Louisiana Administrative Code
Title 28 - EDUCATION
Part CLVII - Bulletin 135-Health and Safety
Chapter 3 - Health
Section CLVII-307 - Diabetes Management and Treatment
Universal Citation: LA Admin Code CLVII-307
Current through Register Vol. 50, No. 3, March 20, 2024
NOTE: This Rule was developed in coordination with the Louisiana State Board of Nursing (LSBN). Any waivers, deletions, additions, amendments, or alterations to this policy shall be approved by both BESE and LSBN.
A. Diabetes Treatment Plans
1. Any public elementary or secondary school
student who seeks care for his diabetes while at school or participating in a
school related activity shall submit a diabetes management and treatment plan
on an annual basis.
2. Such plan
shall be developed by a physician licensed in Louisiana or adjacent state, or
other authorized health care prescriber licensed in Louisiana who is selected
by the parent or guardian to be responsible for such student's diabetes
treatment.
3. The diabetes
management plan shall be kept on file in the school in which the child is
enrolled and shall include:
a. a detailed
evaluation of the student's level of understanding of his condition and his
ability to manage his diabetes;
b.
the diabetes-related healthcare services the student may receive or
self-administer at school or during a school-related activity;
c. a timetable, including dosage
instructions, of any diabetes medications to be administered to the student or
self-administered by the student; and
d. the signature of the student (if age
appropriate), the student's parent or legal guardian, and the physician or
other authorized health care prescriber responsible for the student's diabetes
treatment.
4. The plan
shall be submitted annually to the principal or appropriately designated school
personnel:
a. prior to or within five school
days after the beginning of each school year;
b. upon enrollment, if the student enrolls in
the school after the beginning of the school year;
c. as soon as practicable following the
student's receipt of a diagnosis of diabetes; or
d. as warranted by changes in the student's
medical condition.
5.
The school nurse will be given not less than 5 school days to develop the
individualized healthcare plan (IHP) and shall implement the IHP within 10
school days upon receipt of the diabetes treatment plan.
a. The school nurse must assess the stability
of the student's diabetes for the school setting prior to the development of
the IHP in order to provide continuity of care in the school setting.
6. The parent or legal guardian
shall be responsible for all care related to the student's diabetes management
and treatment plan until all authorized physicians orders, parent
authorization, and all medical supplies deemed necessary to care for the
student in the school setting have been received by the school nurse.
7. The school nurse shall be responsible for
implementing and/or supervising the diabetes management and treatment plan for
the student on campus, during school related activities, and during school
related transportation of the student for the current year.
B. Provision of Care - General Information
1. Upon receipt of the diabetes
management and treatment plan, the school nurse shall conduct a nursing
assessment of the student in his educational environment and develop the
IHP.
2. The school nurse or the
trained unlicensed diabetes care assistant authorized by the school nurse shall
provide care to a student with diabetes, or assist a student with the self-care
of his diabetes, in accordance with the student's diabetes management and
treatment plan and IHP.
3. Diabetes
management and treatment shall be provided to a student with diabetes during
the school day and any school-related activity. School-related activities
include but are not limited to extracurricular activities and sports.
4. No physician, nurse, school employee,
school, or school district shall be liable for civil damages or subject to
disciplinary action under professional licensing regulation or school
disciplinary policies as a result of the activities of an unlicensed diabetes
care assistant.
a. Exception. If a
professional licensing board has cause to believe that a licensee, within its
jurisdiction, improperly trained an unlicensed diabetes care assistant or
improperly assessed the ability of an unlicensed diabetes care assistant to
perform his or her designated functions, then the professional licensing board
may bring disciplinary action against the licensee.
5. With written permission from a student's
parent or legal guardian, a school may provide a school employee with
responsibility for providing transportation or supervision of a student with
diabetes during an off-campus activity with an information sheet that provides
the following information:
a. the identity of
the student;
b. a description of
potential emergencies that may occur as a result of the student's diabetes and
the appropriate responses to such emergencies; and
c. the telephone number of the person(s) to
be contacted in case of an emergency.
C. Unlicensed Diabetes Care Assistants - General Information
1. The school nurse may
utilize a trained unlicensed diabetes care assistant in the treatment and care
of a student with diabetes.
2. An
unlicensed diabetes care assistant is defined as a school employee who is not a
healthcare professional, who is willing to complete training requirements
established by this Rule, and is determined competent by the school nurse to
provide care and treatment to students with diabetes.
3. A school employee shall not be subject to
any penalty or disciplinary action for refusing to volunteer or serve as an
unlicensed diabetes care assistant.
4. If a school chooses to use unlicensed
diabetes care assistants to provide care for students with diabetes at school
or during a school-related activity, all of the rules of this section shall be
followed.
5. Supervision
requirements for unlicensed diabetes care assistants shall be as follows.
a. Unlicensed diabetes care assistants may
serve under the supervision of the school nurse or school principal for
diabetes management care.
b.
Unlicensed diabetes care assistants shall serve under the supervision of a
school nurse for medication administration.
i.
