Whereas, diabetes is a serious, chronic disease that impairs the body’s ability to use food. Diabetes must be managed twenty-four hours a day in order to avoid the …
AMENDED
May 16, 2001
H 3968
Introduced by Reps J Brown, Townsend, WD Smith, Sandifer, McGee,
Robinson, Barrett, Hayes, Simrill, Gourdine, Scott, Cotty, JE Smith,
Cato, Whipper, Tripp, Coates, Kennedy, Allison, JH Neal, Howard, Hosey,
Knotts, GM Smith, McCraw, Law, Koon, Whatley, Cooper, Bales, Leach,
Allen, Altman, Barfield, Battle, Bingham, Bowers, Breeland, R Brown,
Campsen, Chellis, Clyburn, Coleman, Dantzler, Davenport, Delleney, Edge,
Emory, Freeman, Frye, Gilham, Govan, Hamilton, Harrell, Harrison, Harvin,
J Hines, M Hines, Huggins, Kelley, Kirsh, Klauber, Lee, Limehouse,
Littlejohn, Lloyd, Lourie, Mack, Martin, McLeod, Meacham-Richardson,
Merrill, Miller, Moody-Lawrence, JM Neal, Ott, Owens, Parks, Perry,
Phillips, Quinn, Riser, Rivers, Rodgers, Rutherford, Scarborough, Sinclair,
FN Smith, Snow, Stille, Taylor, Vaughn, Walker, Webb, White, Wilder,
Witherspoon and A Young
S Printed 5/16/01–H [SEC 5/17/01 3:48 PM]
Read the first time April 19, 2001
STATEMENT OF ESTIMATED FISCAL IMPACT
ESTIMATED FISCAL IMPACT ON GENERAL
FUND EXPENDITURES:
See Below
ESTIMATED FISCAL IMPACT ON FEDERAL OTHER FUND EXPENDITURES:
0 No additional expenditures or savings are expected
EXPLANATION OF IMPACT:
State Department of Education SDE
Enactment of this bill would have no direct impact on the General
Fund of the State nor on federal and/or other funds, since the bill places
requirements for implementation on the local school districts Any
potential impact on the General Fund of the State is discretionary on the
part of the General Assembly, which may choose to appropriate funds for
costs incurred by the local school districts see Special Notes below
Department of Health and Environmental Control DHEC
The bill requires DHEC to provide private schools with copies of this
legislation and diabetes care provider training materials previously
developed for school districts DHEC indicates that printing and
distribution costs would be minimal, and can be absorbed within the
agencys current operating budget
LOCAL GOVERNMENT IMPACT:
See Special Notes below
SPECIAL NOTES:
Section 44-39-220 B C
requires school districts to provide
training for diabetes care providers and bus drivers It is assumed the
districts would contract with a private entity for this training Total
cost to the training entity is estimated at approximately 200,000
annually, which includes compensation for four employees Therefore, if
the districts were charged the actual cost of training, the total aggregate
impact on the districts can be estimated at 200,000 In addition, since
bus drivers are paid on an hourly rate, the cost to provide compensation
for one days training would be approximately 231,000 5,500 bus drivers x
6 hours x 7 an hour Substitute teachers may also be needed while
training is provided to full-time teachers who may be designated diabetes
care providers The cost per substitute teacher is 40 per day
SDE indicates enactment of this bill may cause school districts to
hire a full time nurse in schools where a nurse is not currently on staff
since section 44-39-210 states that a school nurse is preferred as a
diabetes care provider There are 520 schools that currently do not employ
a nurse A nurses annual salary
and fringe is approximately 40,000
Approved By:
Don Addy
Office of State Budget
A BILL
TO AMEND CHAPTER 39, TITLE 44, CODE OF LAWS OF SOUTH CAROLINA, 1976,
RELATING TO THE DIABETES INITIATIVE OF SOUTH CAROLINA ACT, BY ADDING
ARTICLE 2, SO AS TO ENACT THE DIABETES SCHOOL CARE ACT, TO REQUIRE THE
PRINCIPAL AT EACH PUBLIC SCHOOL TO DESIGNATE THREE EMPLOYEES TO BE DIABETES
CARE PROVIDERS, TO ALSO AUTHORIZE AS EMPLOYEES OF THE DEPARTMENT OF HEALTH
AND ENVIRONMENTAL CONTROL ASSIGNED TO A SCHOOL AND SUBCONTRACTORS TO BE
DIABETES CARE PROVIDERS, TO PROVIDE FOR THE TRAINING OF THESE CARE
PROVIDERS, TO ESTABLISH THE RESPONSIBILITIES AND THE SCOPE OF AUTHORITY FOR
A DIABETES CARE PROVIDER, TO ALLOW A STUDENT WITH DIABETES TO PERFORM
GLUCOSE TESTS, ADMINISTER INSULIN, AND TO ATTEND TO THE CARE AND MANAGEMENT
OF HIS OR HER DIABETES AND TO POSSES NECESSARY SUPPLIES AND EQUIPMENT TO
CONDUCT THESE FUNCTIONS, TO REQUIRE THE DEPARTMENT OF HEALTH AND
ENVIRONMENTAL CONTROL TO MAKE INFORMATION AND TRAINING MATERIALS AVAILABLE
