May 5, 2009, Introduced by Reps. Rick Jones, Tyler, Lori, DeShazor, Walsh, Denby, Switalski, Marleau and Dean and referred to the Committee on Health Policy.
A bill to amend 1976 PA 451, entitled
"The revised school code,"
(MCL 380.1 to 380.1852) by adding section 1180.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 1180. (1) Not later than 1 year after the effective date
of this section, the department of community health shall develop
guidelines for the training of school employees in the care needed
for students with diabetes. All of the following apply to these
guidelines and training:
(a) The guidelines shall be developed in consultation with the
American diabetes association, the Michigan association of school
nurses, and other organizations considered appropriate by the
department of community health.
(b) The guidelines shall provide for annual training by a
licensed health care professional with expertise in diabetes.
(c) The training shall include instruction in at least all of
(i) Recognition and treatment of hypoglycemia and
(ii) Understanding the appropriate actions to be taken when
blood glucose levels are outside the target ranges indicated by the
student's diabetes medical management plan.
(iii) Understanding physician instructions concerning diabetes
medication drug dosage, frequency, and manner of administration.
(iv) Performance of finger-stick blood glucose checking and
ketone checking and recording the results.
(v) Administration of insulin and recording of results.
(vi) Understanding how to perform basic insulin pump functions.
(vii) Administration of glucagon and recording of results.
(viii) Recommended schedules and food intake for meals and
snacks, the effect of physical activity on blood glucose levels,
and actions to be taken in case of schedule disruption.
(d) The training shall require successful completion of a
competency skills checklist.
(e) The department of community health shall identify 1 or
more licensed health care professionals as contact persons for
schools and shall have a contact person available to trained
diabetes personnel by telephone or in person to provide additional
or updated training as required due to changes in a student's
condition or updated information.
(2) If a student with diabetes is enrolled in a school
district, intermediate school district, public school academy, or
nonpublic school and the student's parent or legal guardian has
submitted a diabetes medical management plan to school officials as
provided under subsection (3), the board of the school district or
intermediate school district, board of directors of the public
school academy, or governing body of the nonpublic school shall
ensure that the training described in subsection (1) is provided to
the school nurse assigned to the school, if any, and to at least 2
school employees who work in each school the student attends and
who volunteer for the training. The training shall take place
before the beginning of each school year in which the student is
expected to attend the school or, if a student with diabetes
enrolls in the school during the school year or a student attending
the school is newly diagnosed with diabetes during the school year
and the training has not already occurred for that school year, as
soon as possible after the student's enrollment or diagnosis and
submission of the student's diabetes medical management plan.
(3) For a student with diabetes and the student's school to be
subject to this section, the student's parent or legal guardian
shall submit a diabetes medical management plan for the student to
school officials before the beginning of each school year or upon
enrollment of the student or diagnosis of the student with
diabetes. The diabetes medical management plan shall be developed
by a personal health care team for the student that includes a
licensed physician. If a diabetes medical management plan has been
submitted for a student with diabetes, all of the following apply
to that student:
(a) The training described in subsection (2) shall be provided
to school personnel.
(b) In accordance with the request of the student's parent or
legal guardian and with the diabetes medical management plan,
trained diabetes personnel shall perform functions related to
management of the student's diabetes, including, but not limited
to, some or all of the following:
(i) Responding to blood glucose levels that are outside of the
student's target range.
(ii) Administering insulin or assisting the student in
administering insulin using the insulin delivery system the student
(iii) Providing oral diabetes medications.
(iv) Checking and recording blood glucose levels and ketone
levels or assisting the student with this checking and recording.
(v) Following instructions regarding meals, snacks, and
(vi) Administering glucagon in an emergency situation.
(c) At least 1 of the trained diabetes personnel shall be
present and available to provide the care described in subdivision
(b) to the student at all times during regular school hours and
during school-sponsored before-school or after-school care programs
and extracurricular activities.
(d) Trained diabetes personnel shall be present at each school
in which the student is enrolled. A student's rights concerning
school choice shall not be restricted in any way because the
student has diabetes.
(e) Upon written request of the student's parent or legal
guardian and authorization by the student's diabetes medical
management plan, school officials shall permit the student to
perform blood glucose checks, administer insulin to himself or
herself using the insulin delivery system he or she uses, treat
hypoglycemia or hyperglycemia he or she experiences, and otherwise
attend to the care and management of his or her diabetes in the
classroom or any other 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
care and management functions.
(f) The school board shall ensure that each employee providing
transportation for the student for school-sponsored activities is
provided with training in the recognition and treatment of
hypoglycemia and hyperglycemia and is provided with a 1-page
information sheet that does all of the following:
(i) Identifies the student with diabetes.
(ii) Identifies potential emergencies that may occur as a
result of the student's diabetes and the appropriate responses to
(iii) Provides emergency contact information for the student's
parent or legal guardian.
(4) A school nurse is the preferred diabetes care provider for
a student with diabetes, but trained diabetes personnel are not
required by this section to be licensed health care professionals.
If a school nurse is assigned to a school, the school nurse shall
coordinate the provision of diabetes care at that school under this
section and shall serve as the lead trained diabetes personnel.
(5) A school employee, school district, public school academy,
nonpublic school, or member of a school board, public school
academy board of directors, or nonpublic school governing body is
not liable for damages in a civil action for injury, death, or loss
to person or property allegedly arising as a result of the
activities authorized by this legislation when those acts are
committed as an ordinarily prudent person would have acted under
the same or similar circumstances.
(6) As used in this section:
(a) "Diabetes medical management plan" means a document
developed by the student's personal health care team that sets out
the health services needed by the student at school, that evaluates
the student's ability to self-manage and level of understanding of
the student's diabetes, and that is signed by at least the parent
or legal guardian and the licensed physician who is part of the
student's personal health care team.
(b) "Licensed health care professional" means a physician,
nurse, or physician's assistant licensed under article 15 of the
public health code, 1978 PA 368, MCL 333.16101 to 333.18838.
(c) "School" means any public or nonpublic school that
operates any of grades K to 12.
(d) "School employee" means any person employed by or under
contract with a school district, intermediate school district,
public school academy, or nonpublic school or any person employed
by or under contract with a local health department who is assigned
to a school, or any subcontractor designated for this function.
(e) "Trained diabetes personnel" means a school employee
trained in accordance with this section.