by adding a new
subdivision 9 to provide that a registered professional nurse, when
administering insulin under a prescription, may vary the insulin dosage
under instructions from the parent or person in parental relationship
where explicitly authorized by the prescriber.

Section 3 provides the effective date.

 
JUSTIFICATION:

Children with diabetes require close monitoring and management as their
insulin needs fluctuate throughout the day and from day to day.  To
monitor their needs, children may wear a continual glucose monitor (CGM)
to track glucose levels at regular intervals throughout the school day,
providing the readings on the CGM and transmitting concurrently the data
to a child's parent on a computer, smartphone or. tablet. With such
monitoring devices, a parent is alerted immediately if the child's blood
sugar level drops to a dangerously low level or a high preset level.
Armed with the data, a parent can contact a school nurse to request that
the child's insulin dosage be adjusted depending on the reading provided
by the CGM.

Current law authorizes licensed nurses, nurse practitioners, physician
assistants, or physicians employed by school districts or boards of
cooperative educational services to, among other things, calculate
prescribed insulin dosages, administer prescribed insulin, program the
prescribed insulin pump, refill the reservoir in the insulin pump, and
inject prescribed glucagon to pupils who have received written permis-
sion by a physician and written parental consent to carry and use insu-
lin and glucagon during the school day.

Nevertheless, some school nurses believe they are not permitted under
the law to adjust the levels of the insulin during the day as directed
by a parent even though the child's physician has written an order that
provides for the administration of insulin and adjustment of dosage upon
request by the parent. As a result, a parent must interrupt his or her
job or other responsibilities to go immediately to the child's school
and adjust the dosage in person. Such frequent and unscheduled
disruptions may force a parent to take an unpaid leave of absence,
imposing economic hardship on the family and straining the emotional
well-being of the child with diabetes and the child's family.

To remove any ambiguity in the law and eliminate any inconsistency in
the administration by licensed school personnel in school districts and
BOCES throughout the State of prescribed insulin dosage, this bill makes
clear that such school personnel may adjust the insulin dosage, includ-
ing by insulin pump or other device, under instructions to such school
personnel from a parent or person in parental relationship where adjust-
ment of dosage is explicitly authorized by the prescriber. In this way
we can ensure that children with diabetes can obtain the insulin dosage
they need on a timely basis.

 
LEGISLATIVE HISTORY:

2021-22:S.2635/A.3949 Referred to Education

2019-20:S.1900/A.359 Referred to Education

2017-18:S.5679/A.6520 Referred to Education

 
FISCAL IMPLICATIONS:

None to the State.

 
EFFECTIVE DATE:
This act shall take effect immediately.