SACRAMENTO (KCBS / AP) — 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.
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 only allows 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.
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.
The Obama administration filed a brief in the case supporting the broader policy allowing school employees to administer the shots as well.
Debra Berger with the California Nurses Association told KCBS that since state law only allows nurses to administer insulin, they were not expecting the Supreme Court to reverse the lower court’s decision.
“We think that this is a loss, a huge loss, for the most vulnerable children in our public schools and I think that it’s a decision that we will regret,” Berger said.
The nurses said not only does it take training to administer insulin shots, but there is education that is needed to accurately assess if the treatment was successful because the wrong dose could be fatal.
Professor Hank Greeley, director of Stanford’s Center for Law and the Biosciences, said he understands the nurse’s argument but cited briefs filed in the case which said only five percent of schools have full-time nurses.
“I think they were arguing for the perfect as opposed to the good. In a perfect world we’d have nurses in every school and they could give the shots. That’s not the world our public schools live in right now,” Greeley said.
The nurses’ association said they may turn to the legislature to clarify the law.
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