The Texas legislature recently enacted a new law on medical care at school for students with diabetes [HB 984, 79th Regular Session, 2005]. Based on concerns voiced by our members, Texas AFT opposed parts of the original proposal, which would have required unlicensed school employees, instead of school nurses, to give insulin injections to schoolchildren. After hearing Texas AFT’s concerns, the legislature passed the new law with the following provisos:
(1) The new diabetes law states that school employees “may not be subject to any penalty or disciplinary action for refusing to serve as an unlicensed diabetes care assistant” [Health and Safety Code Sec. 168.004(c), as added by HB 984]. In other words, if you as a teacher or other school employee feel that you would not be qualified to administer insulin or glucagon injections to schoolchildren, even after receiving training, then no school official may require you to do so. In fact, you can refuse to serve as an “unlicensed diabetes care assistant” for any reason.
(2) A school principal is not “required” by law to assign school personnel to serve as “unlicensed diabetes care assistants.” Your principal is only required to “seek” school employees who are willing to perform the duties of an “unlicensed diabetes care assistant” and to “make efforts to ensure” that the school has the non-medical personnel to provide the diabetes care [Health and Safety Code Sec. 168.004(a), as added by HB 984].
(3) A school employee serving as an “unlicensed diabetes care assistant” may not provide the diabetes care unless the child’s parent signs an agreement authorizing the school employee to do so. In addition, the parent must understand that the school employee is not liable for non-criminal damages to the child while performing the diabetes care [Health and Safety Code, 168.007(a), as added by HB 984].
(4) The school principal, not the school nurse, is responsible for supervising “unlicensed diabetes care assistants.” School nurses are responsible for coordinating the training of “unlicensed diabetes care assistants” [Health and Safety Code, 168.004(b), 168.005(b), as added by HB 984].
(5) In case a school nurse is not assigned to a campus, the “unlicensed diabetes care assistant” MUST have access to a diabetes care expert such as a physician or registered nurse OR the principal must have access to the child’s diabetes care doctor [Health and Safety Code, 168.007(b), as added by HB 984].
Texas AFT supports giving children and their parents more access to proper care for medical problems such as diabetes. That is why Texas AFT advocates the assignment of a full-time nurse to every school campus. In addition, Texas AFT has supported funding for Medicaid for children and the Children’s Health Insurance Program (CHIP) as a member of the Texas CHIP Coalition from the very beginning.
If you are ever pressured or coerced to serve involuntarily as an “unlicensed diabetes care assistant” and you are a member of Texas AFT/AFT (either directly or through a local affiliate), please let us know and we will help you assert your rights under the law.
For a model letter you can use if you decline to serve as an unlicensed diabetes care assistant, see below.
Sample Letter to Decline Service as an Unlicensed Diabetes Care Assistant
If you choose not to serve as an unlicensed diabetes care assistant, you should notify your supervisor formally of your decision, using a letter like the one below and keeping a copy for your own records. The following sample letter provides an example of how you can provide formal notice of your decision. The second paragraph is included as an example of the reason you might have for choosing not to serve as an unlicensed diabetes care assistant. However, the law does not require you to state a reason. See the Texas AFT brochure entitled "New Law on Caring for Students With Diabetes at School: Know Your Rights."
This document serves as official notice that I decline to serve as an unlicensed diabetes care assistant. My right to decline to serve in this role is outlined in the Texas Health and Safety Code, Section 168.004(c).
I am not a school nurse or other type of medical professional. I therefore decline to provide unlicensed care that I feel may actually endanger a child in an emergency as a result of my lack of adequate medical training and professional credentials.
While state law requires school principals to “seek” school employees who may volunteer for assignment as an unlicensed diabetes care assistant, the same law does not “require” that any school employee be assigned as an unlicensed diabetes care assistant, and any employee may refuse to serve as one for any reason.
Finally, you may find additional information regarding the basis for my rights under the new diabetes law at www.texasaft.org.