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Current Status Bill Number:View additional legislative information at the LPITS web site.3968 Type of Legislation:General Bill GB Introducing Body:House Introduced Date:20010419 Primary Sponsor:J. Brown All Sponsors:J. Brown, Townsend, W.D. Smith, Sandifer, McGee, Robinson, Barrett, Hayes, Simrill, Gourdine, Scott, Cotty, J.E. Smith, Cato, Whipper, Tripp, Coates, Kennedy, Allison, J.H. Neal, Howard, Hosey, Knotts, G.M. 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, J.M. Neal, Ott, Owens, Parks, Perry, Phillips, Quinn, Riser, Rivers, Rodgers, Rutherford, Scarborough, Sinclair, F.N. Smith, Snow, Stille, Taylor, Vaughn, Walker, Webb, White, Wilder, Witherspoon and A. Young Drafted Document Number:l:\council\bills\nbd\11563ac01.doc Residing Body:Senate Date of Last Amendment:20010516 Subject:Diabetes School Care Act, Medical, Health and Environmental Control, Schools and School Districts, Torts History Body Date Action Description Com Leg Involved ______ ________ ______________________________________ _______ ____________ ------ 20020429 Scrivener's error corrected Senate 20020425 Committee report: Favorable with 13 SMA amendment Senate 20010517 Introduced, read first time, 13 SMA referred to Committee House 20010517 Read third time, sent to Senate ------ 20010517 Scrivener's error corrected House 20010516 Amended, read second time House 20010516 Request for debate withdrawn by Representative Davenport House 20010516 Amended House 20010516 Request for debate withdrawn by Representative Merrill Walker House 20010510 Request for debate by Representative Davenport Merrill Walker House 20010510 Request for debate withdrawn by Representative Littlejohn A. Young Rice G.M. Smith Altman Hayes Robinson House 20010509 Request for debate withdrawn by Representative Easterday House 20010501 Request for debate withdrawn by Representative Sinclair House 20010426 Request for debate by Representative Easterday Rice Hinson Altman Robinson Sinclair House 20010426 Request for debate withdrawn by Representative Weeks Rice Walker Allison J.R. Smith D.C. Smith Lee Sinclair House 20010426 Co-Sponsor removed (Rule 5.2) by Rep. Rice Loftis Talley Thompson House 20010425 Request for debate by Representative Walker Rice J.R. Smith A. Young Weeks Sinclair G.M. Smith Lee House 20010425 Objection by Representative Kirsh House 20010425 Request for debate withdrawn by Representative Coates Ott Miller Talley Sheheen Moody- Lawrence J.R. Smith Robinson Leach Webb Hinson House 20010425 Request for debate by Representative Miller Littlejohn Sheheen Allison Ott Talley J.R. Smith Coates Webb D.C. Smith Hinson Hayes Robinson Moody- Lawrence Leach House 20010424 Co-Sponsor removed (Rule 5.2) by Rep. D.C. Smith J.R. Smith Sharpe House 20010419 Recalled from Committee 27 H3M House 20010419 Introduced, read first time, 27 H3M referred to Committee Versions of This Bill Revised on April 19, 2001 - Word format Revised on May 16, 2001 - Word format Revised on May 17, 2001 - Word format Revised on April 25, 2002 - Word format Revised on April 29, 2002 - Word format
COMMITTEE REPORT
April 25, 2002
H. 3968
Introduced by Reps. J. Brown, Townsend, W.D. Smith, Sandifer, McGee, Robinson, Barrett, Hayes, Simrill, Gourdine, Scott, Cotty, J.E. Smith, Cato, Whipper, Tripp, Coates, Kennedy, Allison, J.H. Neal, Howard, Hosey, Knotts, G.M. 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, J.M. Neal, Ott, Owens, Parks, Perry, Phillips, Quinn, Riser, Rivers, Rodgers, Rutherford, Scarborough, Sinclair, F.N. Smith, Snow, Stille, Taylor, Vaughn, Walker, Webb, White, Wilder, Witherspoon and A. Young
S. Printed 4/25/02--S. [SEC 4/29/02 8:45 AM]
Read the first time May 17, 2001.
