According to the Centers for Disease Control and Prevention (CDC), diabetes is defined as a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both.
ACT 86 is a voluntary option (not mandated) for schools. If schools choose to opt into ACT 86 they must be sure to read the ACT and the Resource Guide in their entirety. Schools must ensure compliance with all the requirements in the law and resource guide and have the appropriate policies, permissions, agreements and orders in place. Each student with diabetes is to have an individual plan in place specific to their diabetes healthcare needs.
Act 86 of 2016 amended
the Public School Code (Article XIV; 24 P.S. §§ 14-1401 – 14-1424) with a
number of provisions related to diabetes education and care in Pennsylvania
schools. More specifically, Act 86
permits school nurses, in consultation with their chief school administrator or
a designee, to identify at least one school employee (“Identified Employee”) in
each school building attended by a student with diabetes to be designated in a
student’s service agreement or Individualized Education Program (IEP) to
administer diabetes medications, use diabetes monitoring equipment, and provide
other diabetes care. If the school
building attended by a student with diabetes does not have a school nurse
assigned to carry the caseload full-time, the chief school administrator may
consult with the school nurse to identify a
Employee should not be the school nurse, and does not need to be a licensed
health care practitioner. The Identified
Employee may decline the responsibility and related directives. An Identified
is required to complete annual education in specifically-identified areas
through educational modules developed by the Pennsylvania Department of Health
(DOH) in consultation with the Pennsylvania Department of Education (PDE), annual education offered by a licensed health
care practitioner with expertise in the care and treatment of diabetes that
includes information substantially similar to that in the educational modules,
or both. These educational modules and other information are included in the
Diabetes in School Children: A
Recommendation & Resource Guide for School Personnel, first released by DOH
and PDE on November 22, 2016. The
resource guide provides detailed steps that administrators, school nurses,
school personnel, parents/guardians, and students should consider to help
ensure effective diabetes management. An
Identified Employee shall be provided a copy of this resource.
Links to the approved Department of Health trainings are located on the right hand side of this page. All three levels are accompanied by recorded narration.
Once an Identified Employee has completed
the education requirements, the employee may perform diabetes care and
treatment for students. For an Identified
Employee who is not a licensed health care practitioner to administer diabetes
medications via injection or infusion, the following must occur:
1. The Identified Employee must complete the annual education modules outlined in subsection (a) or annual education offered by a licensed health care
practitioner with expertise in the treatment and care of diabetes which includes substantially the same information outlined in subsection (a);
school entity must receive written authorization from both the student’s health
care practitioner and parent or guardian that the Identified Employee, who is
not a licensed health care practitioner, may administer specified medications.
The “Guidelines on Bloodborne Pathogens for the Public
Sector” applies to all employers and employees in the public sector who are not
covered by federal standards of the Occupational Safety and Health Administration (OSHA). It addresses all actual or
potential occupational exposures to blood or other infectious materials in a
public sector healthcare facility, home healthcare organization or other
facility providing health care-related services. Schools fall under “other facility providing health
6. Hepatitis B Vaccination. Within 10 working days of
assignment, the employer shall make the Hepatitis B vaccination series
available to all employees who have occupational exposure. (See
definitions below for bolded words)
(a) Such vaccinations shall be:
(i) at no cost to the employee;
(ii) done at a reasonable time and
place during working hours;
(iii) supervised by a licensed
physician/licensed healthcare professional;
(iv) according to the latest
recommendations of the U.S. Public Health Service (USPHS).
(b) Employees who refuse the
vaccination must sign a declination form, but can later decide to receive the
vaccination under the same conditions listed in sub paragraph (a).
(c) Employees shall be offered
booster doses, if these are later recommended by USPHS.
Employer - An employer with public employees whose
duties could reasonably result in occupational exposure to blood and other
material potentially containing a bloodborne pathogen.
Occupational exposure - Reasonably anticipated eye,
mouth, other mucous membrane, non-intact skin, or parenteral contact with
blood, bodily fluids or other potentially infectious materials that result from
the performance of an employee’s job
Parenteral – A piercing of mucous membranes or the
skin barrier through such events as needlesticks, human bites, cuts, and
Public employee - An employee of the Commonwealth or
a political subdivision employed in a health care facility, home health care
organization, or other facility providing healthcare-related services who is
engaged in activities that involve contact with a patient, blood or other body fluids from a patient
and is responsible for patient care with potential exposure to a sharps injury.
This term does not include a licensed individual who provides only intraoral
Students may also be permitted to possess
and use their own diabetes medication and monitoring equipment, with written
authorization from the student’s health care practitioner and parent or guardian
and written acknowledgment from the school nurse that the student has
demonstrated the capability to self-administer medication. This provision may be revoked or restricted
due to noncompliance, and the school entity shall then ensure the medication
and monitoring equipment is readily accessible to the school nurse or other
identified and trained school employee in the student’s building.
schools may also comply with these provisions allowing school employees to be
designated to provide certain diabetes care tasks and students to possess and
self-administer their diabetes medications and monitoring equipment. This
provision does not alleviate school districts from providing school nurse
services when requested by the nonpublic school. It is recommended that a
memorandum of understanding be developed between the two school entities.
The information above is not inclusive of
all the requirements in the School Code. The newly-added and amended school health
services provisions of the School Code should be carefully reviewed by school
entities, in consultation with solicitors and other professionals, to ensure