1. “Individualized emergency health care plan” means a document developed by the school nurse, in consultation with the parent of a pupil with diabetes and other appropriate medical professionals, which is consistent with the recommendations of the pupil’s health care provider(s) and which outlines a set of procedural guidelines that provide specific directions about what to do in a particular emergency situation and is signed by the parent and the school nurse.
2. “Individualized health care plan” means a document developed by the school nurse, in consultation with the parent of a pupil with diabetes and other appropriate medical professionals who may be providing diabetes care to the pupil, which is consistent with the recommendations of the pupil’s health care provider(s) and which sets out the health services needed by the pupil at school and is signed by the parent and the school nurse.
3. “Parent” means parent or legal guardian.
B. Health Care Plans for Pupils with Diabetes
1. The parent of a pupil with diabetes who seeks diabetes care for the pupil while at school shall inform the school nurse who shall develop an individualized health care plan and an individualized emergency health care plan for the pupil.
a. The parent of the pupil with diabetes shall annually provide to the Principal and the school nurse a signed written request and authorization for the provision of diabetes care as may be outlined in the individualized health care plan, which shall include authorization for the emergency administration of glucagons and, if requested by the parent, authorization for the pupil’s self-management and care of his/her diabetes; and
b. If such a request is made by a pupil’s parent, the pupil’s physician or advanced practice nurse must provide a signed written certification to the Principal and the school nurse that the pupil is capable of, and has been instructed in, the management and care of his/her diabetes.
2. The individualized health care plan and individualized emergency health care plan shall be updated by the school nurse prior to the beginning of each school year and as necessary in the event that there is a change in the health status of the pupil.
3. Each individualized health care plan shall include, and each individualized emergency health care plan may include, the following information:
a. The symptoms of hypoglycemia for that particular pupil and the recommended treatment;
b. The frequency of blood glucose testing;
c. Written orders from the pupil’s physician or advanced practice nurse outlining the dosage and indications for insulin administration and the administration of glucagon, if needed;
d. Times of meals and snacks and indications for additional snacks or exercise;
e. Full participation in exercise and sports, and any contraindications to exercise, or accommodations that must be made for that particular pupil;
f. Accommodations for school trips, after-school activities, class parties, and other school-related activities;
g. Education of all school personnel who may come in contact with the pupil about diabetes, how to recognize and treat hypoglycemia, how to recognize hyperglycemia, and when to call for assistance;
h. Medical and treatment issues that may affect the educational process of the pupil with diabetes; and
i. How to maintain communications with the pupil, the pupil’s parent and health care team, the school nurse, and the educational staff.
4. The school nurse assigned to a particular school shall coordinate the provision of diabetes care at that school and ensure that appropriate staff members are trained in the care of pupils with diabetes, including staff members working with school-sponsored programs outside of the regular school day, as provided in the individualized health care plan and the individualized emergency health care plan.
C. Authorized Employees for Administration of Glucagon
1. The school nurse shall have the primary responsibility for the emergency administration of glucagon to a pupil with diabetes who is experiencing severe hypoglycemia. The school nurse shall designate, in consultation with the Superintendent of Schools or designee, additional employees of the school district who volunteer to administer glucagon to a pupil with diabetes who is experiencing severe hypoglycemia. The designated employees shall only be authorized to administer glucagon, following training by the school nurse or other qualified health care professional, when a school nurse is not physically present at the scene.
2. In accordance with the provisions of N.J.S.A. 18A:40-12.14, the activities described in C.1. above shall not constitute the practice of nursing and shall be exempted from all applicable statutory or regulatory provisions that restrict the activities that may be delegated to a person who is not a licensed health care professional.
3. In accordance with the provisions of N.J.S.A. 18A:40-12.14, if a licensed athletic trainer volunteers to administer glucagon to a pupil with diabetes as described in C.1. above, it shall not constitute a violation of the “Athletic Training Licensure Act,” P.L.1984, c.203 (C.45:9-37.35 et seq.).
D. Management and Care of Diabetes by Pupil
1. Upon the written request and authorization from the parent submitted to the Principal and school nurse and as provided in the pupil’s individualized health care plan, the school district shall allow the pupil to manage and care for his/her diabetes as needed in the classroom, in any area of the school or school grounds, or at any school-related activity provided the pupil has been evaluated and determined to be capable of doing so as reflected in the pupil’s individualized health care plan. The pupil’s management and care of his/her diabetes shall include the following:
a. Performing blood glucose level checks;
b. Administering insulin through the insulin delivery system the pupil uses;
c. Treating hypoglycemia and hyperglycemia;
d. Possessing on the pupil’s person at any time the supplies or equipment necessary to monitor and care for the pupil’s diabetes;
e. Compliance with required procedures for medical waste disposal in accordance with district policies and as set forth in the individualized health care plan; and
f. Otherwise attending to the management and care of the pupil’s diabetes.
E. Release for Sharing of Certain Medical Information
1. The school nurse shall obtain a release from the parent of a diabetic pupil to authorize the sharing of medical information between the pupil’s physician or advanced practice nurse and other health care providers.
2. The release shall also authorize the school nurse to share medical information with other staff members of the school district as necessary.
F. Immunity From Liability
1. No school employee, including a school nurse, a school bus driver, a school bus aide, or any other officer or agent of the Board of Education shall be held liable for any good faith act or omission consistent with the provisions of N.J.S.A. 18A:40-12.11 through 18A:40-12.21, nor shall an action before the New Jersey State Board of Nursing lie against a school nurse for any such action taken by a person trained in good faith by the school nurse pursuant to this act. Good faith shall not include willful misconduct, gross negligence, or recklessness.
G. Possession of Syringes
1. The possession and use of syringes consistent with the purposes of N.J.S.A. 18A:40-12.11 through 18A:40-12.21 and Policy 5338 shall not be considered a violation of applicable statutory or regulatory provisions that may otherwise restrict or prohibit such possession and use.
Issued: September 2010