§436.3. Students with diabetes; management and treatment plans; provision of care;
unlicensed diabetes care assistants; student self-monitoring and treatment
A.
(1)Beginning with the 2012-2013 school year, a diabetes management and
treatment plan shall be submitted by each student with diabetes enrolled in a public or
nonpublic elementary or secondary school who seeks care for his diabetes while at school
or while participating in a school-related activity and shall be updated on an annual basis.
Such plan shall be developed by the physician or other licensed health care provider
recognized by the Centers for Medicare and Medicaid Services who is selected by the parent
or guardian to be responsible for such student's diabetes treatment and a current copy of such
plan shall be kept on file
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§436.3. Students with diabetes; management and treatment plans; provision of care;
unlicensed diabetes care assistants; student self-monitoring and treatment
A.(1) Beginning with the 2012-2013 school year, a diabetes management and
treatment plan shall be submitted by each student with diabetes enrolled in a public or
nonpublic elementary or secondary school who seeks care for his diabetes while at school
or while participating in a school-related activity and shall be updated on an annual basis.
Such plan shall be developed by the physician or other licensed health care provider
recognized by the Centers for Medicare and Medicaid Services who is selected by the parent
or guardian to be responsible for such student's diabetes treatment and a current copy of such
plan shall be kept on file at the school in which the student is enrolled.
(2) A student's diabetes management and treatment plan shall contain:
(a) An evaluation of the student's level of understanding of his condition and his
ability to manage his diabetes.
(b) The diabetes-related healthcare services the student may receive or self-administer at school or during a school-related activity.
(c) A timetable, including dosage instructions, of any diabetes medications to be
administered to the student or self-administered by the student.
(d) The signature of the student, the student's parent or legal guardian, and the
physician responsible for the student's diabetes treatment.
(3) The parent or legal guardian of a student with diabetes shall annually submit a
copy of the student's diabetes management and treatment plan to the principal of the school
in which the student is enrolled. The plan shall be reviewed by the appropriate school
personnel:
(a) Prior to or within five days after the beginning of each school year.
(b) Upon enrollment, if the student enrolls in the school after the beginning of the
school year.
(c) As soon as practicable following the student's receipt of a diagnosis of diabetes.
B.(1) The school nurse shall provide care to a student with diabetes, or assist a
student with the self-care of his diabetes, in accordance with the student's diabetes
management and treatment plan. If a school has no school nurse assigned to the school on
a full-time basis, or the school nurse is unavailable, an unlicensed diabetes care assistant may
provide care to a student with diabetes, or assist a student with the self-care of his diabetes,
as provided in this Section.
(2) Each school may adopt a policy to ensure that a school nurse, or at least one
unlicensed diabetes care assistant, shall be present and available to provide care to a student
with diabetes during the regular school day or during school-related activities, in accordance
with the student's diabetes management and treatment plan.
C.(1) For purposes of this Section, "unlicensed diabetes care assistant" means a
school employee who volunteers to be trained in accordance with this Section. "Unlicensed
diabetes care assistant" also means an employee of an entity that contracts with the school
or school system to provide school nurses who are responsible for providing health care
services required by law or state Department of Education regulation.
(2) The principal of the school, in consultation with the school nurse if one is
available, may:
(a) Seek school employees who are not healthcare professionals and who are willing
to be trained to serve as unlicensed diabetes care assistants and provide care to students with
diabetes pursuant to the provisions of this Section. A school employee shall not be subject
to any penalty or disciplinary action for refusing to serve as an unlicensed diabetes care
assistant.
(b) Make efforts to ensure that the school has at least one unlicensed diabetes care
assistant, if the school has a full-time nurse, or at least three unlicensed diabetes care
assistants if the school has no full-time nurse.
(3) An unlicensed diabetes care assistant shall serve under the supervision of the
school nurse or the school principal.
(4) An unlicensed diabetes care assistant, in accordance with the diabetes
management and treatment plan on file for a student, may provide diabetes care to a student,
or assist a student in the self-care of his diabetes, including but not limited to:
(a) Checking and recording blood glucose and ketone levels.