TO PRIVATE SCHOOLS, AND TO PROVIDE THAT A DIABETES
CARE PROVIDER ACTING IN
ACCORDANCE WITH THIS ARTICLE IS IMMUNE FROM CIVIL AND CRIMINAL LIABILITY
AND IS NOT PRACTICING NURSING AND IS EXEMPT FROM ALL APPLICABLE STATUTORY
AND REGULATORY PROVISIONS THAT RESTRICT WHAT ACTIVITIES MAY BE DELEGATED TO
A PERSON WHO IS NOT A LICENSED MEDICAL PROFESSIONAL; AND TO DESIGNATE
SECTIONS 44-39-10 THROUGH 44-39-50 AS ARTICLE 1, CHAPTER 39, TITLE 44
ENTITLED DIABETES INITIATIVE OF SOUTH CAROLINA AND TO RENAME CHAPTER 39,
TITLE 44 AS DIABETES
Amend Title To Conform
Whereas, diabetes is a serious, chronic disease that impairs the bodys
ability to use food Diabetes must be managed twenty-four hours a day in
order to avoid the potentially life-threatening, short-term consequences of
blood sugar levels that are either too high or too low, and to avoid or
delay the serious long-term complications of high blood sugar levels which
include blindness, amputation, heart disease, and kidney failure In order
to manage their disease, students with diabetes must have access to the
means to balance food, medications, and activity level while at school and
at school-related activities; and
Whereas,
because of the significant number of students with diabetes, the
effect of diabetes upon a students ability to learn, and the risk for
serious long and short-term medical complications, the South Carolina
General Assembly finds that it is in the best interest of South Carolinas
children with diabetes to enact the Diabetes School Care Act Now,
therefore,
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1 Chapter 39 of Title 44 is amended by adding:
Article 2
Diabetes Mellitus School Care Act
Section 44-39-200 This article may be cited as the Diabetes
Mellitus School Care Act
Section 44-39-210 For purposes of this article:
1 Diabetes care provider means a school employee trained in
accordance with Section 44-39-220 While a school nurse is a preferred
diabetes care provider, a diabetes care provider is not required to be a
medical professional When a school nurse is assigned to a particular
school, he or she shall coordinate the provision of diabetes care at that
school
2 School means a primary,
elementary, middle, or secondary
public school located within this State
3 School employee means a person employed by a public school
district or a public special school or a person employed by a local health
department who is assigned to a public school or a subcontractor designated
for this function
Section 44-39-220 A The Diabetes Initiative of South
Carolina, working in cooperation with the South Carolina Board of Nursing,
South Carolina Department of Health and Environmental Control, South
Carolina Department of Education, and the South Carolina Office of the
American Diabetes Association shall develop guidelines for the training of
school employees as diabetes care providers Training must be provided
annually by a health care professional with expertise in diabetes and
training guidelines must include instruction in:
1 recognition and treatment of hypoglycemia and
hyperglycemia;
2 understanding the appropriate actions to take when blood
glucose levels are outside of the target ranges indicated by students
physicians order or health care plan, or both;
3 understanding physician instructions concerning drug
dosage, frequency, and the manner of administration;
4 performance of finger-stick blood glucose testing, ketone
testing, and recording the results;
5 administration of oral medications, glucagon, and insulin
and the recording of results;
6 recommended schedules and food intake for meals and
snacks, the effect of exercise upon blood glucose levels, and actions to be
implemented in the case of schedule disruption
B Each public school district shall provide or contract for the
training provided for in subsection A to at least one school employee who
must be designated as a diabetes care provider by the principal at each
public school that does not employ a full-time registered nurse
C Each public school shall develop a written protocol with
procedures to be followed if a student diabetes emergency arises when
neither a registered nurse nor a diabetes care provider is available
Section 44-39-230 A In accordance with the written
instructions of the physician of a student with diabetes, diabetes
care
