American Nurses Ass'n v. Torlakson, 160 Cal. Rptr. 3d 370

Public school diabetic students may receive insulin during the school day; the dispute is who may administer it when a nurse is unavailable.
California law authorizes unlicensed school personnel to administer prescription medications under physician orders with parental consent (Ed. Code 49423; Cal. Code Regs. tit. 5, 601-609).
Regulations define ‘other designated school personnel’ who may administer medications and require physician and parent statements (Regulations title 5, § 604; § 601).
The 2007 Department advisory added an eighth category allowing trained, unlicensed personnel to administer insulin under physician orders for a student (category 8).
Nurses challenged the 2007 advisory; the Department defended it as consistent with state law and federal rights under Section 504 and IDEA.
The court held that unlicensed school personnel may administer prescription medications, including insulin, under physician orders and parental consent, and that the medical-orders exception of the Nursing Practice Act permits this.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Can unlicensed school personnel administer insulin in public schools?	Nurses argue no; only licensed professionals may administer meds.	Tweak: statutes and regs permit unlicensed staff under medical orders.	Yes, permitted under statute and regs.
Does the Nursing Practice Act's medical-orders exception allow such administration by lay staff?	Medical-orders exception does not apply to unlicensed personnel acting as nurses.	Medical-orders exception covers carrying out physician orders by non-nurses.	Yes, medical-orders exception permits unlicensed staff to carry out medical orders.
Are Department advisory statements controlling or persuasive regarding insulin administration by unlicensed personnel?	Advisories are binding interpretations of law.	Advisories are nonbinding guidance not controlling.	Advisories not binding; regulations and statutes govern.
Did the Department violate the APA in issuing the 2007 advisory?	Yes, fail to follow APA process.	Not necessary to decide because statutory interpretation resolves the issue.	Not reached; held unnecessary to decide; the statutory interpretation suffices.

Bruns v. E-Commerce Exchange, Inc., 51 Cal.4th 717 (2011) (de novo review of questions of law)
Cedar Rapids Community School Dist. v. Garret F., 526 U.S. 66 (1999) (education-related services must be provided at no cost)
People v. Arias, 45 Cal.4th 169 (2008) (interpretation of 'assume to practice' principles)
Yamaha Corp. of America v. State Bd. of Equalization, 19 Cal.4th 1 (1998) (agency interpretations lack binding force absent persuasive factors)
Martin v. Szeto, 32 Cal.4th 445 (2004) (inference of legislative intent from subsequent statutes should be cautious)