[atlas:bill]

AN ACT Relating to accommodating children with diabetes in schools; amending RCW 18.71.030; adding a new section to chapter 28A.210 RCW; and providing an effective date.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. A new section is added to chapter 28A.210 RCW to read as follows:

(1) The legislature finds that diabetes imposes significant health risks to students enrolled in the state's public and private schools and that providing for the medical needs of students with diabetes is crucial to ensure both the safety of students with diabetes and their ability to obtain the education guaranteed to all citizens of this state.

(2) The definitions in this subsection apply throughout this section, unless the context clearly requires otherwise.

(a) "Public or private school" means any primary or secondary public or private school located in the state of Washington.

(b) "School diabetes attendant" refers to a school employee trained in accordance with subsection (5) of this section.

(c) "Student with diabetes" means a student enrolled in a public or private school within the state who has been diagnosed by a health care provider as having either type I or type II diabetes.

(3) Upon the written request of the parent or guardian and written orders by a health care provider, a student with diabetes shall 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 at any time and at the school or school grounds, on school buses, 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.

(4)(a) Upon the written request of the parent or guardian and written orders by a health care provider, school diabetes attendants shall perform functions including, but not limited to, (i) assisting students with diabetes to test their blood sugar levels or for the presence of ketones; (ii) testing the blood sugar levels or the presence of ketones for a student with diabetes; (iii) treating or preventing hypoglycemia through the use of glucose, appropriate food or beverages, or glucagon; (iv) treating and preventing hyperglycemia by assisting students with diabetes to take insulin or by administering insulin; and (v) recording the result of blood sugar tests and tests for ketones, and recording the treatment provided.

(b) A school diabetes attendant shall be on-site and available to provide care to each student with diabetes during regular school hours, during school-sponsored before-school and after-school care programs, during field trips and extracurricular activities, and on buses when the bus driver has not completed the necessary training. A school employee may refuse to assume the role of school diabetes attendant if other school employees will fulfill that role.

(c) School diabetes attendants shall be available at each school where a student with diabetes is enrolled and a student's school choice shall in no way be restricted because the student has diabetes.

(5)(a) The Washington state nursing commission shall develop guidelines for the training of school diabetes attendants by August 31, 2002. School diabetes attendants shall be trained to do the following, based on the student's individual needs and the attendant's level of contact with the student:

(i) To recognize hypoglycemia and hyperglycemia;

(ii) To assist students with diabetes in performing or to perform for the student tests designed to determine the student's blood sugar level and to determine whether ketones are present;

(iii) To treat mild or moderate cases of hypoglycemia through the use of glucose or by providing appropriate food or beverages;

(iv) To treat severe cases of hypoglycemia by administering glucagon and/or other steps ordered by the child's health care provider in the child's individual health care plan;

(v) To treat and prevent hyperglycemia by assisting students or administering insulin in accordance with the orders provided by the student's health care provider; and

(vi) To record information relating to the blood sugar and ketone levels of the student with diabetes and the treatments provided in the patient's physician's order or health care plan.

(b) Each public school district and private school shall provide training in the recognition and treatment of hypoglycemia to all bus drivers responsible for the transportation of a student with diabetes if a school diabetes attendant is not present.

(c) The training in (a) of this subsection shall be provided by a health care professional with expertise in diabetes. The training shall take place before the commencement of each school year at every school attended by one or more students with diabetes, or as needed when a student with diabetes is newly enrolled at a school or a student is newly diagnosed with diabetes.

(6) Any public school district, public school district employee, agent, or volunteer, private school, or private school employee, agent, or volunteer who, acting in good faith, provides assistance or services under this section is not liable for any civil damages.

Sec. 2. RCW 18.71.030 and 1996 c 178 s 4 are each amended to read as follows:

Nothing in this chapter shall be construed to apply to or interfere in any way with the practice of religion or any kind of treatment by prayer; nor shall anything in this chapter be construed to prohibit:

(1) The furnishing of medical assistance in cases of emergency requiring immediate attention;

(2) The domestic administration of family remedies;

(3) The administration of oral medication of any nature to students by public school district employees or private elementary or secondary school employees as provided for in chapter 28A.210 RCW;

(4) The practice of dentistry, osteopathic medicine and surgery, nursing, chiropractic, podiatric medicine and surgery, optometry, naturopathy, or any other healing art licensed under the methods or means permitted by such license;

(5) The practice of medicine in this state by any commissioned medical officer serving in the armed forces of the United States or public health service or any medical officer on duty with the United States veterans administration while such medical officer is engaged in the performance of the duties prescribed for him or her by the laws and regulations of the United States;

(6) The practice of medicine by any practitioner licensed by another state or territory in which he or she resides, provided that such practitioner shall not open an office or appoint a place of meeting patients or receiving calls within this state;

(7) The practice of medicine by a person who is a regular student in a school of medicine approved and accredited by the commission, however, the performance of such services be only pursuant to a regular course of instruction or assignments from his or her instructor, or that such services are performed only under the supervision and control of a person licensed pursuant to this chapter;

(8) The practice of medicine by a person serving a period of postgraduate medical training in a program of clinical medical training sponsored by a college or university in this state or by a hospital accredited in this state, however, the performance of such services shall be only pursuant to his or her duties as a trainee;

(9) The practice of medicine by a person who is regularly enrolled in a physician assistant program approved by the commission, however, the performance of such services shall be only pursuant to a regular course of instruction in said program and such services are performed only under the supervision and control of a person licensed pursuant to this chapter;

(10) The practice of medicine by a licensed physician assistant which practice is performed under the supervision and control of a physician licensed pursuant to this chapter;

(11) The practice of medicine, in any part of this state which shares a common border with Canada and which is surrounded on three sides by water, by a physician licensed to practice medicine and surgery in Canada or any province or territory thereof;

(12) The administration of nondental anesthesia by a dentist who has completed a residency in anesthesiology at a school of medicine approved by the commission, however, a dentist allowed to administer nondental anesthesia shall do so only under authorization of the patient's attending surgeon, obstetrician, or psychiatrist, and the commission has jurisdiction to discipline a dentist practicing under this exemption and enjoin or suspend such dentist from the practice of nondental anesthesia according to this chapter and chapter 18.130 RCW;

(13) Emergency lifesaving service rendered by a physician's trained emergency medical service intermediate life support technician and paramedic, as defined in RCW 18.71.200, if the emergency lifesaving service is rendered under the responsible supervision and control of a licensed physician;

(14) The provision of clean, intermittent bladder catheterization for students by public school district employees or private school employees as provided for in RCW 18.79.290 and 28A.210.280;

(15) The administration of or assistance in the administration of glucagon or insulin to students with diabetes by public school district employees or private school employees as provided for in the education equity for students with diabetes act or in section 1 of this act;

(16) The testing or assistance in the testing of students with diabetes for blood sugars and ketones by public school district employees or private school employees as provided for in the education equity for students with diabetes act.

NEW SECTION. Sec. 3. This act takes effect July 1, 2002.