Where a school nurse is not physically present, he or she must be available by
phone for immediate access to the school.
6. Protocols for administration of medication
for the treatment of diabetes shall be consistent with Bulletin 135, §305.
D. Role of Unlicensed Diabetes Care Assistants
1. An unlicensed
diabetes care assistant may provide diabetes care to a student only in
accordance with the student's diabetes management and treatment plan.
a. The student's parent or legal guardian
must sign an agreement authorizing such care.
b. The agreement must be on file with the
school.
2. An unlicensed
diabetes care assistant, in accordance with the diabetes management and
treatment plan on file for a student, may provide diabetes care to a student,
or assist a student in the self-care of his diabetes by:
a. checking and recording blood glucose and
ketone levels;
b. responding to
blood glucose and ketone levels;
c.
administering emergency treatment as prescribed in the student's diabetes
treatment plan and/or IHP;
d.
following carbohydrate counting guidelines established by the school district
or school; and
e. following
medication administration protocols established by the school district or
school.
3. Methods for
training unlicensed diabetes care assistants include:
a. at least six hours of diabetes management
and treatment instruction;
b. at
least five return demonstrations of 100 percent skill competency; and
c. annual skill competency
demonstration.
4. The
unlicensed diabetes care assistant must be monitored by the school nurse for
compliance of treatment plan and skill level.
5. The unlicensed diabetes care assistant
must notify the school nurse of any changes in the status of the
student.
6. During the specific
time spent on management and/or treatment of the student with diabetes, the
unlicensed diabetes care assistant shall be relieved of all other
duties.
7. In performance of their
duties, unlicensed diabetes care assistants shall be exempt from any applicable
state law or rule that restricts the activities that may be performed by a
person who is not a healthcare professional.
E. The Role of the School Nurse
1. The school nurse, in collaboration with
the principal, shall supervise the implementation of the school policies for
diabetes management and treatment and for the administration of medications in
the schools to ensure the safety, health, and welfare of the
students.
2. The school nurse or
other healthcare professional with expertise in caring for persons with
diabetes, in accordance with their authorized scope of practice, shall be
responsible for the training and competency evaluation of non-medical personnel
who have volunteered to serve as a diabetes care assistant.
3. The curriculum for training the unlicensed
diabetes care assistants shall include, but not be limited to the following
topics:
a. recognize the signs and symptoms
of hyperglycemia and hypoglycemia;
b. understand the details of the student's
diabetes management treatment plan and when to contact the school nurse for
additional directions on how to treat the student's change in
condition;
c. understand the proper
action to take if student's blood glucose levels are outside the target ranges
specified in his diabetes management and treatment plan;
d. perform finger sticks to check blood
glucose levels, check urine ketones levels, properly record the results, and
notify the school nurse;
e.
administration of medication as ordered by physician, other authorized
healthcare prescriber in accordance with school policies, procedures and the
student's diabetes management treatment plan;
f. recognize complications which require
emergency assistance;
g. understand
carbohydrate counting, the recommended schedules and food intake for meals and
snacks for a student with diabetes, the effect of physical activity on blood
glucose levels, and the proper actions to be taken if a student's schedule is
disrupted during school or any school related activity;
h. review of school or school district
policies related to confidentiality and blood borne pathogens.
F. The Role of the Student with Diabetes in Self-Care
1. In
accordance with a student's diabetes management and treatment plan the school
shall permit the student to attend to the self-management, administration of
medications, treatment and documentation as outlined in his diabetes management
plan.
H. The Role of the Principal
1. In consultation with the school
nurse, if one is available, the principal may:
a. receive diabetes management and treatment
plan;
b. seek school employee who
is willing to be trained to serve as the unlicensed diabetes care
assistant;
c. ensure the school has
at least one unlicensed diabetes care assistant, if the school has a full time
nurse, or at least three unlicensed diabetes care assistants if the school has
no full time nurse;
d. require the
school to develop carbohydrate count standard guides for those students who eat
school provided lunches;
e.
supervise the implementation of the school policies for diabetes management and
treatment and for the administration of medications in the schools to ensure
the safety, health, and welfare of the students;
f. ensure appropriate supervision of the
unlicensed diabetes care assistant.
I. The Role of the Parent/Legal Guardian
1. Annually submit a copy of the student's
diabetes management and treatment plan to the principal of the school in which
in student is enrolled.
2. Give
consent to implementation of the diabetes management and treatment
plan.
3. Work with appropriate
school personnel in development of the individualized healthcare plan and
provision of care for the student until the individualized healthcare plan and
diabetes management and treatment plan can be implemented.
4. Provide written calculation of
carbohydrates in meals when lunch is provided from home.
5. Provide necessary supplies and equipment
to deliver diabetes management and treatment plan.
6. Follow protocols for administration of
medication consistent with Bulletin 135, §305.
AUTHORITY NOTE: Promulgated in accordance with R.S. 17:436.3.
Disclaimer: These regulations may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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