HOUSE BILL No. 6555

October 15, 2008, Introduced by Reps. Rick Jones, Meisner, Mayes, Spade, Condino, Stahl, Leland, Bauer, Polidori, Espinoza, Brown, Green, Calley, Farrah, Melton, Dean, Shaffer, Agema, Moss, Knollenberg and Pearce 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

 

the following:

 

     (i) Recognition and treatment of hypoglycemia and

 

hyperglycemia.

 

     (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 designate 1 or

 

more 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

 

uses.

 

     (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

 

physical activity.

 

     (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) If the student leaves school on a school-sponsored field

 

trip, trained diabetes personnel shall be available by telephone or

 

other electronic communication device at all times during the field

 

trip.

 


     (e) 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.

 

     (f) 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.

 

     (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 from a student not

 

receiving diabetes care or being prohibited by an employee of the

 


school or school district from engaging in diabetes care or

 

management for himself or herself because of the employee's

 

reasonable belief formed after a reasonable and ordinary inquiry

 

that the conditions prescribed in subsection (3) had not been

 

satisfied. 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 from a pupil

 

receiving diabetes care or being permitted by an employee of the

 

school or school district to engage in diabetes care and management

 

for himself or herself because of the employee's reasonable belief

 

formed after a reasonable and ordinary inquiry that the conditions

 

prescribed in subsection (3) had been satisfied. This subsection

 

does not eliminate, limit, or reduce any other immunity or defense

 

that 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 may

 

have under section 1178 or other state law.

 

     (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.