UNOFFICIAL COPY 22 RS BR 913 Page 1 of 6 XXXX Jacketed AN ACT relating to the emergency administration of medication in schools. 1 Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2 ď˘Section 1. KRS 158.838 is amended to read as follows: 3 (1) (a) Beginning July 15, 2014, the board of each local public school district and the 4 governing body of each private and parochial school or school district shall 5 have at least one (1) school employee at each school who has met the 6 requirements of KRS 156.502 on duty during the entire school day to 7 administer or assist with the self-administration of the following medication: 8 1. Glucagon subcutaneously to students with diabetes who are 9 experiencing hypoglycemia or other conditions noted in the health care 10 practitioner's written statement under subsection (2)(a)2. of this section; 11 2. Insulin subcutaneously, through the insulin delivery method used by the 12 student and at the times and under the conditions noted in the health care 13 practitioner's written statement under subsection (2)(a)2. of this section; 14 [and] 15 3. A seizure rescue medication or medication prescribed to treat seizure 16 disorder symptoms approved by the United States Food and Drug 17 Administration and any successor agency; and 18 4. Naloxone in accordance with KRS 217.186. 19 (b) For those assigned the duties under paragraph (a) of this subsection, the 20 training provided under KRS 156.502 shall include instruction in 21 administering: 22 1. Insulin and glucagon, as well as recognition of the signs and symptoms 23 of hypoglycemia and hyperglycemia and the appropriate steps to be 24 taken to respond to these symptoms; [and] 25 2. Seizure medications, as well as the recognition of the signs and 26 symptoms of seizures and the appropriate steps to be taken to respond to 27 UNOFFICIAL COPY 22 RS BR 913 Page 2 of 6 XXXX Jacketed these symptoms; and 1 3. Naloxone as required under KRS 217.186. 2 (c) Any training program or guidelines adopted by any state agency for training of 3 school personnel in the diabetes care tasks covered by this section shall be 4 fully consistent with training programs and guidelines developed by the 5 American Diabetes Association. Notwithstanding any state agency 6 requirement or other law to the contrary, for purposes of this training a local 7 school district shall be permitted to use any adequate and appropriate training 8 program or guidelines for training of school personnel in the diabetes care 9 tasks covered under this section. 10 (d) Any training program or guidelines adopted by any state agency for training of 11 school personnel in the health care needs of students diagnosed with a seizure 12 disorder shall be fully consistent with best practice guidelines from medical 13 professionals with expertise in seizure treatment. 14 (2) (a) Prior to administering any of the medications listed under 15 subparagraphs[subsection (1)(a)] 1., 2., and 3. of subsection (1)(a) of this 16 section to a student, the student's parent or guardian shall: 17 1. Provide the school with a written authorization to administer the 18 medication at school; 19 2. Provide a written statement from the student's health care practitioner, 20 which shall contain the following information: 21 a. Student's name; 22 b. The name and purpose of the medication; 23 c. The prescribed dosage; 24 d. The route of administration; 25 e. The frequency that the medication may be administered; and 26 f. The circumstances under which the medication may be 27 UNOFFICIAL COPY 22 RS BR 913 Page 3 of 6 XXXX Jacketed administered; and 1 3. Provide the prescribed medication to the school in its unopened, sealed 2 package with the label affixed by the dispensing pharmacy intact. 3 (b) In addition to the statements required in paragraph (a) of this subsection, the 4 parent or guardian of each student diagnosed with a seizure disorder shall 5 collaborate with school personnel to implement the seizure action plan. The 6 Kentucky Board of Education shall promulgate administrative regulations 7 establishing procedures for the implementation of seizure action plans. 8 (3) (a) The statements and seizure action plan required in subsection (2) of this 9 section shall be kept on file in the office of the school nurse or school 10 administrator. 11 (b) Any school personnel or volunteers responsible for the supervision or care of 12 a student diagnosed with a seizure disorder shall be given notice of the seizure 13 action plan, the identity of the school employee or employees trained in 14 accordance with subsection (1)(a) of this section, and the method by which the 15 trained school employee or employees may be contacted in the event of an 16 emergency. 17 (4) The school district or the governing body of each private and parochial school or 18 school district shall inform the parent or guardian of the student that the school and 19 its employees and agents shall not incur any liability as a result of any injury 20 sustained by the student from any reaction to any medication listed under 21 subparagraphs[subsection (1)(a)] 1., 2., and 3. of subsection (1)(a) of this section 22 that a parent or guardian has authorized the school district to administer to a student 23 to treat a hypoglycemic or hyperglycemic episode or a seizure or its administration, 24 unless the injury is the result of negligence or misconduct on behalf of the school or 25 its employees. The parent or guardian of the student shall sign a written statement 26 acknowledging that the school shall incur no liability except as provided in this 27 UNOFFICIAL COPY 22 RS BR 913 Page 4 of 6 XXXX Jacketed subsection, and the parent or guardian shall hold harmless the school and its 1 employees against any claims made for any reaction to any medication listed under 2 subparagraphs[subsection (1)(a)] 1., 2., and 3. of subsection (1)(a) of this section 3 that a parent or guardian has authorized the school district to administer to a student 4 to treat a hypoglycemic or hyperglycemic episode or a seizure or its administration 5 if the reaction is not due to negligence or misconduct on behalf of the school or its 6 employees. 