(b) Responding to blood glucose levels outside of the target range established for a
student.
(c) Administering glucagon and other emergency treatments as prescribed in a
student's diabetes management and treatment plan.
(d) Administering, or assisting a student in administering, insulin through the insulin
delivery system prescribed in the student's diabetes management and treatment plan.
(e) Administering oral diabetes medications to a student as prescribed in the student's
diabetes management and treatment plan.
(f) Assisting a student to follow the instructions in his diabetes management and
treatment plan relative to meals, snacks, and physical activity.
(5)(a) An unlicensed diabetes care assistant may provide diabetes care to a student
only in accordance with the student's diabetes management and treatment plan, and then only
if the student's parent or legal guardian signs an agreement authorizing such care by the
unlicensed diabetes care assistant and such agreement is on file with the school.
(b) An unlicensed diabetes care assistant shall exercise reasonable judgment in
deciding whether to contact a healthcare professional in the event of a medical emergency
involving a student with diabetes.
(c) In the performance of his duties as provided in this Section, an unlicensed
diabetes care assistant who assists a student in compliance with a student's diabetes
management and treatment plan as provided in this Section shall be exempt from any
applicable state law or rule that restricts the activities that may be performed by a person who
is not a healthcare professional.
(d) An unlicensed diabetes care assistant shall be immune from any liability for any
act or omission to act related to the provision of care to a student with diabetes, or assisting
a student with the self-care of his diabetes.
(6) The State Board of Elementary and Secondary Education and the Louisiana State
Board of Nursing jointly shall promulgate rules and regulations specifying methods and a
curriculum for the training of unlicensed diabetes care assistants in accordance with the
Administrative Procedure Act. The rules and regulations shall use the guidelines as required
by this Section and by the latest National Diabetes Education Program, "Helping the Student
with Diabetes Succeed: A Guide for School Personnel". In developing such rules and
regulations, the boards shall include the following in the rulemaking process:
(a) The Louisiana Department of Health.
(b) The American Diabetes Association.
(c) The Juvenile Diabetes Research Foundation International.
(d) The American Association of Diabetes Educators.
(7) Training for an unlicensed diabetes care assistant may be provided by a
healthcare professional with expertise in caring for persons with diabetes or by the school
nurse and shall include:
(a) Recognizing the symptoms of hypoglycemia and hyperglycemia.
(b) Understanding the details of a student's diabetes management and treatment plan.
(c) Understanding the proper action to take if a student's blood glucose levels are
outside the target ranges specified in his diabetes management and treatment plan.
(d) Performing finger sticks to check blood glucose levels, checking urine ketone
levels, and properly recording the results.
(e) Properly administering glucagon and insulin and properly recording the results.
(f) Recognizing complications which require emergency assistance.
(g) Understanding the recommended schedules and food intake for meals and snacks
for a student with diabetes, the effect of physical activity on blood glucose levels, and the
proper actions to be taken if a student's schedule is disrupted.
D. In accordance with a student's diabetes management and treatment plan, a school
shall permit the student to attend to the self-management and care of his diabetes, which may
include the following activities:
(a) Performing blood glucose level checks.
(b) Self-administration of insulin through the insulin delivery system specified in the
student's diabetes management and treatment plan.
(c) Treatment of hypoglycemia and hyperglycemia as specified in the student's
diabetes management and treatment plan.
(d) Possessing on the student's person, at any time, such supplies or equipment as are
necessary to monitor and care for the student's diabetes.
(e) 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.
E. With written permission from a student's parent or legal guardian, a school may
provide a school employee with responsibility for providing transportation for a student with
diabetes, or supervising a student with diabetes during an off-campus activity, with an
information sheet that provides the following information:
(a) The identity of the student with diabetes.
(b) A description of potential emergencies that may occur as a result of the student's
diabetes and the appropriate responses to such emergencies.
(c) The telephone number of the person to be contacted in case of an emergency
involving the student with diabetes.
F. No physician, nurse, school employee, school, or school district shall be liable for
civil damages or subject to disciplinary action under professional licensing regulations or
school disciplinary policies as a result of the activities authorized by this Section.