TITLE 6 PRIMARY
AND SECONDARY EDUCATION
CHAPTER 12 PUBLIC
SCHOOL ADMINISTRATION - HEALTH AND SAFETY
PART 8 DIABETES
SELF-MANAGEMENT BY STUDENTS IN THE SCHOOL SETTING
6.12.8.1 ISSUING AGENCY: New
Mexico Department of Health.
[6.12.8.1 NMAC - N, 02/01/2009]
6.12.8.2 SCOPE: This
rule applies to students enrolled in public, private, home or parochial schools
in New Mexico unless otherwise expressly limited.
[6.12.8.2 NMAC - N, 02/01/2009]
6.12.8.3 STATUTORY
AUTHORITY: This rule is adopted pursuant to the Department
of Health Act, Section 9-7-6(E) and the Public Health Act, Sections 24-1-3(B),
24-1-3(G), and 24-1-3(O) NMSA 1978.
[6.12.8.3 NMAC - N, 02/01/2009]
6.12.8.4 DURATION:
Permanent.
[6.12.8.4 NMAC - N, 02/01/2009]
6.12.8.5 EFFECTIVE
DATE: February 1, 2009 unless a later date is cited
in the history at the end of a section.
[6.12.8.5 NMAC - N, 02/01/2009]
6.12.8.6 OBJECTIVE: The
purpose of this rule is to grant students who are authorized pursuant to this
rule the right to self-manage their diabetes care in the school setting and to develop
mechanisms that support safe diabetes self-management in the school
environment.
[6.12.8.6 NMAC - N, 02/01/2009]
6.12.8.7 DEFINITIONS:
A. "Developmental level" means the appropriate age-specific stage
of emotional, mental and physical growth as determined by the school nurse or
other designated registered nurse or clinician.
B. "Equipment
and supplies" means those materials required to store or dispose of
sharps, to perform self-assessment procedures, or to self-administer medication.
C. "Health
care practitioner" means a person authorized under law in New Mexico to
prescribe drugs for the treatment of diabetes and associated medical
conditions.
D. “Individualized
healthcare plan” means a written plan that identifies the student’s health care
needs and is developed by the school nurse or designated registered nurse or
clinician cooperatively with the student and parent or guardian based on the
orders provided by the student’s health care practitioner.
E. "Medication"
means a drug as that term is defined in section 201(g)(1) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 321) and includes oral and non-oral drugs in
a pharmacy-labeled container.
F. "Other designated
registered nurse or clinician" means a registered nurse or clinician
designated by the school district to act in the capacity of a school nurse.
G. "School nurse"
means a registered nurse (RN), clinical nurse specialist (CNS) or certified nurse
practitioner (CNP) licensed by the New Mexico public education department to
provide nursing services in the school setting.
H. "Self-administration"
means a student's own use of prescribed diabetes medication pursuant to a prescription
from a health care practitioner.
I. "Self-assessment'
means a student’s monitoring of his/her blood glucose levels and for the
presence of ketones.
J. "Sharps"
means a device with a keen edge or sharp point used to puncture the skin for
the purpose of self-assessment or a needle used to inject medication.
[6.12.8.7 NMAC - N, 02/01/2009]
6.12.8.8 REQUIREMENTS:
A. General rights: Schools (whether public or nonpublic) are
required to grant to any student in grades kindergarten through 12
authorization to carry and use equipment and supplies, for storage and disposal
of sharps, for self-assessment and for self-administration of diabetes
treatment medications prescribed by a health care practitioner if all of the
following conditions are met.
(1) A
health care practitioner has prescribed the medication, directed the
instruction of the student in the correct and responsible use of the
medication, and approved the student's ability to perform self-assessment and
medication self-administration, pursuant to Subsection B of 6.12.8.8 NMAC.
(2) The
student has demonstrated to the school nurse or other designated registered
nurse or clinician the skill level and developmental level necessary to
correctly store and use any equipment and supplies required to perform
self-assessment and self-administration of such medication as prescribed by the
health care practitioner (or the practitioner's designee).
