78R6388 ESH-D
By: Duncan 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) "Medical management plan" means the document
required by Section 38.102.
(2) "School" means a public or private elementary or
secondary school or an open-enrollment charter school.
(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 provider" means a school
employee who has completed the training required by Section 38.103.
Sec. 38.102. MEDICAL MANAGEMENT PLAN. (a) A medical
management 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:
(A) the student's parent or guardian; and
(B) the student's personal health care team.
(b) A medical management plan must:
(1) identify the health care services the student may
receive at school; and
(2) be signed by 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 medical
management 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 PROVIDER. (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;
and
(5) the agency.
(b) A school employee is not required to be a health care
professional to be designated as a trained diabetes care provider.
(c) If a school nurse is assigned to a campus:
(1) the school nurse must be one of the trained
diabetes care providers at that campus; or
(2) the school nurse shall supervise other school
employees acting as trained diabetes care providers.
(d) 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.
(e) The training must include instruction in:
(1) recognizing hypoglycemia and hyperglycemia;
(2) understanding the proper action to take if the
blood glucose levels of a student with diabetes are outside the
target ranges indicated by the student's medical management plan;
(3) understanding 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) understanding 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 proper
actions to be taken if a student's schedule is disrupted.
(f) The board of trustees of a school district and the
governing body of each private school or open-enrollment charter
school shall ensure that there are at least three trained diabetes
care providers at each campus attended by one or more students with
diabetes.
Sec. 38.104. TRAINING FOR SCHOOL BUS DRIVERS. A school
district, private school, or open-enrollment charter school shall
provide to each bus driver who is responsible for transporting a
student with diabetes training in:
(1) recognizing hypoglycemia and hyperglycemia; and
(2) understanding the proper action to take in
response to an emergency involving a student with diabetes.
Sec. 38.105. REQUIRED CARE OF STUDENTS WITH DIABETES. (a)
At the request of a parent or guardian of a student with diabetes
and in compliance with the student's medical management plan, a
trained diabetes care provider shall:
(1) respond to the student's blood glucose level if it
is outside the target range specified in the medical management
plan;
(2) administer glucagon to the student;
(3) administer insulin to the student or assist the
student in administering insulin through an insulin delivery system
that the student uses;
(4) provide oral diabetes medication to the student;
(5) check and record the student's blood glucose
levels and ketone levels or assist the student with checking and
recording those levels; and
(6) assist the student in following instructions
regarding meals, snacks, and physical activity.
(b) A school shall ensure that at least one trained diabetes
care provider is present and available to provide the required care
to a student with diabetes:
(1) during the regular school day;
(2) during any school-sponsored before-school or
after-school program in which a student with diabetes participates;
(3) on any field trip that a student with diabetes
takes;
(4) during any extracurricular activity in which a
student with diabetes participates; and
(5) on a school bus on which a student with diabetes is
transported, if the bus driver has not received the training
required by Section 38.104.
(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 providers.
(d) A trained diabetes care provider who performs an
activity described by Subsection (a) in compliance with the medical
management 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 of a parent or guardian of a student with diabetes,
and if permitted by the student's medical management plan, a school
may 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.
Sec. 38.107. IMMUNITY FROM LIABILITY. (a) A physician,
school nurse, or school employee is immune from liability for civil
damages resulting from an action taken in compliance with this
subchapter if the person acted in the same manner as an ordinarily
reasonable and prudent person would have acted under the same or
similar circumstances.
(b) If a physician, school nurse, or school employee is
immune from liability under Subsection (a), the school that employs
the person is also immune from liability.
SECTION 2. Subchapter C, Chapter 38, Education Code,
applies beginning with the 2004-2005 school year.
SECTION 3. This Act takes effect September 1, 2003.