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977Type of Legislation: General Bill GBIntroducing Body: SenateIntroduced Date: 20020205Primary Sponsor: GieseAll Sponsors: Giese, J. Verne Smith, Land, Short, Drummond, Fair, Mescher, Leatherman, Verdin, Ritchie and BrantonDrafted Document Number: l:\council\bills\ggs\22266ac02.docResiding Body: SenateDate of Last Amendment: 20020529Subject: Attendant care services, person who is not a licensed nurse authorized to provide in- home careHistory Body Date Action Description Com Leg Involved ______ ________ ______________________________________ _______ ____________ House 20020530 Read third time, returned with amendment ------ 20020530 Scrivener's error corrected House 20020529 Amended, read second time House 20020522 Request for debate withdrawn by Representative Tripp J. Brown Breeland House 20020521 Request for debate by Representative Tripp Vaughn Stuart Hayes D.C. Smith Webb Breeland J. Brown Hosey Miller J.M. Neal Emory G. Brown J. Hines Littlejohn Talley Cotty Sheheen Davenport Freeman Parks Moody- Lawrence ------ 20020516 Scrivener's error corrected House 20020515 Committee report: Favorable with 27 H3M amendment House 20020403 Introduced, read first time, 27 H3M referred to Committee Senate 20020402 Read third time, sent to House Senate 20020328 Amended, read second time Senate 20020327 Committee report: Favorable with 13 SMA amendment Senate 20020205 Introduced, read first time, 13 SMA referred to Committee Versions of This Bill Revised on March 28, 2002 - Word format Revised on April 2, 2002 - Word format Revised on May 15, 2002 - Word format Revised on May 16, 2002 - Word format Revised on May 29, 2002 - Word format Revised on May 30, 2002 - Word format
Indicates Matter Stricken
Indicates New Matter
May 29, 2002
Introduced by Senators Giese, J. Verne Smith, Land, Short, Drummond, Fair, Mescher, Leatherman, Verdin, Ritchie and Branton
S. Printed 5/29/02--H. [SEC 5/30/02 4:38 PM]
Read the first time April 3, 2002.
TO AMEND SECTION 40-33-10, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO DEFINITIONS USED IN THE LICENSURE AND REGULATION OF NURSES, SO AS TO DEFINE "ATTENDANT CARE SERVICES" AND "INDIVIDUAL IN NEED OF IN-HOME CARE"; AND TO AMEND SECTION 40-33-50, RELATING TO CIRCUMSTANCES TO WHICH THE CHAPTER DOES NOT APPLY, SO AS TO PROVIDE THAT THE CHAPTER MAY NOT BE CONSTRUED TO PROHIBIT A PERSON NOT LICENSED UNDER THIS CHAPTER FROM PROVIDING ATTENDANT CARE SERVICES WHICH ENABLE A PERSON TO REMAIN AT HOME RATHER THAN IN AN INSTITUTION AND WHICH INCLUDES HOMEMAKER AND COMPANION SERVICES AND CERTAIN HEALTH MAINTENANCE ACTIVITIES.
Amend Title To Conform
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Section 40-33-10 of the 1976 Code is amended by adding appropriately lettered items at the end to read:
"( ) 'Attendant care services' means those basic and ancillary services that enable an individual in need of in-home care to live in the individual's home and community rather than in an institution and to carry out functions of daily living, self-care, and mobility.
( ) 'Basic services' includes, but is not limited to:
(1) getting in and out of a bed, wheelchair, motor vehicle, or other device;
(2) assistance with routine bodily functions including, but not limited to, health maintenance activities, bathing and personal hygiene, dressing and grooming, and feeding, including preparation and cleanup.
( ) 'Ancillary services' means services ancillary to the basic services provided to an individual in need of in-home care who needs one or more of the basic services and includes:
(1) homemaker-type services including, but not limited to, shopping, laundry, cleaning, and seasonal chores;
(2) companion-type services including, but not limited to, transportation, letter writing, reading mail, and escorting; and
(3) assistance with cognitive tasks including, but not limited to, managing finances, planning activities, and making decisions.
( ) 'Health maintenance activities' include, but are not limited to, catheter irrigation, administration of medications, enemas and suppositories, and wound care, if these activities could be performed by the individual if the individual were physically capable.
( ) 'Individual in need of in-home care' means a functionally disabled individual in need of attendant care services because of impairment who requires assistance to complete functions of daily living, self-care, and mobility including, but not limited to, attendant care services."
SECTION 2. Section 40-33-50 of the 1976 Code is amended to read:
"Section 40-33-50. No provision of this chapter
shall may be construed to prohibit:
As prohibiting gratuitous nursing by friends or members of the family;
As prohibiting the incidental care of the sick by domestic servants or persons primarily employed as housekeepers as long as they do not practice nursing within the meaning of this chapter;
As prohibiting nursing assistance in case of an emergency;
As prohibiting the practice of nursing by students enrolled in approved schools of nursing or approved schools of practical nursing, nor by graduates of these schools pending the results of the first licensing examination taken by the graduate following graduation;
As prohibiting the practice of nursing in this State by any a legally qualified nurse of another state whose engagement requires him to accompany and care for a patient temporarily residing in this State during the period of one such engagement, not to exceed six months in length, provided such a person does not represent or hold himself out as a nurse licensed to practice in this State;
As prohibiting the practice of any a legally qualified nurse of another state who is employed by the United States Government or any a bureau, division or agency thereof, while in the discharge of his official duties;
As prohibiting nursing care given to their maternity patients, in the performance of their duties, by lay midwives trained and supervised under the authority of the South Carolina Department of Health and Environmental Control, so long as such midwives confine such nursing care to maternity patients only and do not claim to be licensed practical nurses .;
As prohibiting the practice of nursing by a licensed nurse of another state or country who is enrolled in a board-approved course of study or board-approved experimental project requiring nursing practice as a part of the educational program . ;
(9) a person not licensed under this chapter from providing attendant care services directed by or on behalf of an individual in need of in-home care;
(10) performance of an act which a person would normally perform if the person were physically and cognitively able."
SECTION 3. A. 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 two school employees who must be designated as a diabetes care provider by the principal at each public school that does not employ a full-time nurse. However, failure of a school employee to agree to be a diabetes care provider does not constitute insubordination.
(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 are authorized to 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 written instructions regarding meals, snacks, and physical education.
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.
(B) 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. The South Carolina Attorney General's Office shall intervene and provide the legal defense in any lawsuit brought under the provisions of this act against a school district, school, or school employee.
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. 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 student's, 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.
(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.
(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 private school diabetes care provider trained pursuant to Section 44-39-220 who is carrying out the functions enumerated in Section 44-39-220(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 Section 44-39-220(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 Section 44-39-220(A) is not performing nursing procedures, functions, or tasks and is not engaging in the practice of professional or practical nursing.
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."
B. 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)."
C. 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".
D. Notwithstanding the provisions of Section 44-39-220 of the 1976 Code as added by this section, the training required to be provided pursuant to Section 44-39-220 for school employees is not required to be implemented until the 2003-2004 school year.
SECTION 4. This act takes effect upon approval by the Governor.
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