By: Duncan S.B. No. 1662
(In the Senate - Filed March 14, 2003; March 20, 2003, read
first time and referred to Committee on Health and Human Services;
May 2, 2003, reported adversely, with favorable Committee
Substitute by the following vote: Yeas 7, Nays 0; May 2, 2003, sent
to printer.)
COMMITTEE SUBSTITUTE FOR S.B. No. 1662 By: Janek
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 plan" means the document
required by Section 38.102.
(2) "School" means a public elementary or secondary
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 assistant" means a school
employee who has completed the training required by Section 38.103.
Sec. 38.102. INDIVIDUAL HEALTH PLAN. (a) An individual
health 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.
(b) An individual health 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 individual health
plan. The plan must be submitted to and reviewed by the school:
(1) before the beginning of each school year;
(2) on enrollment of the student, if the student
enrolls in the school after the beginning of a 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;
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 assistant.
(c) If a school nurse is assigned to a campus:
(1) the school nurse must be one of the trained
diabetes care assistants at that campus; or
(2) the school nurse shall supervise other school
employees acting as trained diabetes care assistants.
(d) If a school nurse is not assigned to a campus, the
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, physician
assistant, registered nurse, certified diabetes educator, or
licensed dietitian.
(e) 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.
(f) 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 individual health 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.
(g) The board of trustees of a school district shall ensure
that there are at least three trained diabetes care assistants at
each campus attended by one or more students with diabetes.
Sec. 38.104. INFORMATION FOR SCHOOL BUS DRIVERS. A school
district shall provide a single page of information identifying and
providing emergency information, including contact phone numbers,
for a student with diabetes for personnel involved in transporting
and supervising that student on a school-related activity.
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 individual health
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 individual health
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 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 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 individual health 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.
* * * * *