(3) The
school nurse or other designated registered nurse or clinician, with input from
the parent or guardian and based on the student’s health care practitioner’s
medical orders, has formulated a written individualized healthcare plan for
management of diabetes care for the student that includes but is not limited to
the correct storage and disposal of sharps by the student, the performance of
self-assessment procedures and the self-administration of medication.
(4) The
school has informed the parent or guardian of the student in writing that the
school, including its employees and agents, is to incur no liability as a
result of any injury arising from the performance of self-assessment procedures
and the self-administration of medication nor from any injury arising from the
student carrying and disposing of equipment and supplies to perform these
procedures.
(5) The student's parent or guardian has
completed and submitted to the school:
(a) all written documentation required by
school policy; and
(b) the
required treatment plan/medical orders; and
(c) a signed statement from the parent or
guardian of the student acknowledging that the school, including its employees
and agents, is to incur no liability as a result of any injury arising from the
performance of self-assessment procedures and the self-administration of
medication nor from any injury arising from the student carrying and disposing
of equipment and supplies to perform these procedures, and the parent or
guardian will indemnify and hold harmless the school, including its employees
and agents, against any claim arising out of the performance of these
procedures or storing and disposing of equipment and supplies to perform them.
B. Terms and limits of the
student's rights: A student granted
authorization under Subsection A of 6.12.8.8 NMAC shall:
(1) retain these rights not to exceed the
duration of the current school year, but may lose these rights if, as
determined by the school nurse and the school administrator, endangerment to
the student's person or other persons occurs through the misuse of equipment,
supplies, or medication or if the student's self-administration of medication
is inconsistent with the prescribed dosage; and
(2) be responsible for storing and disposing
of all sharps as agreed upon with the school nurse or other designated
registered nurse or clinician; and
(3) be allowed to possess equipment and to perform
routine self-assessment and self-treatment at locations identified in
Subsection C of 6.12.8.8 NMAC but away from major traffic pathways as agreed
upon with the school nurse or other designated registered nurse or clinician.
C. Extent of authorization: An authorization
granted under Subsection A of 6.12.8.8 NMAC must allow the student granted
authorization to store and dispose of equipment and supplies necessary for
self-treatment and self-assessment in the school setting including:
(1) while
at any location on school property, including the classroom, but away from
major traffic pathways as agreed upon with the school nurse or other designated
registered nurse or clinician;
(2) while at a school-sponsored activity;
(3) during regular before-school and
after-school activities; and
(4) in transit to or from school or
school-sponsored activities.
D. Duration of authorization: An authorization granted under Subsection A
of 6.12.8.8 NMAC is effective only for the duration of the school year for
which it is granted and must be renewed each subsequent school year in
accordance with this subsection. It may
be revoked at any time for failure to comply with Subsection B of 6.12.8.8
NMAC.
E. Back-up medication: The school must ensure that in the event of a
diabetes emergency any back-up medication and equipment and supplies provided
by the parent or guardian are kept at an easily accessible location agreed upon
by the student and authorized individuals.
The school must develop policies and procedures to address the
safekeeping of these materials. Authorized
school personnel who in case of an emergency and in good faith provide a person
with back-up medication, equipment, or supplies are to incur no liability as a
result of providing the materials and medication to an authorized student or
individual.
F. Maintenance of information: Information described in Paragraphs (3) and
(5) of Subsection A of 6.12.8.8 NMAC shall be kept on file at the student's
school of enrollment in a location easily accessible by authorized individuals
who have a legitimate need to know. Each
school district must have in place policies and procedures that are in
compliance with the Family Educational Rights and Privacy Act (20 U.S.C. 1232g)
and Health Insurance Portability and Accountability Act of 1996 (HIPAA) to
address the safekeeping and confidentiality of the described information.
[6.12.8.8
NMAC - N, 02/01/2009]
HISTORY of 6.12.8 NMAC: [RESERVED]