Appendix A: California Department of Education (CDE) K.C. Settlement Agreement and Legal Advisory
(2007 Legal Advisory).) In the case now before us, the American Nurses Association and other
trade organizations representing registered and school nurses (collectively Nurses) challenge the
Department ’ s advice as condoning the unauthorized practice of nursing. The American Diabetes
Association (Association), which is a party to the federal settlement agreement, defends the
Department ’ s advice as intervener.
In fact, California law expressly permits trained, unlicensed school personnel to
administer prescription medications such as insulin in accordance with the written statements of
a student ’ s treating physician and parents (Ed. Code, §§ 49423, 49423.6; Cal. Code Regs., tit. 5,
§§ 600, 604, subd. (b)) and expressly exempts persons who thus carry out physicians ’ medical
orders from laws prohibiting the unauthorized practice of nursing (Bus. & Prof. Code, § 2727,
subd. (e)). Through these provisions, state law in effect leaves to each student ’ s physician, with
parental consent, the question whether insulin may safely and appropriately be administered by
unlicensed school personnel, and reflects the practical reality that most insulin administered
outside of hospitals and other clinical settings is in fact administered by laypersons. The Nurses‟
arguments to the contrary lack merit.
6.1
I. BACKGROUND
The question whether California law permits unlicensed school personnel to administer
medications is, like all questions of law, subject to de novo review. (See Bruns v. E-Commerce
Exchange, Inc. (2011) 51 Cal.4th 717, 724 .) We thus draw freely from the undisputed evidence
in setting out the facts of the case before us.
Diabetes is a chronic, incurable disease that prevents the human body from properly
using food to produce energy. Insulin, a hormone produced in the pancreas, transports glucose (a
BP 2006 – Provision of Healthcare Services
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Desert Mountain Special Education Local Plan Area (DMSELPA) (rev. 11/16)
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