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COMMITTEE REPORT
May 15, 2002
S. 977
Introduced by Senators Giese, J. Verne Smith, Land, Short, Drummond, Fair, Mescher, Leatherman, Verdin, Ritchie and Branton
S. Printed 5/15/02--H. [SEC 5/16/02 7:50 PM]
Read the first time April 3, 2002.
To whom was referred a Bill (S. 977) 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, 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, by adding an appropriately numbered SECTION to read:
/SECTION __. 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 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."
B. 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".
C. Notwithstanding the provisions of Section 44-39-220 of the 1976 Code as added by 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./
Renumber sections to conform.
Amend totals and title to conform.
JOE E. BROWN for Committee.
EXPLANATION OF IMPACT:
The Department of Labor, Licensing and Regulation has indicated this bill would not have any impact on the department, the General Fund of the State or federal and/or other funds. The bill is clarifying definitions of attendant case services.
Approved By:
Don Addy
Office of State Budget
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.
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:
(1) As prohibiting gratuitous nursing by friends or members of the family;
(2) 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;
(3) As prohibiting nursing assistance in case of an emergency;
(4) 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;
(5) 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;
(6) 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;
(7) 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.;
(8) 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. This act takes effect upon approval by the Governor.
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