BILL NUMBER: AB 1802	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member Hall
   (Coauthor: Assembly Member Blumenfield)
   (Coauthor: Senator Cox)

                        FEBRUARY 10, 2010

   An act to add Section 49414.6 to the Education Code, relating to
pupil health.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1802, as introduced, Hall. Pupil health: diabetes: insulin
injections.
   Existing law provides that each pupil who is required to take,
during the regular schoolday, medication prescribed for him or her by
a physician, may be assisted by the school nurse or other designated
school personnel if the school district receives a written statement
from the physician detailing the method, amount, and time schedules
by which the medication is to be taken and a written statement from
the parent or guardian of the pupil indicating the desire that the
school district assist the pupil in the matters set forth in the
physician's statement. Existing law, in the absence of a credentialed
school nurse or other licensed nurse, authorizes a school district
to provide voluntary emergency medical training to school personnel,
as defined, to administer emergency medical assistance to pupils with
diabetes suffering from severe hypoglycemia, subject to specified
conditions.
   This bill would authorize a parent or guardian of a pupil with
diabetes, if a credentialed school nurse or other licensed health
care professional is not immediately available onsite at the school,
to designate one or more school employees as parent-designated school
employees for the purpose of administering insulin to the pupil as
necessary during the regular school day. The bill would authorize a
parent-designated school employee to administer insulin only (1) on a
volunteer basis, (2) in accordance with the performance instructions
set forth by the licensed health care provider of the pupil, and (3)
after receiving appropriate training. The bill would require that
the parent or guardian submit a written statement, valid for a
maximum of one year, indicating the names of the school employees
being designated, stating that those employees have volunteered to
serve and have submitted a letter of intent, as specified, and
acknowledging the provisions discussed below regarding immunity from
criminal and civil liability. The bill would require the school
district to keep a copy of that statement and to obtain other
specified statements from the physician of the pupil and the parent
or guardian. The bill would require a school district, within 3
business days of receiving a written request from the parent or
guardian of a pupil with diabetes to notify school staff regarding
the intent of the parent or guardian to designate school employees to
administer insulin to the pupil, and to distribute to all staff
members a written notice regarding that request, as specified. The
bill would authorize a licensed health care professional, as
described, to provide training to parent-designated school employees
in the administration of insulin and to supervise those employees in
performing that task. The bill would provide that a parent-designated
school employee who, acting in good faith and in substantial
compliance with the instructions of the pupil's licensed health care
professional, administers insulin pursuant to the bill's provisions
is not liable in any criminal action or for civil damages in his or
her individual or official capacity as a result of administering the
insulin. By requiring school districts to perform additional duties,
the bill would impose a state-mandated local program.
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  (a) The Legislature finds and declares all of the
following:
   (1) Diabetes is an incurable disease in which the body does not
produce or properly use insulin, a hormone needed for daily life.
   (2) Diabetes is the sixth leading cause of death in the United
States.
   (3) Numerous medical and scientific studies have shown that the
complications associated with the disease can be prevented through
proper disease management.
   (4) Approximately 15,000 children in California have diabetes,
many of whom attend public schools.
   (5) The vast majority of pupils with diabetes must receive insulin
by injection or through an insulin pump one or more times each day
during school hours as well as during other school activities.
   (6) Lack of access to insulin whenever needed during the school
day puts pupils with diabetes at risk for developing serious, and
potentially life-threatening, short and long-term complications of
the disease as well as diminishing their ability to learn.
   (7) While schools have ensured that the majority of children with
diabetes have assistance with blood glucose monitoring and glucagon
administration in the event of an emergency, accessing assistance
with insulin administration remains very difficult.
   (8) There is a severe nursing shortage in California, especially
in public elementary and secondary schools, with the result that,
according to the California School Nurses Organization, there is only
one credentialed school nurse for every 2,700 pupils in the
California public school system.
   (9) The subject of which employees a school district may designate
to administer insulin to pupils as required by their medical
condition remains controversial, and school districts have
experienced significant confusion and uncertainty in determining how
to meet the needs of these pupils because school nurses or other
health care professionals are not always available to administer
insulin as prescribed by their health care providers.
   (b) It is therefore the intent of the Legislature in enacting this
act to clarify and expand upon existing law to provide school
districts with explicit options and added flexibility in providing
insulin administration to pupils who require this service by
establishing protocols that parents of pupils with diabetes may use
to designate volunteer school employees to be trained to administer
insulin to the pupil.
