California Supreme Court: Trained School Employees May Administer Insulin

(Getty Images)

(Getty Images)

By KQED News Staff and Wires

SACRAMENTO — Trained school employees can administer insulin shots to diabetic students if a nurse is not available, the California Supreme Court unanimously ruled on Monday.

The ruling reverses a lower court decision that said California law allows only licensed professionals to administer the shots.

“Sometimes [parents] have had to quit their job or jeopardize their employment because of the constant need to provide care when a school nurse wasn’t available.”
The Supreme Court ruled that “state law in effect leaves to each student’s physician, with parental consent, the question whether insulin may safely and appropriately be administered by unlicensed school personnel, and reflects the practical reality that most insulin administered outside of hospitals and other clinical settings is in fact administered by laypersons.”

The decision supports a 2007 agreement between the state Department of Education and the American Diabetes Association, which addressed a shortage of nurses to attend to all diabetic students by allowing trained teachers and administrators to give the shots.

That agreement settled a class-action lawsuit in federal court, alleging the state’s schools had failed to ensure diabetic students receive legally required health care services.

Nurses’ organizations sued to block the agreement, arguing that state law allows only nurses to administer prescription medication, including insulin. They said inappropriately administered shots could hurt students.

But parents and groups such as the American Diabetes Association said many school districts across the state are experiencing a shortage of licensed nurses, which could leave the children who cannot self-administer their shots at risk.

“Students with diabetes will no longer be placed in situations that endanger their health, their safety and their access to educational opportunities,” Dwight Holing with the American Diabetes Association told KQED. “Sometimes [parents] have had to quit their job or jeopardize their employment because of the constant need to provide care when a school nurse wasn’t available,” he added. “Today, that ends.”

There are an estimated 14,000 diabetic students in California public schools. The state has one nurse for every 2,200 students. Sixty-nine percent of California’s schools have only a part-time nurse, and 26 percent have no nurse at all.

In a statement, the American Nurses Association said it was “extremely disappointed” with the decision and that it lowers the level of care children will receive at school. “Moreover, the California Supreme Court has essentially decided that state heath care licensing laws meant to protect patients can be ignored to the detriment of vulnerable populations.”

The Obama administration filed a brief in the case supporting the broader policy allowing school employees to administer the shots as well.

Ryder Diaz contributed to this report.

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  • Jennifer

    This is common practice in Australia. I worked as an advanced practice RN and my role was to provide competency based training to teachers for PEG feeding, seizure management including administering intranasal or buccal midazolam, pre-filled adrenaline syringes for anaphylaxis and yes, we even taught suctioning at one school that had a child starting school with a tracheostomy! There was an approved, structured teaching format including PowerPoint presentations and competency assessment tools and regular competency assessments. etc and there has never been any litigation issues.I have seen firsthand that if there is adequate resources and education, then even very unstable diabetic children have been safely managed. No staff are ever forced or coerced into learning, and NO teacher aide is ever signed off as competent unless they ARE competent. All meds are locked away securely and 2 people always check and sign each dose.