HB 1338-1_ Filed 02/28/2006, 09:19 Landske
Adopted 3/1/2006

SENATE MOTION


MADAM PRESIDENT:

    I move that Engrossed House Bill 1338 be amended to read as follows:

    Page 4, between lines 1 and 2, begin a new paragraph and insert:      "SECTION 3. IC 20-34-5 IS ADDED TO THE INDIANA CODE AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2006]:
     Chapter 5. Care of Students With Diabetes
    Sec. 1. The department and the state department of health shall:
        (1) develop and implement a pilot program that meets the requirements of this chapter not later than July 1, 2007; and
        (2) implement this chapter statewide not later than July 1, 2009.
    Sec. 2. As used in this chapter, "unlicensed assistive personnel" means a school employee who:
        (1) is not a licensed health care professional;
        (2) has successfully completed the training required under section 10 of this chapter; and
        (3) has immunity from liability under IC 34-30-14.
    Sec. 3. As used in this chapter, "diabetes management and treatment plan" means a plan prepared under section 7 of this chapter.
    Sec. 4. As used in this chapter, "individualized health plan" means a coordinated plan of care designed to meet the unique health care needs of a student with diabetes in a school setting.
    Sec. 5. As used in this chapter, "school employee" means an individual employed by:
        (1) a public school or an accredited nonpublic school;
        (2) a local health department working with a school under this chapter; or
        (3) another entity with which a school has contracted to perform the duties required under this chapter.
    Sec. 6. As used in this chapter, "student" refers to a student

with diabetes.
    Sec. 7. (a) A diabetes management and treatment plan must be prepared and implemented for a student with diabetes while the student is at school or participating in a school activity. The plan must be developed by:
        (1) the student's parent or guardian; and
        (2) the licensed physician responsible for the student's diabetes treatment or another diabetes health care provider ordered in writing by the physician.
    (b) A diabetes management and treatment plan must:
        (1) identify the health care services the student may need at school;
        (2) evaluate the student's:
            (A) ability to manage; and
            (B) level of understanding of;
        the student's diabetes;
        (3) specify the care that may be performed by the student with an agreed upon level of supervision; and
        (4) be signed by the student's parent or guardian and the licensed physician responsible for the student's diabetes treatment or another diabetes health care provider ordered in writing by the physician.
    (c) The parent or guardian of a student with diabetes who will be attending school or participating in a school activity shall submit a copy of the student's diabetes management and treatment plan to the school. The plan must be submitted to and be reviewed by the school:
        (1) before or at the beginning of a school year;
        (2) at the time the student enrolls, if the student is enrolled in school after the beginning of the school year; or
        (3) as soon as practicable following a diagnosis of diabetes for the student.
    Sec. 8. (a) An individualized health plan must be developed for each student with diabetes who will be attending school or participating in a school activity. The school's principal and school nurse shall develop a student's individualized health plan in collaboration with:
        (1) the student's parent or guardian;
        (2) to the extent practicable, the licensed physician responsible for the student's diabetes treatment or another diabetes health care provider ordered in writing by the physician; and
        (3) one (1) or more of the student's teachers.
    (b) A student's individualized health plan must incorporate the components of the student's diabetes management and treatment plan. A school shall develop a student's individualized health plan upon receiving the student's diabetes management and treatment plan.
    Sec. 9. (a) At each school in which a student with diabetes is enrolled, the school principal shall:


        (1) seek school employees to serve as unlicensed assistive personnel; and
        (2) make efforts to ensure that the school has adequate personnel to safely implement a diabetes case plan.
    (b) Unlicensed assistive personnel serve under the supervision of the school nurse.
    (c) A school employee may not be subject to any disciplinary action for refusing to serve as unlicensed assistive personnel.
    Sec. 10. (a) The state department of health, with the assistance of interested parties, shall develop a training program that includes instruction in the following:
        (1) Recognizing the symptoms of hypoglycemia and hyperglycemia.
        (2) Understanding the proper action to take if the blood glucose levels of a student are outside the target ranges indicated on the student's diabetes management and treatment plan.
        (3) Understanding the details of a student's individualized health plan.
        (4) Performing finger sticks to check blood glucose levels, checking urine ketone levels, and recording the results of the checks.
        (5) Properly administering glucagon and insulin, and recording the results of the administration.
        (6) Recognizing complications that require emergency medical assistance.
        (7) Understanding recommended schedules and food intake for meals and snacks for a student, the effect of physical activity on blood glucose levels, and the proper action to be taken if a student's schedule referred to in this subdivision is disrupted.
    (b) If a school nurse is assigned to a school, the school nurse shall coordinate the training of school employees acting as unlicensed assistive personnel, using the training program developed under subsection (a).
    (c) Training for unlicensed assistive personnel must be provided by a health care professional with expertise in the care of students with diabetes or by a school nurse. The training must be provided before the beginning of the school year or as soon as practicable following:
        (1) the enrollment; or
        (2) the diagnosis;
of a student with diabetes at a school that previously had no students with diabetes.
    (d) The school nurse or principal shall maintain a copy of the training program and the records of training completed by the school employees.
    Sec. 11. (a) If a school nurse is assigned to a school and the

nurse is available, the nurse shall perform the tasks necessary to assist a student in carrying out the student's individualized health plan.
    (b) If a school nurse is not assigned to a school or is not available, unlicensed assistive personnel shall perform the tasks necessary to assist a student in carrying out the student's individualized health plan, in compliance with the training guidelines provided under section 10 of this chapter. Unlicensed assistive personnel must have access to a health care professional with expertise in the care of students with diabetes or a school nurse must have access to the licensed physician responsible for the student's diabetes treatment if unlicensed assistive personnel act under this subsection.
    (c) Unlicensed assistive personnel may act under this section only if the parent or guardian of the student signs an agreement that:
        (1) authorizes unlicensed assistive personnel to assist the student; and
        (2) states that the parent or guardian understands that, as provided under IC 34-30-14, unlicensed assistive personnel is not liable for civil damages for assisting in the student's care.
    (d) Unlicensed assistive personnel who assist a student under this section in carrying out the student's individualized health plan:
        (1) is not considered to be engaging in the practice of nursing;
        (2) is exempt from applicable statutes and rules that restrict activities that may be performed by an individual who is not a health care professional; and
        (3) shall contact a health care provider in a medical emergency involving a student with diabetes.
    (e) A school corporation may not restrict the assignment of a student to a particular school on the basis that the school does not have the required unlicensed assistive personnel.
    Sec. 12. As provided in a student's individualized health plan, a school corporation shall allow the student to attend to the management and care of the student's diabetes, including performing the following activities:
        (1) Performing blood glucose level checks.
        (2) Administering insulin through the insulin delivery system the student uses.
        (3) Treating hypoglycemia and hyperglycemia.
        (4) Possessing on the student's person at any time the supplies or equipment necessary to monitor and care for the student's diabetes.



        (5) Otherwise attending to the management and care of the student's diabetes in the classroom, in any area of the school or school grounds, or at any school related activity.
".
    Renumber all SECTIONS consecutively.
    (Reference is to EHB 1338 as printed February 24, 2006.)


________________________________________

Senator LANDSKE


RS 133801/DI jhm
2006