To whom was referred a Bill (H. 3968) 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, etc., respectfully
That they have duly and carefully considered the same and recommend that the same do pass with amendment:
Amend the bill, as and if amended, before the enacting words, page 2 before line 5 by inserting:
/Whereas, the General Assembly recognizes the value of having nurses placed in every South Carolina school and considers having a nurse in each school a desired goal; however, under current fiscal constraints funding such an initiative is not within the means of the General Assembly and other measures to provide good healthcare to our school children should be pursued;/
Amend the bill, further, page 2, line 21, before /School/ by inserting /Mellitus/.
Amend the bill, further, Section 44-39-220(B), page 3, beginning on line 30 by deleting /one school employee/ and inserting /two school employees/; and on line 33, after the /./ by inserting /However, failure of a school employee to agree to be a diabetes care provider does not constitute insubordination./
Amend the bill, further, Section 44-39-230(A), page 3, line 41 by deleting /shall/ and inserting / are authorized to/; and on page 4, line 8 before /instruction/ by inserting /written/.
Amend the bill, further, Section 44-39-230(A), page 4, by deleting lines 10-12 and inserting:
/However, a diabetes care provider may only perform these functions if the school has obtained the informed consent of a parent for the child to receive these services./
Amend the bill, further, Section 44-39-230 by deleting subsection (B) on page 4, lines 13-15; by deleting (C)(1) on page 4 lines 16-20; and on page 4, line 21 by deleting /(2)/ and inserting /(B)/.
Amend the bill, further, Section 44-39-240(A), page 4, line 38 after the /./ by inserting /However, if a student demonstrates an inability or unwillingness to perform these monitoring and treatment functions in a manner that is safe to the student, other students, and staff, the principal may, after consultation with the student's parents or guardian and, where possible, the student's physician, designate a medically appropriate alternative site that is not disruptive to the classroom for the performance of these monitoring and treatment functions./
Amend the bill, further, Section 44-39-240 by deleting subsections (B) and (C) on page 4, lines 39-43 and inserting:
/ (B) A student's school choice, as may be authorized by law, may not be restricted due to the student having diabetes.
(C) A student 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 programs, after school care programs, field trips, and extracurricular activities unless, based upon a statement from the student's physician, the student's diabetic condition is such that the activity or program may endanger the health or welfare of the student or of other students./
Amend the bill, further, by deleting Section 44-39-250(B)(1), page 5, lines 11 through 16 and inserting:
/(B)(1) A private school diabetes care provider trained pursuant to Section 44-39-220 who is carrying out the functions enumerated in subsection (A), anyone training a private school diabetes care provider as prescribed in this article, a private school employing a diabetes care provider trained pursuant to Section 44-39-220 who is carrying out the functions enumerated in subsection (A), or any other private school official acting within the scope of authority as prescribed in this article is acting within the scope of his or her official duties and is immune from civil and criminal liability.
(2) Notwithstanding any other provision of law, a private school diabetes care provider trained pursuant to Section 44-39-220 who is carrying out the functions enumerated in subsection (A) is not performing nursing procedures, functions, or tasks and is not engaging in the practice of professional or practical nursing/
Amend the bill, further, by deleting Section 44-39-260 and inserting:
/ Section 44-39-260. All costs associated with implementing the training provisions contained in this article must be borne by the State Department of Education./
Amend the bill, further, by deleting SECTION 3 of the bill and inserting:
/SECTION 3. Section 15-78-60 of the 1976 Code, as last amended by Act 407 of 2000, is further amended by adding an appropriately numbered item to read:
"( ) for the acts or omissions of a diabetes care provider, as defined in Section 44-39-210(1)./
Renumber sections to conform.
Amend title to conform.
HARVEY S. PEELER, JR. for Committee.
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".
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 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 student's 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 Carolina's 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:
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 student's physician's 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 student's 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.
(C)(1) 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 student's 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 student's 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.
(B)(1) 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 44-39-230(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 44-39-260. 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 act's effective date.
SECTION 4. This act takes effect upon approval by the Governor.
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