1. Does Connecticut allow school staff members who are not health care professionals to administer insulin?
No. State regulations only allow school staff to administer medications by mouth, nose, or on the skin. These regulations do not specifically allow injection of medication such as insulin:
In the absence of a licensed nurse, only qualified personnel for schools who have been properly trained may administer medications to students as delegated by the school nurse, specifically: (1) Qualified personnel for schools may administer oral, topical, intranasal or inhalant medications. Conn. Gen. Stat. § 10-212a-2(d).
Regardless, federal laws may allow unlicensed staff to provide this care. This may be necessary so that children with diabetes can access education just like any other child. In case of a conflict between federal and state laws, federal laws protect the rights of children. The law in this area is very complicated so we encourage you to contact us for further information.
2. Does Connecticut allow school staff members who are not health care professionals to administer glucagon?
Yes. State law makes a specific exception that allows school staff with specific diabetes care training to administer glucagon when a nurse is not present:
With the written authorization of a student's parent or guardian, [and] pursuant to a written order of the student's physician licensed […] a school nurse shall provide general supervision to a qualified school employee to administer medication with injectable equipment used to administer glucagon to a student with diabetes that may require prompt treatment in order to protect the student against serious harm or death. Such authorization shall be limited to situations when the school nurse is absent or unavailable.
3. Does Connecticut allow students to self-manage diabetes at school?
Yes. Blood glucose testing can take place anytime, anywhere on school grounds. A written physician order is required:
No local or regional board of education may prohibit blood glucose self-testing by children with diabetes who have a written order from a physician [...]. No local or regional board of education may restrict the time and location of blood glucose self-testing by a child with diabetes on school grounds who has written authorization from a parent or guardian and a written order from a physician stating that such child is capable of conducting self-testing on school grounds. Conn. Gen. Stat. § 10-220j.
In addition, guidance from the Connecticut Department of Education encourages schools to allow children with enough maturity to self-manage all types of diabetes care. For example, some children “can draw up and give shots on occasion” while others are “[c]apable of doing the majority of shots and blood tests” and “[m]ay be more willing to inject multiple shots per day.” Conn. Dep’t of Educ., Learning and Diabetes: A Resource Guide for Connecticut Schools and Families (2012).
4. Does Connecticut allow students to carry diabetes supplies such as needles, insulin, and blood glucose testing devices?
Yes. for medication. Connecticut allows students to carry medication with approval from the school. State rules do not give a right to always carry diabetes care supplies, but there are no barriers, either:
If approved by the board of education, students who are able to self-administer medication may do so provided […] such medication is transported to the school and maintained under the student's control in accordance with the board of education's policy on self medication by students. Conn. Gen. Stat. § 10-212a-4. […] All medications, except those approved for transporting by students for self-medication, shall be delivered by the parent or other responsible adult and shall be received by the nurse assigned to the school. […] Conn. Gen. Stat. § 10-212a-5.
5. Does Connecticut make clear that diabetes care must be provided on field trips, school-sponsored activities, and school buses?
Yes. Connecticut guidance specifically says that parents do not need to attend field trips, and that diabetes care must be provided on school sponsored trips:
Students with diabetes often need support from an adult on school trips. Although it is not unusual to invite parents to chaperone field trips, parental attendance is not a prerequisite for participation by the student with diabetes. If parents do not accompany their child on field trips, the school nurse needs to determine the level of health care needed on this trip and whether or not it is necessary for a nurse to participate. Often a nurse is not needed on the trip; however, school personnel need to be properly trained to accompany the student with diabetes off-site and ensure that all the student’s supplies are brought along with the student … Conn. Dep’t of Educ., Learning and Diabetes: A Resource Guide for Connecticut Schools and Families (2012).
6. May parents/guardians provide input to a school nurse to make adjustments to the timing and dosing of their child’s insulin?
Yes. School nurses are permitted to adjust the timing and dosage of insulin within a pre-determined range with parental/guardian input if authorized by a physician’s order. The school nurse retains his/her professional judgment regarding the dose adjustment. Connecticut State Department of Education School Nurse Guidance, Connecticut State Department of Education Diabetes Management Plan and School Treatment Authorizations (DMP)
Resources:
For more information, see the following helpful resources:
- Connecticut Schools Agree to Train Staff on CGMs (July 23, 2020).
- Connecticut General Statues Section 10-212a. Administration of Medication.
- Connecticut General Statute Section 10-220j. Blood glucose self-testing by children. Guidelines.
- Connecticut General Statute Section 20-87a. Nurse practice act. Definitions. Scope of Practice.
- Connecticut Department of Education, Learning and Diabetes: A Resource Guide for Connecticut Schools and Families (2012).