State law addresses plans for managing chronic conditions.
New Jersey Administrative Code 6A:16-2.1 Health services policy and procedural requirements.
(a) Each district board of education shall develop and adopt the following written policies, procedures, and mechanisms for the provision of health, safety, and medical emergency services, and shall ensure staff are informed as appropriate:
- The treatment of asthma in the school setting, which shall include, but not be limited to, the following requirements:
- i. Each school nurse shall be authorized to administer asthma medication through use of a nebulizer pursuant to N.J.S.A. 18A:40-12.8(a);
- ii. Each school nurse shall receive training in airway management and in the use of nebulizers and inhalers consistent with nationally recognized Standard, including, but not limited to, those of the National Institutes of Health and the American Academy of Allergy, Asthma and Immunology, pursuant to N.J.S.A. 18A:40-12.8(a); and
- iii. Each student authorized to use asthma medication pursuant to N.J.S.A. 18A:40-12.3 or a nebulizer shall have an asthma treatment plan prepared by the student's medical home and submitted to the certified school nurse. The treatment plan shall identify, at a minimum, asthma triggers and shall be included in the individualized healthcare plan and individualized emergency healthcare plan, pursuant to N.J.A.C. 6A:16-2.3(b), for meeting the medical needs of the student while attending school or a school-sponsored function;
New Jersey Statutes 18A:40-12.13 Development of health care plans for students with diabetes.
- a. The parent or guardian of a student with diabetes who seeks diabetes care while at school shall inform the school nurse who shall develop an individualized health care plan and an individualized emergency health care plan for the student provided that:
- (1) the parents or guardians of the student annually provide to the board of education written authorization for the provision of diabetes care as may be outlined in the individualized plans including authorization for the emergency administration of glucagon and, if requested by the student's parents or guardians pursuant to section 5 of this act, authorization for the student's self-management and care of his diabetes; and
- (2) if a request is made by a student's parent or guardian pursuant to section 5 of this act, the student's physician or advanced practice nurse provides written certification to the board of education that the student is capable of, and has been instructed in, the management and care of his diabetes.
b. The individualized health care plan and individualized emergency health care plan developed in accordance with subsection a. of this section shall be updated by the school nurse prior to the beginning of each school year and as necessary in the event that there is a change in the health status of the student.
c. Each individualized health care plan shall include, and each individualized emergency health care plan may include, the following information:
- (1) the symptoms of hypoglycemia for that particular student and the recommended treatment;
- (2) the symptoms of hyperglycemia for that particular student and the recommended treatment;
- (3) the frequency of blood glucose testing;
- (4) written orders from the student's physician or advanced practice nurse outlining the dosage and indications for insulin administration and the administration of glucagon, if needed;
- (5) times of meals and snacks and indications for additional snacks for exercise;
- (6) full participation in exercise and sports, and any contraindications to exercise, or accommodations that must be made for that particular student;
- (7) accommodations for school trips, after-school activities, class parties, and other school-related activities;
- (8) education of all school personnel who may come in contact with the student about diabetes, how to recognize and treat hypoglycemia, how to recognize hyperglycemia, and when to call for assistance;
- (9) medical and treatment issues that may affect the educational process of the student with diabetes; and
- (10) how to maintain communications with the student, the student's parent or guardian and health care team, the school nurse, and the educational staff.
New Jersey Statutes 18A:40-12.5 Development of policy for emergency administration of epinephrine to students.
- Each board of education or chief school administrator of a nonpublic school shall develop a policy in accordance with the guidelines established by the Department of Education pursuant to section 4 of P.L.2007, c.57 (C.18A:40-12.6a) for the emergency administration of epinephrine via a pre-filled auto-injector mechanism to a pupil for anaphylaxis provided that:
- a. the parents or guardians of the pupil provide to the board of education or chief school administrator of a nonpublic school written authorization for the administration of the epinephrine;
- b. the parents or guardians of the pupil provide to the board of education or chief school administrator of a nonpublic school written orders from the physician or advanced practice nurse that the pupil requires the administration of epinephrine for anaphylaxis;
- c. the board or chief school administrator of a nonpublic school informs the parents or guardians of the pupil in writing that the district and its employees or agents or the nonpublic school and its employees or agents shall have no liability as a result of any injury arising from the administration of the epinephrine via a pre-filled auto-injector mechanism;
- d. the parents or guardians of the pupil sign a statement acknowledging their understanding that the district or the nonpublic school shall have no liability as a result of any injury arising from the administration of the epinephrine via a pre-filled auto-injector mechanism to the pupil and that the parents or guardians shall indemnify and hold harmless the district and its employees or agents or the nonpublic school and its employees or agents against any claims arising out of the administration of the epinephrine via a pre-filled auto-injector mechanism; and
- e. the permission is effective for the school year for which it is granted and is renewed for each subsequent school year upon fulfillment of the requirements in subsections a. through d. of this section.
The policy developed by a board of education or chief school administrator of a nonpublic school shall require:
- (1) the placement of a pupil's prescribed epinephrine in a secure but unlocked location easily accessible by the school nurse and designees to ensure prompt availability in the event of an allergic emergency at school or at a school-sponsored function. The location of the epinephrine shall be indicated on the pupil's emergency care plan. Back-up epinephrine via a pre-filled auto-injector mechanism shall also be available at the school if needed;
- (2) the school nurse or designee to be promptly available on site at the school and school-sponsored functions in the event of an allergic reaction; and
- (3) the transportation of the pupil to a hospital emergency room by emergency services personnel after the administration of epinephrine, even if the pupil's symptoms appear to have resolved.
Promoting Health and Learning School Nursing Practice in New Jersey’s Public Schools
Document addresses managing chronic health conditions, such as asthma, diabetes, or allergies.