AN ACT. (S. B. 2016) (Conference) (No ) (Approved September 13, 2012)

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1 (S. B. 2016) (Conference) (No ) (Approved September 13, 2012) AN ACT To amend Sections 1, 2, 3, 4, and 5 of Act No , better known as the Asthmatic School Children Treatment Act, in order to include diabetes and other diseases among the conditions for which students are authorized to selfadminister medication, as well as in the Treatment Plan established in said Act; and for other related purposes. STATEMENT OF MOTIVES Diabetes is one of the most concerning health issues that affect our population. At present, the Center for Disease Control (CDC) has reported that the incidence of diabetes in the United States has doubled in the past twenty-five years. It also reports that there are currently more than 23.6 million people in the United States with diabetes, and another 57 million are in the stages prior to developing diabetes, known as pre-diabetes. Persons who have higher than normal blood sugar levels have an increased risk of developing diabetes. In Puerto Rico, an estimated 12.5 percent of the population has diabetes and more than 2,500 people die each year from this condition. Diabetes has been the third leading cause of death among Puerto Ricans since This disease makes no distinction as to the age of those who suffer from it; however, it has become a common disease among infants. The International Diabetes Federation published in its Diabetes Atlas that more than seventy thousand (70,000) children develop Type 1 diabetes every year, and that four hundred forty thousand (440,000) children under the age of fourteen (14) worldwide have diabetes.

2 2 One of the major concerns that parents have is how to manage the care and attention of their diabetic children while they are in school. Although presently there are documents and circular letters that seek to address this situation, there is no express declaration on the rights of diabetic children such as that set forth for children with asthma. Since diabetes is a growing concern, particularly due to the incidence in children, this Legislative Assembly deems it meritorious to grant diabetic students the same rights that are presently granted to students with asthma. This effort fosters a straightforward setting where information can be distributed in order to develop preventive treatment strategies. Aimed at furthering the public policy that characterizes this Government where health is an undeniable right of all Puerto Ricans, it is necessary to grant this population the rights that have already been granted to students with other conditions. Therefore, it is hereby provided that both teachers and students be fully aware of the particularities of the condition that affects them, thus helping to stop the disproportionate rise of this condition. BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF PUERTO RICO: Section 1.- Section 1 of Act No is hereby amended to read as Section 1.- This Act shall be known as the Act for the Treatment of Schoolchildren with Asthma, Diabetes, and other Diseases. Section 2.- Section 2 of Act No is hereby amended to read as Section 2.- Every public or private school student shall have the right to selfadminister medication for the treatment of his asthma, diabetes, or other disease, upon previous consent of the parents, guardian, or tutor.

3 3 Section 3.- Section 3 of Act No is hereby amended to read as Section 3.- In coordination with the Secretary of Education, the Secretary of Health is hereby authorized to adopt the regulations needed to comply with this Act pursuant to the Rehabilitation Act of 1973; the Americans with Disabilities Act (ADA), as amended; and the Family and Medical Leave Act of 1993[sic] and that when doing so, they shall take into consideration the safety and health of students with asthma, diabetes, and other diseases. The regulations adopted by the Department of Health shall: (a) Establish the minimum age for a student to be allowed to selfadminister medication to treat asthma, diabetes, or other disease while in school. (b) Require a certification detailing that the student with asthma, diabetes, or other disease received the adequate training by a qualified healthcare professional on the correct and responsible use of the medication, including: type of medication, method, and procedure of self-administration, dosage of the medication to be selfadministered, time and frequency of self-administration, instructions for appropriate handling, and safe storage of the medication. (c) Require that the student s parent or guardian authorize, in writing, the student to carry, possess, and self-administer medication while in school or while in a school-related activity. (d) Require that any student with asthma, diabetes, or other disease have a written Action Plan from his primary healthcare provider for managing the condition and directions for the use of the medication needed during school hours. (e) Include by regulations other diseases deemed pertinent. (f) All school personnel shall receive basic training in diabetes, such as how to recognize and respond to the signs and symptoms of hypoglycemia and hyperglycemia, and the emergency contact in the event of an emergency.

4 4 (g) Every teacher and school health personnel shall receive basic training in diabetes, and shall also acknowledge their role and responsibilities and know what to do in the event of an emergency (h) At least one employee per school shall receive advanced training in diabetes, which shall include diabetes management and control practices, routine care, and assistance to students with diabetes in the event of an emergency. Any person acting in accordance with the provisions of this Act shall not be held liable in case of any complication arising from the administration of the medication; provided, that said person acted according to the training received. Section 4.- Section 4 of Act No is hereby amended to read as Section 4.- In order for a student to self-administer medication to treat asthma, diabetes, or other condition as prescribed by the Secretary of Health through regulations, said student shall be required to present a medical certificate stating his condition, the name of the medication to be used for the treatment thereof, and that he is competent to safely self-administer the medication. In the case of patients with diabetes, insulin shall be administered under the supervision of a duly trained adult. This certificate shall apply to the school where the student is enrolled and for the school year for which it was issued. If the student is transferred to another school, a copy of the documents shall be provided to the new school in which said student is enrolled. Furthermore, it shall be the responsibility of the parent, guardian, or tutor to provide updated documents at the beginning of every school year, or upon any change or issuance of a new certificate in order for the student to enjoy said right.

5 5 Section 5.- Section 5 of Act No is hereby amended to read as Section 5.- No school or person shall interfere with a student s right to use the medication necessary to manage his asthma, diabetes, or other condition at school. Any person who acts in accordance with the provisions of this Act shall be immune from liability for any complication that results from the use of the medication that is self-administered by the student. Section 6.- This Act shall take effect sixty (60) days after its approval.

6 6 CERTIFICATION I hereby certify to the Secretary of State that the following Act No (S. B. 2016) (Conference) of the 7 th Regular Session of the 16 th Legislative Assembly of Puerto Rico: AN ACT to amend Sections 1, 2, 3, 4, and 5 of Act No , better known as the Asthmatic School Children Treatment Act, in order to include diabetes and other diseases among the conditions for which students are authorized to self-administer medication, as well as in the Treatment Plan established in said Act; and for other related purposes. has been translated from Spanish to English and that the English version is correct. In San Juan, Puerto Rico, on this 24 th day of April, Orlando Pagán-Ramírez Director