  SEC. 2.  Section 49414.6 is added to the Education Code, to read:
   49414.6.  (a) Notwithstanding the Nursing Practice Act (Chapter 6
(commencing with Section 2700) of Division 2 of the Business and
Professions Code) or any other provision of law, if a credentialed
school nurse or other licensed health care professional is not
immediately available onsite at the school, the parent or guardian of
a pupil with diabetes may designate one or more school employees for
the purpose of administering insulin to the pupil as necessary
during the regular school day, as defined in subdivision (g) of
Section 601 of Title 5 of the California Code of Regulations. A
parent-designated school employee may administer insulin pursuant to
this section only (1) on a volunteer basis, (2) in accordance with
the performance instructions set forth by the licensed health care
provider of the pupil, and (3) after receiving appropriate training
pursuant to subdivision (b). The parent or guardian shall file a
written statement, valid for a maximum of one year, indicating the
names of the school employees being designated, stating that those
employees have volunteered to serve as parent-designated school
employees and have submitted the letter of intent described in
subdivision (d), and acknowledging the immunity from criminal and
civil liability provided in subdivision (h). The school district
shall keep a copy of this statement and shall obtain the statements
required by subdivision (a) of Section 49423.
   (b) A school employee may serve as a parent-designated school
employee pursuant to subdivision (a) only if he or she has been
trained in administering insulin by a licensed nurse, physician,
certified diabetes educator, or other health care professional with
expertise in diabetes. A health care professional employed by the
school district provides training pursuant to this subdivision shall
not be responsible for the supervision of the parent-designated
school employee in administering medication to the pupil.
   (c) Within three business days of receiving a written request from
the parent or guardian of a pupil with diabetes that school staff be
notified regarding the intent of the parent or guardian to designate
school employees to administer insulin to the pupil, a school
district shall distribute to all staff members a written notice
regarding that request that contains all of the following
information:
   (1) A statement that the parent or guardian of a child with
diabetes is seeking to designate school employees to administer
insulin to the pupil.
   (2) A statement, consistent with subdivision (d), that a designee
will only administer insulin on a volunteer basis and that the school
district will take no action against any staff member who does not
volunteer for designation.
   (3) A statement that training will be provided to all
parent-designated school employees, pursuant to subdivision (b).
   (4) A statement that parent-designated school employees are
protected from liability pursuant to subdivision (h).
   (5) Information regarding who to contact to volunteer to be a
parent-designated school employee.
   (d) Each parent-designated school employee shall submit a
voluntary letter of intent stating the employee's willingness to
serve as a parent-designated school employee. A school employee shall
not be required or coerced in any manner to serve as a
parent-designated school employee. The school district shall take no
disciplinary or retaliatory action against any school employee who
does not volunteer to serve as a parent-designated school employee.
   (e) All materials necessary to administer insulin shall be
provided by the parent or guardian of the pupil.
   (f) Notwithstanding any other provision of law, a licensed health
care professional, including a physician, credentialed school nurse,
registered nurse, or certificated public health nurse, may provide
training to parent-designated school employees in the administration
of insulin and supervise those employees in performing that task.
   (g) This section is not intended to alter or diminish the rights
of pupils to receive medication at school or to restrict the persons
who may be designated by the school district to administer that
medication under any other provision of law. Nothing in this section
alters or diminishes the rights of eligible pupils or the obligations
of school districts under the federal Individuals with Disabilities
Education Act (20 U.S.C. Sec. 1400 et seq.) or Section 504 of the
federal Rehabilitation Act (29 U.S.C. Sec. 701 et seq.), and the
federal Americans with Disabilities Act (42 U.S.C. Sec. 12101 et
seq.), and the failure of a parent to designate a school employee
pursuant to subdivision (a) does not alter the school district's
obligation to administer insulin under those laws.
   (h) A parent-designated school employee who, acting in good faith
and in substantial compliance with the instructions of the pupil's
licensed health care professional, administers insulin pursuant to
this section shall not be liable under state law in any criminal
action or for civil damages in his or her individual or official
capacity as a result of administering the insulin.
  SEC. 3.  If the Commission on State Mandates determines that this
act contains costs mandated by the state, reimbursement to local
agencies and school districts for those costs shall be made pursuant
to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of
the Government Code.