providers shall perform functions including, but not limited to:
1 administering glucagon in an emergency situation;
2 assisting a student in administering insulin through the
insulin delivery system the student uses;
3 assisting a student in administering other oral diabetes
medications;
4 assisting a student in performing and recording blood
glucose testing and ketone testing or assisting a student with such
testing; and
5 following instruction regarding meals, snacks, and
physical education
However, a diabetes care provider may only perform such functions if
the students parent or guardian has informed the school that the student
has diabetes mellitus
B A diabetes care provider must be on site and available to
assist or to provide care to students with diabetes as set forth in
subsection A during regular school hours
C1 A diabetes care provider is immune from civil and criminal
liability if the care provider is acting within the scope of his authority
as prescribed in this article and in accordance with the training standards
and
procedures as provided for in Section 44-39-220
2 Notwithstanding any other provision of law, a diabetes
care provider trained pursuant to Section 44-39-220 who is carrying out the
functions enumerated in subsection A is not engaging in the practice of
nursing and is exempt from all applicable statutory and regulatory
provisions that restrict activities that may be delegated to a person who
is not a licensed medical professional
Section 44-39-240 A Upon written request of the parent or
guardian and authorization by the students physician, a student with
diabetes must be permitted to perform blood glucose tests, administer
insulin through the insulin delivery system the student uses, treat
hypoglycemia and hyperglycemia, and otherwise attend to the care and
management of his or her diabetes in the classroom, in any 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 monitoring and treatment functions
B A students school choice shall in no way be restricted
because
the student has diabetes
C a student with diabetes may not be denied access or prohibited
from participating in school activities and programs including, but not
limited to, school-sponsored before-school programs, after school care
programs, field trips, and extracurricular activities
D Each public school district shall develop a policy to implement
the provisions of this article
Section 44-39-250 A The South Carolina Department of Health
and Environmental Control shall provide each private school in the State
with a copy of this article and shall make the training materials developed
in accordance with Section 44-39-220 available to private schools
B1 A diabetes care provider employed by a private school or a
subcontractor designated for this function is immune from civil and
criminal liability if the care provider is acting within the scope of his
authority as prescribed in this article and in accordance with the training
standards and procedures as provided for in Section 44-39-220
2 Notwithstanding any other provision of law, a diabetes
care provider who received training
comparable to the training provided for
in Section 44-39-220 who is carrying out the functions enumerated in
Section 44-39-230A is not engaging in the practice of nursing and is
exempt from all applicable statutory and regulatory provisions that
restrict activities that may be delegated to a person who is not a licensed
medical professional
Section 44-39-260 All costs associated with implementing the
provisions contained in this article must be borne by the State through an
annual appropriation from the state general fund or through private
funding To the extent that a school district incurs any expenses that are
not paid for by the State, the provisions in this article that apply to
that school district are suspended
SECTION 2 Sections 44-39-10 through 44-39-50 of the 1976 Code are
designated as Article 1, Chapter 39, Title 44 entitled Diabetes Initiative
of South Carolina Chapter 39, Title 44 of the 1976 Code is renamed
Diabetes
SECTION 3 Notwithstanding the provisions of Section 44-39-220 of the
1976 Code as added by Section 1 of this act, the training required to be
provided pursuant to
that section for school employees is not required to
be implemented until one year after this acts effective date
SECTION 4 This act takes effect upon approval by the Governor
—-XX—-
