Chapter 243
2008 -- H 7014
SUBSTITUTE A AS AMENDED
Enacted 07/05/08
A N A C T
RELATING
TO EDUCATION -- HEALTH AND SAFETY OF PUPILS
Introduced
By: Representatives Gemma, Schadone, Singleton, Picard, and Rice
Date
Introduced: January 02, 2008
It is enacted by the General Assembly as
follows:
SECTION 1. Chapter
16-21 of the General Laws entitled "Health and Safety of Pupils" is
hereby amended by adding thereto the following
sections:
16-21-28.1.
Legislative findings. – (a) Approximately one in five hundred (500)
school
children have diabetes. Individuals with
diabetes need to manage their diabetes carefully to keep
their blood glucose levels within target range.
(b) High blood
glucose levels contribute to medical complications, such as blindness,
kidney failure, amputations and cardiovascular
disease, while severely low blood glucose levels
can lead to unconsciousness or seizures with a
potential for brain damage or death.
(c) While
episodes of unconsciousness or seizures are uncommon, schools should be
prepared to promptly respond to such emergencies
due to the urgency of the situation, and the
inability of the student to drink or ingest food
that might restore their blood sugar level.
(d) Across the
country, schools are increasingly more prepared and trained for medical
emergencies using defibrillators and giving
injections to counter allergic reactions.
(e) The
American academy of pediatrics September 2003 policy guidelines on
administration of medication in school states:
"Some medications, such as epinephrine injections
for severe allergic reactions or glucagons for
hypoglycemia (low blood sugar), have few
significant adverse effects. Because these
episodes, by nature, occur at unpredictable times when
a school nurse may not be available, trained
designated school staffs should be available."
(f) The Rhode
Island chapter of the American academy of pediatrics states (November
20, 2005) that: "While quite rare, such
episodes (of hypoglycemic unconsciousness or seizure)
run the risk of serious long-term complications,
and potentially death, if there is a delay in
appropriate treatment."
16-21-28.2.
Requirements for glucagon administration in a school setting. – (a)
The
department of elementary and secondary education
and the department of health shall incorporate
into their policies, rules and regulations for
addressing incidents of hypoglycemia resulting in
unconsciousness, seizure and/or the inability to
swallow in order to provide for the health and
safety of children who have been medically
identified as having diabetes. The policies, rules and
regulations shall include procedures whereby:
(1) a parent or
legal guardian of any child may expressly authorize school employees or
those employed on behalf of the school, for when
there is no school nurse immediately available,
to administer glucagon on such child in case of
an emergency, while at school or school-
sponsored activities;
(2) the
glucagon shall be kept in a conspicuous place, readily available; and
(3) glucagon
administration training may be provided by a licensed physician, physician
assistant, advanced practiced registered nurse,
or registered nurse, however in no case shall
school nurse teachers be required to provide
training; and the school administration shall allow
staff to voluntarily assist with the emergency
administration of glucagon when authorized by a
parent or legal guardian.
(b) A school
employee, including administrative staff, shall not be subject to penalty or
disciplinary action for refusing to be trained
in glucagon administration.
(c) A parent or
legal guardian shall provide a diabetes management plan or physician's
order, signed by the student's health care
provider, that prescribes the care and assistance needed
by the student including glucagon
administration.
16-21-28.3.
Performance standards. – The department of health, in conjunction
with
the American diabetes association, and the Rhode
Island chapter of American academy of
pediatrics, shall develop performance standards
and guidelines for the training and supervision of
personnel, other than the school nurse, who
provide emergency medical assistance to students
under this section. Such personnel shall only be
authorized to provide such assistance upon
successful completion of glucagon administration
training.
16-21-28.4. Immunity
for those using glucagon. – No school teacher, school
administrator, school health care personnel,
person employed on behalf of the school, any other
school personnel, nor any local educational
authority shall be liable for civil damages which may
result from acts or omissions in use of glucagon
which may constitute ordinary negligence. This
immunity does not apply to acts or omissions
constituting gross negligence or willful or wanton
conduct.
16-21-28.5.
Training of school personnel. – Training on the administration of
epinephrine or glucagon for school personnel, or
those employed on behalf of the school, shall
not be considered the delegation of nursing
practice.
16-21-28.6.
Administration. – The administration of epinephrine or glucagon by
school
personnel, or those employed on behalf of the
school, shall not be considered the practice of
nursing.
SECTION 2. This
act shall take effect upon passage.
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LC00026/SUB A/2
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