Bill Text: HI HB861 | 2016 | Regular Session | Introduced

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Bill Title: Students With Diabetes; Schools

Spectrum: Strong Partisan Bill (Democrat 11-1)

Status: (Introduced - Dead) 2015-12-17 - Carried over to 2016 Regular Session. [HB861 Detail]

Download: Hawaii-2016-HB861-Introduced.html

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HOUSE OF REPRESENTATIVES	H.B. NO.	861
TWENTY-EIGHTH LEGISLATURE, 2015
STATE OF HAWAII

A BILL FOR AN ACT

 

 

RELATING TO HEALTH.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 

     SECTION 1.  The legislature finds that there is a rapidly growing population of students with diabetes attending public schools.  Diabetes often prevents these students from participating in school functions and events.  Diabetes can also adversely affect students' ability to perform routine school tasks such as test taking.  While many of the symptoms of diabetes can be treated and mitigated with timely health management measures, such as medication or food intake, current school policies and practices fail to accommodate those options in an effective manner.

The legislature finds that diabetes must be managed twenty-four hours a day to avoid the potentially life-threatening short-term consequences of blood glucose levels that are either too high or too low, and to avoid or delay the serious long-term complications of high blood glucose levels, which include blindness, amputation of limbs, heart disease, and kidney failure.  Well-managed blood glucose levels enable students with diabetes to be more productive and successful in school.  In order to manage their disease, students with diabetes must have access to the means to balance food, medications, and physical activity levels while at school and at school-related activities.

Diabetes is generally a self-managed disease, and many students with diabetes are able to perform most of their own diabetes care tasks.  However, some students, because of their age, inexperience, or other factors, need help with some or all diabetes care tasks.  Further, all students with diabetes will need assistance in the event of a diabetes emergency.  The school nurse plays a central role in providing or facilitating care for a student with diabetes in the school setting.  All public schools in Hawaii have a health aide, but many do not have a full-time nurse on campus.  In addition, even when a nurse is assigned to a school full-time for a specific student requiring nursing services throughout the day, that nurse is not available to provide direct care to other students requiring nursing services during the school day, during extracurricular activities, and on field trips.  Because diabetes management is needed throughout the school day, additional personnel who have completed appropriate training are needed at schools to perform diabetes care tasks at school and school-related activities so that students with diabetes have the same access to educational opportunities that other students in Hawaii have.

SECTION 2.  Chapter 302A, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:

"Part    .   CARE OF STUDENTS with DIABETES

§302A-A  Definitions.  Whenever used in this part, unless a different meaning clearly appears from the context:

"Diabetes medical management plan" means a plan that identifies the health needs of the student, sets forth prescribed care to address health needs at school, and is signed by the student's personal health care professional and a parent or guardian.

"Nurse" shall have the same definition as in section 457-2 and shall include any other licensed or registered nurse providing care to students with diabetes under this part.

"School" means any public or charter elementary, intermediate, secondary, or high school located within the State, including its governing body.

"School employee" means any person employed by a school or by the department of health and assigned to a public or charter school, or any subcontractor designated for this function.

"Trained diabetes care personnel" means any school employee or volunteer who is trained to provide services to students as provided under this part.

§302A-B  Diabetes training.  (a)  The department shall consult with the department of health and the American Diabetes Association to develop and adopt rules pursuant to chapter 91 for the training of school employees and qualified volunteers to provide care to students with diabetes.  The rules shall include a requirement that each school provide annual diabetes training programs for all nurses, trained diabetes care personnel, and persons seeking to become trained diabetes care personnel.  In addition, the guidelines shall address:

(1)  Recognition and treatment of hypoglycemia and hyperglycemia;

(2)  An understanding of the appropriate actions to be taken when blood glucose levels are outside of the target ranges indicated by the student's medical management plan;

(3)  Understanding of a physician's instructions concerning diabetes medication dosages, frequency, and manner of administration;

(4)  Performance of finger-stick blood glucose checking, ketone checking, and recording of results;

(5)  The administration of insulin and the recording of the results;

(6)  Understanding how to perform basic insulin pump functions;

(7)  Recognizing diabetes-related complications that require emergency assistance;

(8)  Understanding recommended schedules and food intake for meals and snacks, the physical effects of physical activity on blood glucose levels, and actions to be taken in case of schedule disruption;

(9)  Understanding of any other appropriate medical procedures and technology that may be developed from time to time for testing, treatment, or care of the student with diabetes; and

(10) Understanding of long-term complications of diabetes and the importance of teaching students with diabetes about self-management skills that shall be supported in the school setting as prescribed by the student's diabetes medical management plan.

(b)  Each school which a student with diabetes attends shall provide the training required under subsection (a) to a minimum of three school employees.  If at any time fewer than three school employees are available to be trained at the school, the principal or other school administrator shall distribute a written notice to all staff stating that it is seeking employees to serve as diabetes care personnel.  The notice shall inform staff of:

     (1)  The requirement that the school provide diabetes care to students with diabetes and recruit personnel willing to be trained to provide diabetes care;

     (2)  The tasks to be performed;

     (3)  The voluntary nature of participation;

     (4)  Training, which will be provided at no cost;

     (5)  Liability protections for persons willing to be trained; and

     (6)  Contact information of the coordinator.

     (c)  A school shall not discourage any employee from participating in the training program or subject any employee who declines to serve as trained diabetes care personnel to any penalty or disciplinary action for that decision.

