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H. 3154
STATUS INFORMATION
General Bill
Sponsors: Rep. J. Brown
Document Path: l:\council\bills\nbd\11027ac03.doc
Introduced in the House on January 14, 2003
Currently residing in the House Committee on Medical, Military, Public and Municipal Affairs
Summary: Diabetes School Care Act
HISTORY OF LEGISLATIVE ACTIONS
Date Body Action Description with journal page number
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12/4/2002 House Prefiled
12/4/2002 House Referred to Committee on Medical, Military, Public and
Municipal Affairs
1/14/2003 House Introduced and read first time HJ-64
1/14/2003 House Referred to Committee on Medical, Military, Public and
Municipal Affairs HJ-64
View the latest legislative information at the LPITS web site
VERSIONS OF THIS BILL
TO AMEND CHAPTER 39, TITLE 44, CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING ARTICLE 2 SO AS TO ENACT THE "DIABETES SCHOOL CARE ACT", TO REQUIRE THE PRINCIPAL AT EACH PUBLIC SCHOOL TO DESIGNATE THREE EMPLOYEES TO BE DIABETES CARE PROVIDERS, TO ALSO AUTHORIZE AS EMPLOYEES OF THE DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL ASSIGNED TO A SCHOOL AND SUBCONTRACTORS TO BE DIABETES CARE PROVIDERS, TO PROVIDE FOR THE TRAINING OF THESE CARE PROVIDERS, TO ESTABLISH THE RESPONSIBILITIES AND THE SCOPE OF AUTHORITY FOR A DIABETES CARE PROVIDER, TO ALLOW A STUDENT WITH DIABETES TO PERFORM GLUCOSE TESTS, ADMINISTER INSULIN, AND TO ATTEND TO THE CARE AND MANAGEMENT OF HIS OR HER DIABETES AND TO POSSES NECESSARY SUPPLIES AND EQUIPMENT TO CONDUCT THESE FUNCTIONS, TO REQUIRE THE DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL TO MAKE INFORMATION AND TRAINING MATERIALS AVAILABLE TO PRIVATE SCHOOLS, AND TO PROVIDE THAT A DIABETES CARE PROVIDER ACTING IN ACCORDANCE WITH THIS ARTICLE IS IMMUNE FROM CIVIL AND CRIMINAL LIABILITY AND IS NOT PRACTICING NURSING AND IS EXEMPT FROM ALL APPLICABLE STATUTORY AND REGULATORY PROVISIONS THAT RESTRICT WHAT ACTIVITIES MAY BE DELEGATED TO A PERSON WHO IS NOT A LICENSED MEDICAL PROFESSIONAL; TO AMEND SECTION 15-78-60, AS AMENDED, RELATING TO EXCEPTIONS TO THE WAIVER OF IMMUNITY UNDER THE SOUTH CAROLINA TORT CLAIMS ACT, SO AS TO ALSO INCLUDE IN THESE EXCEPTIONS, ACTS OR OMISSIONS OF A DIABETES CARE PROVIDER; AND TO DESIGNATE SECTIONS 44-39-10 THROUGH 44-39-50 AS ARTICLE 1, CHAPTER 39, TITLE 44 ENTITLED "DIABETES INITIATIVE OF SOUTH CAROLINA" AND TO RENAME CHAPTER 39, TITLE 44 AS "DIABETES".
Whereas, the General Assembly recognizes the value of having nurses placed in every South Carolina school and considers having a nurse in each school a desired goal; however, under current fiscal constraints funding such an initiative is not within the means of the General Assembly and other measures to provide good healthcare to our school children should be pursued; and
Whereas, diabetes is a serious, chronic disease that impairs the body's ability to use food. Diabetes must be managed twenty-four hours a day in order to avoid the potentially life-threatening, short-term consequences of blood sugar levels that are either too high or too low, and to avoid or delay the serious long-term complications of high blood sugar levels which include blindness, amputation, heart disease, and kidney failure. In order to manage their disease, students with diabetes must have access to the means to balance food, medications, and activity level while at school and at school-related activities; and
Whereas, because of the significant number of students with diabetes, the effect of diabetes upon a student's ability to learn, and the risk for serious long and short-term medical complications, the South Carolina General Assembly finds that it is in the best interest of South Carolina's children with diabetes to enact the "Diabetes Mellitus School Care Act." Now, therefore,
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Chapter 39 of Title 44 of the 1976 Code is amended by adding:
Section 44-39-200. This article may be cited as the 'Diabetes Mellitus School Care Act'.
Section 44-39-210. For purposes of this article:
(1) 'Diabetes care provider' means a school employee trained in accordance with Section 44-39-220. While a school nurse is a preferred diabetes care provider, a diabetes care provider is not required to be a medical professional. When a school nurse is assigned to a particular school, he or she shall coordinate the provision of diabetes care at that school.
(2) 'School' means a primary, elementary, middle, or secondary public school located within this State.
(3) 'School employee' means a person employed by a public school district or a public special school or a person employed by a local health department who is assigned to a public school or a subcontractor designated for this function.
