• Abstract and Figures
• Public Full-text

Senate Sunset Committee Meeting Thursday, June 14th 1:00p.m. Senate Majority Caucus Room Legislative Hall Meeting Attendance Committee Members Present Email Chair Senator John Walsh [email protected] Stephanie L. Hansen [email protected] David P. Sokola [email protected] Anthony Delcollo [email protected] Absent Email Brian Pettyjohn [email protected] Staff Present Email Ryan Dunphy [email protected] Christella St. Juste [email protected] Public Attendees Steve Yeatman DSCYF Sarah Goncher Department of Justice Pamela Zickafoose Dpt. of Professional Regulations/Board of Nursing David Mangler Department of Professional Regulations Cheryl Heiks Connections Megan Williams Board of Nursing Agenda 1. HB 352 (Longhurst) AN ACT TO AMEND TITLE 24 OF THE DELAWARE CODE RELATING TO NURSING. The meeting was called to order at 1:05 P.M. Consideration of Meeting Minutes Senator Jack Walsh, Chair, brought the Senate Sunset Committee meeting to order with the first item on the agenda, consideration of the meeting minutes from June 6th, 2018. The Senator asked the Committee if they had any corrections to the meeting minutes. As there were none, he asked for motions to approve the meeting minutes from June 6th, 2018. Senator David Sokola motioned to approve the meeting minutes. Senator Stephanie Hansen seconded that motion. The meeting minutes from June 6th, 2018 were approved unanimously. Consideration of HB 352 HB 352 (Longhurst) AN ACT TO AMEND TITLE 24 OF THE DELAWARE CODE RELATING TO NURSING Synopsis: This Act permits licensed child care providers, who successfully complete a State-approved medication training, to administer medication to children in their care, including by non-intravenous injection, if a child has a medical need during child care hours that requires it. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual. Senator Jack Walsh introduced the bill and asked if the committee had any questions. Seeing none, the Senator asked if the public had any comment. Megan Williams, Board of Nursing President, offered the Board of Nursing’s statement regarding the bill. She stated that the bill opens up opportunities for access to care, but that there are concerns regarding to the safety mechanisms built in the bill. She then circulated talking points to the committee members. She spoke about the safety concerns surrounding injectable medications of insulin, a high risk medication that is typically only administered by trained personnel. She explained that in acute care locations, it takes two nurses to agree in order to administer insulin. She raised concerns about the availability of syringes, similar to what has been seen with the opioid epidemic. She further explained that the Board feels that the education programs in place that teach people how to administer medication do not insure the safety of the recipient. She concluded by offering a potential amendment to the bill which would reconcile the Board of Nursing’s concerns to the bill. Senator Delcollo asked Megan if the DSCYF was consulted in the making of amendment. Megan Williams stated that she was not aware of any direct interactions between the groups in the drafting of the amendment. Senator Sokola asked if parents can administer these medications. Megan Williams responded that parents are able to administer the medications. Senator Sokola commented that nurses are not always with the child and that day care providers and parents are with the child the most. He stated that, with reasonable training, day care providers and parents should be able to administer medications. He added that he shares the concerns of the Board of Nursing. He then read over the amendment. Senator Walsh stated that the amendment removes nurses from the liability portion of the bill. Megan Williams confirmed that it does remove nurses but still is placed under the Nursing Practice Act. Senator Sokola stated that there already is a child care medication portion under the code relating to nursing, title 24 and that this bill would just add injections to the list of medications. Megan Williams added that this bill would add child care facilities under the list of facilities in this bill. She added that this would add 3,000 sites across the state that do not normally have medical oversight. Senator Sokola stated that these sights already do administer non-injectable medication and this bill adds injectable medication to this list. Senator Walsh indicated that injections in this bill are non-intravenous. He asked Megan if insulin is intravenous Megan Williams responded by saying that insulin is injected subcutaneously in the tissue. Senator Delcollo asked about the position of the Board of Nursing and if their position was that the parent ought not to be able to consent to allow these organizations to administer medications. He continued by stating his concern, which was if access is not allowed to be taken when necessary and the proper training mechanisms are in place, then children may potentially be put at risk. He included the use of subcutaneous medicine such as an EpiPen. Megan Williams stated that in emergency situations, there are different regulations and that this bill has more to do with day-to-day medication administration. She restated the Board’s concerns about some of the safety provisions in this bill. Senator Hansen discussed the difficulty in finding child care that has the capabilities to deal with different children’s medical needs. She stated that finding child care can be very difficult. If there are children with different medical needs, finding child care can be even more difficult and burdensome on the family. Megan Williams acknowledged Sen. Hansen’s concerns, stating that there is a need to increase access as much as possible. She said that the Board of Nursing felt it was important to voice their concerns in regards to protection of the public. Senator Delcollo asked if Megan had an opportunity to speak to any of the sponsors of the bill prior to the committee meeting. Megan Williams said that she individually did not meet with any of the authors of the bill but some individuals on the Board did. Senator Delcollo asked if she heard any feedback from these conversations. Megan Williams stated that she did not. Senator Delcollo stated that the correct oversight could be necessary but the amendment did not include the necessary actors to make it worth fully supporting. He thanked Megan for coming down and offered some suggestions toward the amendment could have been enhanced. Senator Sokola mentioned that there might be a discrepancy in the title that is being amended and that a Senate attorney may want to be consulted to make sure that this bill does not go beyond the scope of the title. Senator Walsh asked if there were any more comments. Steve Yeatman, DSCYF, stated that the DSCYF supports the bill fully without the proposed amendment from the Board of Nursing. He said that he had the chance to speak with Pamela Zickafoose and David Mangler from the Department of Professional Regulations about a possible amendment, but decided with his attorney that the bill did not need to be amended. Senator Walsh asked Steve if he wanted him to read the amendment offered by the Board of Nursing. Steve Yeatman stated that the amendment would not accomplish what the Board of Nursing thought it would accomplish. He added that this bill came to them through a parent seeking child care who was turned down from a child care provider who could not provide injectable medication to their child. He added that this went to the United States Department of Justice and come through their department, Professional Regulations, and Delaware’s Department of Justice. Through this process, they found that Delaware is at high risk of discriminating against children the way the code is written. Senator Sokola asked if this bill was drafted using other states as models for similar legislation. Steve Yeatman said that there is consensus in the medical field that non-medical personnel giving injectable medicine with proper training is becoming safe and effective for diabetes care. He then listed organizations that come to this consensus. He then said that they put regulations out for public comment during the month of May. Written permission of the parents is required. Next is a written statement from the child’s physician. Finally, he stated that the medical community would decide what training is necessary to effectively train non-medical personnel. He added that the organization did not want to create an all-encompassing training, as each training and situation could be individualized by the physician. He also stated that they are not looking to train everyone. Training would only occur when a child who needs this care would come to a day care facility. Senator Hansen asked how long the training usually lasts. Steve Yeatman stated that the training length is up to the child’s doctor. He said that in some cases, the parents could even administer the training. Senator Delcollo asked if this bill would survive scrutiny from federal statutes. Sarah Goncher, Department of Justice, stated that the Department of Justice supports the bill and added that taking away the prohibition of injection could protect the state. Senator Delcollo stated that this bill would provide clarity to show how to obtain and provide access to this care. Sarah Goncher added that this bill does not go any further than it needs to. It simply takes away the prohibition. Steve Yeatman added that the ultimate goal would be to provide affordable and safe childcare, while stating that he would be willing to work with the Board of Nursing to work on future bills.

Load more

  5

Copy Link