7 (5) The permission for the administration of any of the medications listed under 8 subparagraphs[subsection (1)(a)] 1., 2., and 3. of subsection (1)(a) of this section 9 shall be effective for the school year in which it is granted and shall be renewed 10 each following school year upon fulfilling the requirements of subsections (2) to (4) 11 of this section. 12 (6) The school nurse or school administrator shall check the expiration date monthly for 13 each medication listed under subsection (1)(a) of this section that is in the 14 possession of the school. At least one (1) month prior to the expiration date of each 15 medication, the school nurse or school administrator shall inform the parent or 16 guardian of the expiration date. 17 (7) Upon the written request of the parent or guardian of the student and written 18 authorization by the student's health care practitioner, a student with diabetes shall 19 be permitted to perform blood glucose checks, administer insulin through the 20 insulin delivery system the student uses, treat hypoglycemia and hyperglycemia, and 21 otherwise attend to the care and management of his or her diabetes in the school 22 setting and at school-related activities. A student shall be permitted to possess on 23 his or her person at all times necessary supplies and equipment to perform these 24 monitoring and treatment functions. Upon request by the parent or student, the 25 student shall have access to a private area for performing diabetes care tasks. 26 (8) (a) Beginning July 15, 2014, a school district shall permit a student who has 27 UNOFFICIAL COPY 22 RS BR 913 Page 5 of 6 XXXX Jacketed diabetes or a seizure disorder to attend the same school the student would 1 attend if the student did not have diabetes or a seizure disorder. Such a student 2 may only be transferred to a different school based on health care needs if the 3 individualized education program team, the Section 504 team, or, if 4 appropriate, the student's health services team, makes the determination that 5 the student's health condition requires that the student's care be provided by a 6 licensed health care professional at a different school. For the purpose of this 7 determination, the teams shall include the parent or guardian. The parent or 8 guardian may invite the student's treating physician to the team meeting and 9 the team shall consider the physician's input, whether in person or in written 10 form, when making this determination. This determination shall be based on 11 individualized factors related to the student's health conditions. A school 12 district shall not prohibit a student who has diabetes or a seizure disorder from 13 attending any school on the sole basis that: 14 1. The student has diabetes or a seizure disorder; 15 2. The school does not have a full-time school nurse; or 16 3. The school does not have school employees who are trained in 17 accordance with KRS 156.502 and assigned to provide care under this 18 section. 19 (b) Parents or guardians of students who have diabetes or a seizure disorder shall 20 not be required or pressured by school personnel to provide care for a student 21 with diabetes or a seizure disorder during regular school hours or during 22 school-related activities in which the student is a participant. For the purposes 23 of this paragraph, a participant is not a student who merely observes the 24 activity. 25 (9) (a) The requirements in this section for seizure rescue medication identified 26 under subsection (1)(a)3.[of subsections (1) to (8)] of this section shall apply 27 UNOFFICIAL COPY 22 RS BR 913 Page 6 of 6 XXXX Jacketed only to schools that have a student enrolled who[: 1 (a) ] has a seizure disorder and has a seizure rescue medication or medication 2 prescribed to treat seizure disorder symptoms approved by the United States 3 Food and Drug Administration and any successor agency prescribed by the 4 student's health care provider.[; or] 5 (b) The requirements in this section for diabetes medication identified under 6 subparagraphs 1. and 2. of subsection (1)(a) of this section shall apply only 7 to schools that have a student enrolled who has diabetes mellitus and has any 8 of the medications listed under subsection (1)(a) of this section prescribed by 9 the student's health care provider. 10 (10) Nothing in this section shall be construed to require a school employee to consent to 11 administer medications listed under subsection (1)(a) of this section to a student if 12 the employee does not otherwise consent to provide the health service under KRS 13 156.502. 14 (11) Notwithstanding any other provision of the law to the contrary: 15 (a) The administration of the medications listed under subsection (1)(a) of this 16 section by school employees shall not constitute the practice of nursing and 17 shall be exempt from all applicable statutory and regulatory provisions that 18 restrict the activities that may be delegated to or performed by a person who is 19 not a licensed health care professional; and 20 (b) A licensed health care professional may provide training to or supervise 21 school employees in the administration of the medications listed under 22 subsection (1)(a) of this section. 23