Section 44-39-220. (A) The Diabetes Initiative of South Carolina, working in cooperation with the South Carolina Board of Nursing, South Carolina Department of Health and Environmental Control, South Carolina Department of Education, and the South Carolina Office of the American Diabetes Association shall develop guidelines for the training of school employees as diabetes care providers. Training must be provided annually by a health care professional with expertise in diabetes and training guidelines must 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 student's physician's order or health care plan, or both;
(3) understanding physician instructions concerning drug dosage, frequency, and the manner of administration;
(4) performance of finger-stick blood glucose testing, ketone testing, and recording the results;
(5) administration of oral medications, glucagon, and insulin and the recording of results;
(6) recommended schedules and food intake for meals and snacks, the effect of exercise upon blood glucose levels, and actions to be implemented in the case of schedule disruption.
(B) Each public school district shall provide or contract for the training provided for in subsection (A) to at least two school employees who must be designated as a diabetes care provider by the principal at each public school that does not employ a full-time registered nurse. However, failure of a school employee to agree to be a diabetes care provider does not constitute insubordination.
(C) Each public school shall develop a written protocol with procedures to be followed if a student diabetes emergency arises when neither a registered nurse nor a diabetes care provider is available.
Section 44-39-230. (A) In accordance with the written instructions of the physician of a student with diabetes, diabetes care providers may perform functions including, but not limited to:
(1) administering glucagon in an emergency situation;
(2) assisting a student in administering insulin through the insulin delivery system the student uses;
(3) assisting a student in administering other oral diabetes medications;
(4) assisting a student in performing and recording blood glucose testing and ketone testing or assisting a student with such testing; and
(5) following written instructions regarding meals, snacks, and physical education.
However, a diabetes care provider may only perform these functions if the school has obtained the informed consent of a parent for the child to receive these services.
(B) Notwithstanding any other provision of law, a diabetes care provider trained pursuant to Section 44-39-220 who is carrying out the functions enumerated in subsection (A) is not engaging in the practice of nursing and is exempt from all applicable statutory and regulatory provisions that restrict activities that may be delegated to a person who is not a licensed medical professional.
Section 44-39-240. (A) Upon written request of the parent or guardian and authorization by the student's physician, a student with diabetes must be permitted to perform blood glucose tests, administer insulin through the insulin delivery system the student uses, treat hypoglycemia and hyperglycemia, and otherwise attend to the care and management of the student's diabetes in the classroom, in any area of the school or school grounds, and at any school-related activity and to possess on his or her person at all times all necessary supplies and equipment to perform these monitoring and treatment functions. However, if a student demonstrates an inability or unwillingness to perform these monitoring and treatment functions in a manner that is safe to the student, other students, and staff, the principal, after consultation with the student's parents or guardian and, where possible, the student's physician, may designate a medically appropriate alternative site that is not disruptive to the classroom for the performance of these monitoring and treatment functions.
(B) A student's school choice, as may be authorized by law, may not be restricted due to the student having diabetes.
(C) A student may not be denied access or prohibited from participating in school activities and programs including, but not limited to, school sponsored before-school programs, after-school programs, after-school care programs, field trips, and extracurricular activities unless, based upon a statement from the student's physician, the student's diabetic condition is such that the activity or program may endanger the health or welfare of the student or of other students.
(D) Each public school district shall develop a policy to implement the provisions of this article.
Section 44-39-250. (A) The South Carolina Department of Health and Environmental Control shall provide each private school in the State with a copy of this article and shall make the training materials developed in accordance with Section 44-39-220 available to private schools.
(B)(1) A private school diabetes care provider trained pursuant to Section 44-39-220 who is carrying out the functions enumerated in Section 44-39-220, anyone training a private school diabetes care provider as prescribed in this article, a private school employing a diabetes care provider trained pursuant to Section 44-39-220 who is carrying out the functions enumerated in Section 44-39-220, or any other private school official acting within the scope of authority as prescribed in this article is acting within the scope of that person's official duties and is immune from civil and criminal liability.
(2) Notwithstanding any other provision of law, a private school diabetes care provider trained pursuant to Section 44-39-220 who is carrying out the functions enumerated in subsection (A) is not performing nursing procedures, functions, or tasks and is not engaging in the practice of professional or practical nursing.
Section 44-39-260. All costs associated with implementing the training provisions contained in this article must be borne by the State Department of Education."
SECTION 2. Section 15-78-60 of the 1976 Code, as last amended by Act 407 of 2000, is further amended by adding an appropriately numbered item to read:
"( ) for the acts or omissions of a diabetes care provider, as defined in Section 44-39-210(1).
SECTION 3. Sections 44-39-10 through 44-39-50 of the 1976 Code are designated as Article 1, Chapter 39, Title 44 entitled "Diabetes Initiative of South Carolina" Chapter 39, Title 44 of the 1976 Code is renamed "Diabetes".
SECTION 4. This act takes effect upon approval by the Governor.
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