California Law:
(RECENTLY VETOED BY CALIFORNIA GOVERNOR)
Schools That Have Students With Diabetes
BILL NUMBER: SB 1320 ENROLLED
BILL TEXT
PASSED THE SENATE AUGUST 30, 2000
PASSED THE ASSEMBLY AUGUST 28, 2000
AMENDED IN ASSEMBLY AUGUST 25, 2000
AMENDED IN ASSEMBLY AUGUST 7, 2000
AMENDED IN SENATE MAY 26, 2000
AMENDED IN SENATE MAY 3, 2000
AMENDED IN SENATE APRIL 24, 2000
AMENDED IN SENATE APRIL 13, 2000
INTRODUCED BY Senator Escutia
(Principal coauthor: Assembly Member Calderon)
(Coauthors: Assembly Members Alquist and Firebaugh)
JANUARY 3, 2000
An act to add Article 2.5 (commencing with Section 49430) to Chapter 9 of Part
27 of the Education Code, relating to pupil health.
LEGISLATIVE COUNSEL'S DIGEST
SB 1320, Escutia. Pupil health.
(1) Existing law requires the governing board of a
school district to give diligent care to the health and physical development of
pupils.
This bill would require every school to permit any pupil with
diabetes to test his or her blood glucose levels either in classrooms or very
close to classrooms. The bill would require every school to comply with the
universal precautions and requirements for handling and disposing of
contaminated sharps, as prescribed by regulations
adopted by the Department of Industrial Relations. The bill would also require
every school that has at least one pupil with diabetes to ensure that, in the
absence of a school nurse, there is at least one adult at the school who is
knowledgeable about testing blood glucose levels, recognizing and treating
hypoglycemia and hyperglycemia, and administering glucagon, and would require
that
school to provide training to that adult. The bill would also
require every school that has at least one diabetic pupil who is not able to
administer his or her own insulin and for whom the child's parent or guardian is
not able to arrange assistance for the child to ensure the availability of a
licensed health care provider to administer the insulin. The requirements on
schools made by the bill
would impose a state-mandated local program.
(2) The California Constitution requires the state
to reimburse local agencies and school districts for certain costs mandated by
the state. Statutory provisions establish procedures for making that
reimbursement, including the creation of a State Mandates Claims Fund to pay the
costs of mandates that do not exceed $1,000,000 statewide
and other procedures for claims whose statewide costs exceed $1,000,000.
This bill would provide that, if the Commission on State Mandates determines
that the bill contains costs mandated by the state, reimbursement for those
costs shall be made pursuant to these statutory provisions.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares as follows:
(a) Type 2 diabetes, which is significantly influenced by diet and exercise, is
rising rapidly in children. In 1997, 16,000 people in California under the age
of 18 were diagnosed with diabetes. A vast majority of diabetes in children has
been Type 1. However, in 1992, only 2 to 4 percent of all childhood diabetes
cases were Type 2; from September 1999 to March 2000, Children's Hospital of Los
Angeles
received 94 new diabetes patients, of which 24 (25 percent) were Type 2.
(b) Diabetes is expected to double in prevalence in California in the next 20
years. Two million Californians have diabetes. The prevalence of diabetes is at
least 50 percent higher among Hispanics and African-Americans than whites in
every age group tracked. Diabetes is the leading cause of adult onset blindness,
kidney failure, and amputation of the lower extremities and is a significant
contributor to heart disease and stroke. Between 1994 and 1997, an
average of 21,025 deaths annually were attributable directly or indirectly to
diabetes in California.
(c) Diabetes costs California over $12 billion annually only for direct costs.
The state provides no funding to California's Diabetes Control Program.
SEC. 2. Article 2.5 (commencing with Section 49430) is added to Chapter 9 of
Part 27 of the Education Code, to read:
Article 2.5. The Pupils with Diabetes Program
49430. (a) Every school shall allow any pupil with
diabetes to test his or her blood glucose levels either in classrooms or very
close to classrooms. Every school shall comply with the universal precautions
and requirements for handling and disposing of contaminated sharps, as
prescribed by regulations adopted by the Department of Industrial Relations.
(b) Every school that has at least one pupil with diabetes shall ensure that, in
the absence of a school nurse, there is at least one adult at the school who is
knowledgeable about testing blood glucose levels, recognizing and treating
hypoglycemia and hyperglycemia, and administering glucagon.
(c) An adult required by subdivision (b) shall observe the child's
self-administration of insulin, and, in life-threatening
circumstances, shall call 911, administer glucagon, and notify the on-call
credentialed school nurse.
(d) Every school that has at least one pupil with diabetes that does not have a
full-time school nurse shall provide training to at least one nonmedically
trained adult to provide the knowledge required pursuant to subdivision (b). The
training may be provided by school nurses, the American Diabetes Association,
other recognized diabetes training and education organizations, or parents or
guardians of the enrolled pupils with diabetes.
