78R16823 ESH-D
By: Duncan, et al. S.B. No. 1662
Substitute the following for S.B. No. 1662:
By: Capelo C.S.S.B. No. 1662
A BILL TO BE ENTITLED
AN ACT
relating to the care of elementary and secondary school students
with diabetes.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 38, Education Code, is amended by adding
Subchapter C to read as follows:
SUBCHAPTER C. CARE OF STUDENTS WITH DIABETES
Sec. 38.101. DEFINITIONS. In this subchapter:
(1) "Individual health care plan" means the document
required by Section 38.102.
(2) "School" means an elementary or secondary school
of an independent school district.
(3) "School employee" means a person employed by:
(A) a school;
(B) a local health department that assists a
school under this subchapter; or
(C) another entity with which a school has
contracted to perform its duties under this subchapter.
(4) "Trained diabetes care assistant" means a school
employee who has completed the training required by Section 38.103.
Sec. 38.102. INDIVIDUAL HEALTH CARE PLAN. (a) An
individual health care plan must be developed for each student with
diabetes who will seek care for the student's diabetes while at
school. The plan shall be developed by:
(1) the student's parent or guardian; and
(2) the student's personal health care team, which
should include the student's physician and school employees whose
duties are relevant to the student's medical condition.
(b) An individual health care plan must:
(1) identify the health care services the student may
receive at school; and
(2) be signed by the student's parent or guardian and
the student's personal health care team.
(c) The parent or guardian of a student with diabetes who
seeks care for the student's diabetes while the student is at school
shall submit to the school a copy of the student's individual health
care plan. The plan must be submitted to and reviewed by the
school:
(1) before the beginning of the school year;
(2) on enrollment of the student, if the student
enrolls in the school after the beginning of the school year; or
(3) as soon as practicable following a diagnosis of
diabetes for the student.
Sec. 38.103. TRAINED DIABETES CARE ASSISTANT. (a) The
Texas Diabetes Council shall develop, with the assistance of the
following entities, guidelines for the training of school employees
in the care of students with diabetes:
(1) the School Health Program of the Texas Department
of Health;
(2) the American Diabetes Association;
(3) the Juvenile Diabetes Research Foundation
International;
(4) the American Association of Diabetes Educators;
(5) the agency; and
(6) the Texas School Nurses Organization.
(b) A school employee is not required to be a health care
professional to be designated as a trained diabetes care assistant.
The board of trustees of a school district may not require a school
employee to serve as a trained diabetes care assistant.
(c) If a school nurse is assigned to a campus:
(1) the school nurse may be recognized as a trained
diabetes care assistant at that campus; or
(2) the school nurse may supervise one or more other
school employees acting as trained diabetes care assistants.
(d) A school nurse may be recognized as a trained diabetes
care assistant without completing the training under this section
if:
(1) the nurse is a registered nurse; and
(2) the nurse has received formal advanced training in
diabetes care as part of the nurse's continuing education.
(e) If a school nurse is not assigned to a campus:
(1) each trained diabetes care assistant must have
access, for emergency or informational assistance, to an individual
who has expertise in the care of persons with diabetes, such as a
physician, registered nurse, certified dietitian educator, or
licensed dietitian; or
(2) the school must have access to a licensed health
care professional who is a member of the student's personal health
care team.
(f) Training under this section must be provided annually by
a health care professional with expertise in the care of persons
with diabetes. The training must be provided before the beginning
of the school year or as soon as practicable following:
(1) the enrollment of a student with diabetes at a
campus that previously had no students with diabetes; or
(2) a diagnosis of diabetes for a student at a campus
that previously had no students with diabetes.
(g) The training must include instruction in:
(1) recognizing signs of hypoglycemia and
hyperglycemia;
(2) steps to take if the blood glucose levels of a
student with diabetes are outside the target ranges indicated by
the student's individual health care plan;
(3) how to follow a physician's instructions
concerning diabetes medication dosages, administration, and
frequency of administration;
(4) performing finger-sticks to check blood glucose
levels, checking ketone levels, and recording the results of those
checks;
(5) administering glucagon and insulin and recording
the results of the administration; and
(6) the recommended schedules and food intake for
meals and snacks for a student with diabetes, the effect of physical
activity on blood glucose levels, and the steps to take if a
student's schedule is disrupted.
(h) The training must be provided without charge to the
school employee receiving the training.
(i) The board of trustees of a school district shall ensure
that there is at least one trained diabetes care assistant at each
campus attended by one or more students with diabetes.
Sec. 38.104. INFORMATION FOR CERTAIN EMPLOYEES. A school
district shall provide to each school employee who is responsible
for transporting a student with diabetes or for supervising a
student with diabetes during an off-campus activity a one-page
information sheet that:
(1) identifies the student with diabetes;
(2) identifies potential emergencies involving the
student's diabetes and appropriate responses to such emergencies;
and
(3) provides telephone numbers of persons the employee
may contact in an emergency involving the student's diabetes.
Sec. 38.105. REQUIRED CARE OF STUDENTS WITH DIABETES. (a)
At the written request of a parent or guardian of a student with
diabetes and in compliance with the student's individual health
care plan, a trained diabetes care assistant shall:
(1) respond to the student's blood glucose level if it
is outside the target range specified in the student's individual
health care plan; and
(2) assist the student in following instructions
regarding meals, snacks, and physical activity.
(b) A school shall ensure to the greatest extent practicable
that the trained diabetes care assistant is present and available
to provide the required care to a student with diabetes during the
regular school day.
(c) A school district may not restrict the assignment of a
student with diabetes to a particular campus on the basis that the
campus does not have the required trained diabetes care assistants.
(d) A trained diabetes care assistant who performs an
activity described by Subsection (a) in compliance with the
individual health care plan of a student with diabetes:
(1) is not considered to be engaging in the practice
of:
(A) professional nursing under Chapter 301,
Occupations Code, or other state law; or
(B) vocational nursing under Chapter 302,
Occupations Code, or other state law; and
(2) is exempt from any applicable state law or rule
that restricts the activities that may be performed by a person who
is not a health care professional.
Sec. 38.106. INDEPENDENT MONITORING AND TREATMENT. On the
written request signed by a parent or guardian of a student with
diabetes, and if permitted by the student's individual health care
plan, a school shall permit the student to:
(1) perform blood glucose level checks;
(2) administer insulin through the insulin delivery
system the student uses;
(3) treat hypoglycemia and hyperglycemia;
(4) possess on the student's person at any time any
supplies or equipment necessary to monitor and care for the
student's diabetes; and
(5) otherwise attend to the management and care of the
student's diabetes in the classroom, in any area of the school or
school grounds, or at any school-related activity.
SECTION 2. Subchapter C, Chapter 38, Education Code, as
added by this Act, applies beginning with the 2004-2005 school
year.
SECTION 3. This Act takes effect September 1, 2003.