1. Does Colorado allow school staff members who are not health care professionals to administer insulin?
Yes. A specific state statute allows nurses to delegate insulin administration to unlicensed staff:
The injection of insulin or glucagon is a nursing task that may be delegated […] Dosages of insulin may be injected by the Delegate [a school staff member] as designated in the IHP [Individualized Health Plan]. […] 3 CCR 716-1 §§ 8.1, 8.3.
However, unlicensed staff may only administer "routine daily meal boluses of insulin, based on carbohydrate counts and blood glucose levels," and "selection of the type of insulin and dosage levels shall not be delegated." Non-routine "corrective dosages of insulin" may only be given after consulting with the nurse, parent, or guardian and by closely following the individualized health plan. 3 CCR 716-1 § 8.3.
2. Does Colorado allow school staff members who are not health care professionals to administer glucagon?
Yes. As stated above, a specific state rule allows nurses to delegate glucagon administration to unlicensed staff. 3 CCR 716-1 § 8.1. In addition, unlicensed people can provide "nursing assistance in the case of an emergency." Colorado Revised Statutes § 12-38-125.
3. Does Colorado allow students to self-manage diabetes at school?
Yes. Capable students are allowed to self-manage care. While there are no specific rules about time and place of care, there are no barriers, either:
When the Delegator [the school nurse] determines that the Client [the student] is capable of self-administration, as documented in the IHP [Individualized Health Plan], the Delegator may delegate to the Delegatee [a school staff member] as designated in the IHP the verification of insulin dosage via pump or injection. 3 CCR 716-1 § 8.4.
4. Does Colorado allow students to carry diabetes supplies such as needles, insulin, and blood glucose testing devices?
Yes. Students must have access to all types of diabetes care supplies:
In addition, all students with diabetes must have access (as appropriate) to glucose monitoring equipment, oral or injectable medications, including insulin and glucagon, nutritional supplements such as snacks, and a fast acting source of glucose. The student must have knowledge about the equipment used in her/his diabetes management (e.g., syringes, insulin pen, insulin pump), access to a documentation system for his/her blood glucose readings, insulin dosages, and access to a bathroom. School Nurse Role in Care and Management of the Child with Diabetes in Colorado Schools and Child Care Settings.
For more information, see the following helpful resources:
- Colorado Revised Statutes Section 12-38-125 (Nurse Practice Act).
- 3 Code of Colorado Regulations 716.1 Section 8.1- 8.5 (Nurse Practice Regulations).
- Colorado Kids with Diabetes State Standards & Guidelines, August 2019
- www.coloradokidswithdiabetes.org provides many additional resources, including training resources and model forms.