Court ruling limits insulin administration to licensed nurses
Legislative fix needed to extend authorization to others, judges advise
Published: June 14, 2010
Students with diabetes will not be able to rely on trained but unlicensed school personnel to administer needed insulin injections following an appellate court ruling issued last week.
The 3rd District Court of Appeal upheld a 2008 trial court decision that only licensed nurses can administer insulin injections. The rulings, in a lawsuit brought by nurses associations against the state superintendent of public instruction and the California Department of Education, struck down a 2007 CDE advisory that, ironically, resulted from the settlement of a 2005 federal class action lawsuit. That case was brought by the American Diabetes Association accusing the state of “failing to ensure the provision of health care services to students with diabetes, including insulin administration, that was necessary to enable those students to obtain free appropriate public education,” according to the June 8 opinion.
The wording of the ruling suggests that, while the judges believe existing law sides with the nurses, the law ought to be changed.
“In this case we consider not whether California law should, but whether California law does, allow designated voluntary school personnel, who are not licensed nurses, to administer insulin to diabetic students who require the injections under a Section 504 Plan … or Individualized Education Program,” the opinion begins. “Like the trial court, we conclude the answer is no.”
“Whatever may be thought of the wisdom, expediency, or policy of a statute, we [judges] have no power to rewrite the statute to make it conform to a presumed intention that is unexpressed,” the opinion states later.
“The ruling speaks to the practical matter of there being too few resources available for students with diabetes,” CSBA Associate General Counsel Judy Cias said. “The appellate court concurred with the trial court that a legislative fix is necessary. Both the trial court and appellate court seemed to say that unlicensed personnel could administer insulin safely but that California law does not allow it, so it’s up to the Legislature. Students need access to someone to help administer the medication and volunteers can be trained to safely do it.”
CSBA’s Governmental Relations Department has been advocating a legislative remedy to give students with diabetes needed assistance with insulin injections without relying solely on licensed nurses.
CSBA supported Assembly Bill 1802, which would have authorized duly trained school personnel under specified circumstances to administer the insulin to students when needed, and Senate Bill 1051, which would have provided authorization for trained personnel to administer a specific medication to a student experiencing a seizure. Both bills died in committee.
CSBA is revising its sample policies and administrative regulation to help guide school districts and county offices of education on the issue following the court ruling, which will take effect 30 days after its June 8 issuance. The parties have not yet decided whether to request review by the California Supreme Court.
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