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School Staff Can Give Insulin Shots, Cal. Supreme Court Rules

By Betty Wang, JD on August 16, 2013 | Last updated on March 21, 2019

In a landmark case for schools in California, the California Supreme Court has ruled against the state's nurses' union on the issue of administering school insulin shots.

If no nurse is available at the school, then school employees can now also administer insulin shots to diabetic students under certain conditions, The Sacramento Bee reports. This ruling effectively reverses a lower court's decision that only allowed licensed professionals to administer the shots.

The primary issue in the case of American Nurses Association v. Torlakson was whether trained but unlicensed school personnel were allowed to administer prescription medication, such as insulin, to students under California law. The state Board of Education decided in 2007 that this was allowed; the American Nurses Association ("ANA") then challenged this in a class action suit.

The Final Decision (For Now)

The Supreme Court of California turned to a plain reading of state law for its decision. As long as there was written consent from both the student's physician and her parents, insulin can indeed be administered by an unlicensed but trained school personnel member, instead of a licensed nurse, the court held.

The court recognized that practical realities played into the case as well. With a shortage of school nurses (26 percent of California schools don't have any nurses on staff, the Bee reports) and the fact that diabetes is a fairly common condition for many children, it only made sense.

In addition, the court noted that most insulin that was administered in settings outside of the hospital or clinic is also administered by laypersons, like the diabetic himself or his parents or friends. Many other states also allow for unlicensed persons in authority to do so.

Reactions From Both Sides

Legal Newsline reports that the ANA was disappointed by the decision. The ANA claimed that insulin was a "dangerous drug," and that they were concerned about the level of care the children would receive, along with their safety.

The ANA is now considering whether to appeal to the U.S. Supreme Court.

The American Diabetes Association, however, was pleased with the result, Legal Newsline reports. Karen Talmadge, chair of the ADA's board, said in a statement, "School staff can volunteer to be trained and provide diabetes care when a school nurse is unavailable. This means parents of children with diabetes can feel confident of their children's well-being when they send them to school every day."

Talmadge also added that the decision "made it clear that state law is not an obstacle to children with diabetes receiving the proper care and the insulin they need to be healthy and medically safe at school."

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