(d)  The nurse or a health care professional with expertise in diabetes care shall coordinate the training outlined under subsection (a).  If there is any student with diabetes enrolled at the school before the start of the school year, the school shall hold the training before each school year starts.  If a student with diabetes enrolls in the school or is diagnosed with diabetes after the school year has started and the school has not held the diabetes care training before the start of the school year, the training shall be held no more than thirty days following the student's enrollment or diagnosis.

(e)  Each school shall provide training for all school employees responsible for the supervision of any student with diabetes, including bus drivers who transport students with diabetes, regarding the recognition of hypoglycemia and hyperglycemia and the appropriate action to take in an emergency situation.

§302A-C  Diabetes medical management plan.  The parent or guardian of each student with diabetes who seeks diabetes care for the student while at school shall submit a diabetes medical management plan for that student to the school.  The school shall implement the diabetes medical management plan upon receipt.

§302A-D  Required care.  (a)  Any school that has enrolled a student who has submitted a diabetes medical management plan shall ensure that the student receives the appropriate diabetes care specified in the student's diabetes medical management plan.

(b)  In accordance with the student's diabetes medical management plan, a nurse or trained diabetes care personnel shall perform diabetes care, including:

(1)  Checking and recording blood glucose levels and ketone levels or assisting a student with diabetes in checking and recording blood glucose levels and ketone levels;

(2)  Responding to blood glucose levels that are outside of the student's target blood glucose range as stated in the student's diabetes medical management plan;

(3)  Administering insulin or assisting a student in administering insulin via the insulin delivery system that the student uses;

(4)  Providing diabetes medicine to be taken orally by the student; and

(5)  Facilitating compliance with the recommendations in the student's diabetes medical management plan regarding meals, snacks, and physical activity.

(c)  A nurse or trained diabetes care personnel shall be at each school that has enrolled a student with diabetes during regular school hours, after-school care programs, field trips, extended off-site excursions, extracurricular activities, and on buses when the bus driver has not completed the necessary training required under section 302A-B.

(d)  Notwithstanding any law to the contrary, the provision of care required under subsection (a) shall not constitute the practice of nursing.  Trained diabetes care personnel who are not nurses as defined under section 457-2 shall be exempt from statutory provisions that restrict the activities that may be delegated to or performed by a person who is not a licensed or registered health care professional to the extent required to perform duties pursuant to this part.

(e)  Notwithstanding any law to the contrary, it shall be lawful for a licensed health care professional to provide training to school employees as required under section 302A-B and to supervise trained diabetes care personnel in the administration of required care under subsection (a).

(f)  Except in cases of gross negligence or intentional conduct, schools, nurses, trained diabetes care personnel, and any other person acting in good faith and in accordance with the provisions established under this part shall not be subject to civil liability or to discipline for unprofessional conduct.

§302A-E  School assignment; provision of care.  (a)  A student with diabetes shall be permitted to attend any school that the student would otherwise be able to attend if the student did not have diabetes.

(b)  A school shall not prohibit a student with diabetes from enrolling on the basis that:

(1)  The student has diabetes; or

(2)  The school does not have a full-time nurse or full-time trained diabetes care personnel available.

(c)  The school at which the student with diabetes is enrolled shall provide the required diabetes care as provided under section 302A-D.

(d)  The school shall not require or pressure the parents or guardian of a student with diabetes to be the sole provider of or mandate their participation in providing diabetes care for a student with diabetes while that student is attending school or participating in school-related activities.

§302A-F  Independent monitoring and treatment.  (a)  Upon written request of a parent or guardian of a student with diabetes and in accordance with the student's diabetes medical management plan, a student with diabetes shall be permitted to:

(1)  Perform the student's own blood glucose checks, administer insulin through the insulin delivery system that the student uses, and otherwise attend to the care and management of the student's diabetes as provided in the student's diabetes medical management plan at school and during any school-related activity; and

(2)  Possess on the student's person all necessary supplies and equipment to perform the diabetes monitoring and treatment activities required under the student's diabetes medical management plan.

(b)  Upon request, a school shall provide a student with diabetes access to a private area so that the student may perform diabetes care activities.

§302A-G  Reports.  (a)  Each school that has at least one student with diabetes enrolled shall provide to the department an annual report no later than October 15 of each year.  The report shall include:

(1)  The number of students with diabetes enrolled at the school; and

(2)  Documentation of the school's compliance with the provisions of this part.

(b)  The department shall adopt rules pursuant to chapter 91 specifying the format of the report and the criteria for the documentation of the schools' compliance with the provisions of this part.

(c)  The department shall publish each report on its website by November 15 of each year.

§302A-H  Administrative complaints.  (a)  An impartial hearing before the department may be requested by any parent or guardian of a student with diabetes or by a student with diabetes for the failure of a school to comply with this part.

(b)  A student with diabetes or the student's parent or guardian may bring a lawsuit against the school for failure to comply with this part.  In the event that the student with diabetes or the student's parent or guardian prevails, in addition to any judgment awarded, the court may allow reasonable attorney's fees and costs of the action to be paid by the school.

(c)  Any action brought by a student with diabetes or the student's parent or guardian  under this part shall not alter or limit the remedies available under any other state or federal law, including section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act, and the Individuals with Disabilities Education Act of 2004."

SECTION 3.  Within one hundred eighty days of the effective date of this Act, the department of education shall adopt rules under chapter 91, Hawaii Revised Statutes, to effectuate the purpose of this Act.

SECTION 4.  This Act shall take effect upon its approval.

 

INTRODUCED BY:	_____________________________

 

 

Report Title:

Students With Diabetes; Schools

 

Description:

Requires the Department of Education to provide care to students with diabetes pursuant to a student's diabetes medical management plan.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.