H.F. 2432 Section 1. NEW SECTION . 280.30 Diabetes care. 1 1. Definitions. For purposes of this section: 2 a. “Diabetes medical management plan” means a document 3 developed by a student’s personal health care team that sets 4 out the health services needed by the student at school and 5 that is signed by the student’s personal health care team and 6 parent or guardian. 7 b. “School employee” means a person employed by a public 8 school, any person employed by a local health department who is 9 assigned to a public school, or a subcontractor designated for 10 this function. 11 c. “Trained diabetes personnel” means a school employee who 12 volunteers to be trained in accordance with subsection 2. Such 13 an employee need not be a health care professional. 14 2. Training of designated school employees. 15 a. The department of education, in coordination with the 16 department of public health, the American diabetes association, 17 and individuals licensed under chapter 148 and designated by 18 the department of public health, shall by January 1, 2013, 19 develop guidelines for the training of volunteer school 20 employees as provided in paragraph “c” in the care needed for 21 students with diabetes. The department shall make available to 22 public schools information on training guidelines for diabetes 23 management. Training guidelines shall include instruction in 24 all of the following: 25 (1) Recognition and treatment of hypoglycemia and 26 hyperglycemia. 27 (2) Understanding the appropriate actions to take when 28 blood glucose levels are outside of the target ranges indicated 29 by a student’s diabetes medical management plan. 30 (3) Understanding physician instructions concerning 31 diabetes medication dosage, frequency, and manner of 32 administration. 33 (4) Performance of finger-stick blood glucose checking, 34 ketone checking, and recording the results. 35 -1- LSB 5762HV (3) 84 je/rj 1/ 5

H.F. 2432 (5) The administration of glucagon and insulin and the 1 recording of results. 2 (6) Recognizing complications that require emergency 3 assistance. 4 (7) Recommended schedules and food intake for meals and 5 snacks, the effect of physical activity upon blood glucose 6 levels, and actions to be implemented in the case of schedule 7 disruption. 8 (8) Understanding of universal precautions regarding bodily 9 fluids as they apply to the management of diabetes in a school 10 setting. 11 b. A public school shall incorporate training in the 12 recognition of hypoglycemia and hyperglycemia and actions to 13 take in response to emergency situations as part of the overall 14 training provided to all school personnel. 15 c. The board of directors of a public school district 16 may ensure that the training outlined in paragraph “a” is 17 available to school employees at a school attended by a student 18 with diabetes. The principal or school administrator at such 19 a school shall distribute written notice that training is 20 available for employees who volunteer to be trained. 21 d. The board of directors of a public school district shall 22 not subject a school employee to any penalty or disciplinary 23 action for refusing to serve as trained diabetes personnel or 24 prohibit or restrict a school employee from volunteering for 25 training. 26 e. The training outlined in paragraph “a” may be coordinated 27 by a school nurse and provided by a school nurse or other 28 health care professional with expertise in diabetes. 29 3. Diabetes medical management plan. The parent or guardian 30 of each student who seeks diabetes care while at school shall 31 submit to the student’s school a diabetes medical management 32 plan. The student’s school shall review and implement the 33 diabetes medical management plan upon receipt. 34 4. Required care. 35 -2- LSB 5762HV (3) 84 je/rj 2/ 5

H.F. 2432 a. In accordance with the request of a parent or guardian 1 of a student with diabetes and the student’s diabetes medical 2 management plan, a school nurse, or, in the absence of a school 3 nurse, trained diabetes personnel shall perform functions 4 including but not limited to responding to blood glucose levels 5 that are outside of the student’s target range; administering 6 glucagon; administering insulin or assisting a student in 7 administering insulin through the insulin delivery system the 8 student uses; providing oral diabetes medications; checking and 9 recording blood glucose levels and ketone levels or assisting 10 a student with such checking and recording; and following 11 instructions regarding meals, snacks, and physical activity. 12 b. A student’s school choice shall not be restricted because 13 the student has diabetes. 14 5. Independent monitoring and treatment. A student with 15 diabetes, upon written request of the student’s parent or 16 guardian and as authorized by the student’s diabetes medical 17 management plan, shall be permitted to perform blood glucose 18 checks, administer insulin through the insulin delivery system 19 the student uses, treat hypoglycemia and hyperglycemia, and 20 otherwise attend to the care and management of the student’s 21 diabetes in the classroom and in any area of the school or 22 school grounds, and to possess on the student’s person at all 23 times all necessary supplies and equipment to perform these 24 monitoring and treatment functions. 25 EXPLANATION 26 This bill directs the department of education, in 27 coordination with the department of public health, the American 28 diabetes association, and individuals licensed under Code 29 chapter 148 and designed by the department of public health, 30 to develop guidelines by January 1, 2013, for the training of 31 public school employees in the care needed for students with 32 diabetes. The bill provides that the department of education 33 shall make available to public schools information on training 34 guidelines including instruction in a variety of functions 35 -3- LSB 5762HV (3) 84 je/rj 3/ 5

H.F. 2432 necessary for the monitoring and treatment of diabetes. The 1 bill requires public schools to incorporate training in the 2 recognition of hypoglycemia and hyperglycemia and actions to 3 take in response to emergency situations as part of the overall 4 training provided to all school personnel. 5 The bill provides that the board of directors of a public 6 school district may ensure that the training is available to 7 school employees at each school attended by a student with 8 diabetes. A school employee who has received such training is 9 defined as a “trained diabetes personnel”. The principal or 10 school administrator at such a school must distribute written 11 notice that training is available to volunteering employees. 12 The bill provides that the board of directors of a public 13 school district cannot penalize an employee for refusing to 14 volunteer or restrict an employee from volunteering. The bill 15 provides that the training may be coordinated by a school 16 nurse and provided by a school nurse or other health care 17 professional with expertise in diabetes. 18 The bill requires the parent or guardian of a public school 19 student who seeks diabetes care while at school to submit 20 to the student’s school a diabetes medical management plan. 21 The student’s school is required to review and implement the 22 diabetes medical management plan upon receipt. A “diabetes 23 medical management plan” means a document developed by a 24 student’s personal health care team that sets out the health 25 services needed by the student at school and that is signed by 26 the student’s personal health care team and parent or guardian. 27 The bill provides that in accordance with the request of a 28 parent or guardian of a public school student with diabetes 29 and the student’s diabetes medical management plan, a school 30 nurse, or, in the absence of a school nurse, trained diabetes 31 personnel shall perform various functions necessary for the 32 monitoring and treatment of diabetes. The bill provides that 33 a student’s school choice shall not be restricted because the 34 student has diabetes. 35 -4- LSB 5762HV (3) 84 je/rj 4/ 5

H.F. 2432 The bill provides that upon written request of the student’s 1 parent or guardian and as authorized by the student’s diabetes 2 medical management plan, a student with diabetes shall be 3 permitted to perform various functions necessary for care and 4 management of the student’s diabetes in the classroom and in 5 any area of the school or school grounds, and to possess at 6 all times all necessary supplies and equipment to perform such 7 functions. 8 -5- LSB 5762HV (3) 84 je/rj 5/ 5