(e) Every school that has at least one pupil with diabetes who is not able to
administer his or her own insulin and for whom the parent or guardian of the
child is not able to arrange assistance for the child, shall ensure the
availability of a licensed health care provider, including, but not limited to,
a credentialed school nurse, public health nurse, registered nurse, or licensed
vocational nurse
(who has been trained and shall be under the overall supervision of a
credentialed school nurse in the administration of insulin), to administer
insulin.
SEC. 3. The California Constitution requires the state to
reimburse local agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that reimbursement,
including the creation of a State Mandates Claims Fund to pay the costs of
mandates that do not exceed $1,000,000 statewide and other procedures for claims
whose statewide costs exceed $1,000,000.
This bill would provide that, if the Commission on State Mandates determines
that the bill contains costs mandated by the state, reimbursement for those
costs shall be made pursuant to these statutory provisions.
Legislative and Legal Issues
Settlement Reached in Board of Education Lawsuit
School Children with Diabetes Nationwide May Benefit
In a case that could have positive implications for students with diabetes in public schools, settlement of a Federal Lawsuit has been announced between the parents of a student and the East Haddam Board of Education, East Haddam, Ct.
The settlement will allow the student, Katelyn Cross, access to her glucose monitor and diabetes supplies within the school, wherever and whenever it is necessary. Stipulated in the agreement was certification by the doctor that Katelyn was competent to perform a fingerstick and that there was no risk of a blood pathogen from the procedure.
The school district had adopted a policy that allowed students to perform glucose testing only in the Health office despite the compelling results of the Diabetes Control and Complications Trial (DCCT) in the early 90's. These results clearly showed that tight glucose control could significantly reduce the long-term complications associated with diabetes.
The parents and their attorneys argued that this requirement amounted to unlawful discrimination under the Americans with Disabilities Act and filed suit in District Federal Court in 1996.
Putting the glucose monitoring issue in perspective, more and more schools are adopting policies allowing classroom glucose monitoring as being in the best interest of the child. Health departments in certain states, such as Vermont, have published comprehensive guidelines supporting glucose testing wherever the child feels most comfortable.
"We are hopeful that resolution of our discrimination problems will help others whose schools refuse to provide accommodations for children whose doctor's feel classroom testing is appropriate" the Crosses said. "We're very thankful for the strong support provided by the Juvenile Diabetes Foundation and the American Diabetes Association in the resolution of this case."
While the East Haddam school district learned a lot about diabetes during the course of resolving the lawsuit, the family learned a lot as well. "The experience taught us to stand up for what we believe and also provided a sense of empowerment for Katelyn. Diabetes control is a relentless 24 hour a day process and equipment and supplies needed to monitor one's health must not be confiscated when entering a public building."
Diabetes is an incurable disease that affects the body's ability to produce or respond properly to insulin, a hormone that allows blood sugar to enter the cells of the body and be used for energy. People with Type I diabetes - which makes up the vast majority of students with diabetes - as well as some people with Type 2 diabetes, must receive insulin every day either through injections or an insulin pump. However, use of insulin can cause too much sugar to cross the cell membranes. This results in abnormally low blood sugar levels or "hypoglycemia." Knowing how much insulin is required or whether one's blood sugar level is high or low is determined by a simple fingerstick procedure.
Diabetes affects approximately 16 million people nationwide. It is the country's sixth deadliest disease and can lead to heart disease, stroke, kidney failure, blindness and amputations.
For additional information, please contact:
Doreen Cross
30 Alger Road
East Haddam, CT 06423
23 January 2000
Section 504 and Education
Section 504 and Education Discrimination against students on the basis of disability is
prohibited in education programs or activities that receive Federal financial assistance.
Section 504 of the Rehabilitation Act of 1973 requires that: No qualified handicapped person shall, on the basis of handicap, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity which receives or benefits from Federal financial assistance ....
The Office for Civil Rights of the Department of Education (OCR) enforces the law prohibiting specific discriminatory activities, including the discriminatory assignment of students with disabilities to segregated classes or facilities. The law applies to elementary and secondary as well as postsecondary schools. In elementary and secondary schools, students with disabilities may be assigned to separate facilities or courses of special education only when such placement is necessary to provide them equal educational opportunity and when the separate facilities and services are comparable to other facilities and services.
For more information on Section 504 and the U.S. Department of Education, Office for Civil Rights (OCR), read the following publications or contact the OCR enforcement office serving your area.
- Office for Civil Rights: Ensuring Equal Access To Quality Education
- Impact of the Civil Rights Laws
- Section 504 Regulation of the Rehabilitation Act of 1973
- Auxiliary Aids and Services for Postsecondary Students with Disabilities: Higher Education's Obligations Under Section 504 and Title II of the ADA
- Placement of School Children with Acquired Immune Deficiency Syndrome
- Student Placement in Elementary and Secondary Schools and Section 504 and Title II of the Americans with Disabilities Act
- The Civil Rights of Students with Hidden Disabilities Under Section 504 of the Rehabilitation Act of 1973
- Other OCR Products and Publications