HB 747

1	A bill to be entitled
2	An act relating to the care of public school students with
3	diabetes; creating s. 1006.0627, F.S.; providing findings
4	and definitions; requiring the Department of Education to
5	develop guidelines for the training of school employees in
6	the care of students with diabetes; requiring training to
7	include specified instruction; requiring a school nurse or
8	other health care professional to provide training;
9	requiring the parent of a student with diabetes to submit
10	to the school a diabetes medical management plan;
11	providing required care by trained diabetes personnel;
12	exempting activities from certain statutory and regulatory
13	provisions; authorizing a student's independent monitoring
14	and treatment; providing immunity from civil liability or
15	disciplinary action; requiring district school boards to
16	report information to the department; providing an
17	effective date.
18
19	Be It Enacted by the Legislature of the State of Florida:
20
21	Section 1.  Section 1006.0627, Florida Statutes, is created
22	to read:
23	1006.0627  Care of students with diabetes.-
24	(1)  FINDINGS.-The Legislature finds that:
25	(a)  Diabetes is a serious, chronic disease that impairs
26	the body's ability to use food as energy due to a deficiency of
27	the hormone insulin and must be managed 24 hours a day in order
28	to avoid the potentially life-threatening short-term
29	consequences of blood glucose levels that are either too high
30	(hyperglycemia) or too low (hypoglycemia) and to avoid or delay
31	the serious long-term complications of high blood glucose levels
32	which include blindness, amputation, heart disease, and kidney
33	failure.
34	(b)  In order to manage the disease, a student with
35	diabetes must have access to the means to balance food,
36	medication, and physical activity levels while at school and at
37	school-related activities.
38	(c)  Diabetes is a self-managed disease and many students
39	with diabetes are able to perform most of their own diabetes
40	care tasks, and such students should be permitted to do so in
41	the school setting.
42	(d)  Some students with diabetes, because of age,
43	inexperience, or other factors, need help with some or all of
44	their diabetes care tasks, and all students with diabetes will
45	need help in the event of a diabetes emergency.
46	(e)  The school nurse is the preferred person in the school
47	setting to provide or facilitate care for a student with
48	diabetes, and many schools in the state do not have a full-time
49	nurse or school nurse who is available on site at all times.
50	(f)  Since diabetes management is needed at all times,
51	school employees who have completed training coordinated by a
52	school nurse and who provide care under the supervision of a
53	school nurse must be prepared to perform diabetes care tasks at
54	school and all school-related activities when a school nurse is
55	unavailable in order that students with diabetes be medically
56	safe and have the same access as other students to educational
57	opportunities.
58	(2)  DEFINITIONS.-For purposes of this section, the term:
59	(a)  "Diabetes medical management plan" means a document
60	developed by a student's personal health care team that sets out
61	the health services needed by the student at school and is
62	signed by the student's personal health care team and parent.
63	(b)  "School employee" means a person or subcontractor
64	employed by a district school board or a person employed by a
65	local health department who is assigned to a public school.
66	(c)  "Trained diabetes personnel" means a school employee
67	who voluntarily is trained in accordance with subsection (3).
68	Such employee need not be a health care professional.
69	(3)  TRAINING OF DESIGNATED SCHOOL EMPLOYEES.-
70	(a)  The Department of Education, in cooperation with the
71	Department of Health, the American Diabetes Association, the
72	American Association of Diabetes Educators, and the Florida
73	Association of School Nurses, shall develop guidelines for the
74	training of school employees in the care of students with
75	diabetes.
76	(b)  District school boards shall annually provide training
77	that is commensurate with a school employee's role in the care
78	of students with diabetes. Training shall include instruction in
79	all of the following:
80	1.  Recognizing and treating hyperglycemia and
81	hypoglycemia.
82	2.  Understanding the appropriate actions to take when
83	blood glucose levels are outside of the target ranges indicated
84	by a student's diabetes medical management plan.
85	3.  Understanding prescriber instructions concerning
86	diabetes medication drug dosage, frequency, and manner of
87	administration.
88	4.  Performing of fingerstick blood glucose checks and
89	ketone checks and recording the results.
90	5.  Administering insulin and glucagon, an injectable to
91	immediately raise blood glucose levels for severe hypoglycemia,
92	and recording doses administered.
93	6.  Understanding how to perform basic insulin pump
94	functions.
95	7.  Recognizing complications that require emergency
96	assistance.
97	8.  Understanding recommended schedules and food intake for
98	meals and snacks, the effect of physical activity upon blood
99	glucose levels, and actions to be implemented in the case of
100	schedule disruption.
101	9.  Understanding and operating continuous glucose
102	monitors.
103	(c)  The training shall be coordinated by a school nurse
104	and provided by a school nurse or other health care professional
105	with expertise in diabetes. Such training shall take place prior
106	to the commencement of each school year or as needed when a
107	student with diabetes is newly enrolled at a school or a student
108	is newly diagnosed with diabetes. The school nurse shall provide
109	followup training and supervision.
110	(d)  Each district school board shall ensure that the
111	training is provided to a minimum of three school employees at
112	each school attended by a student with diabetes.
113	(e)  The school nurse or other qualified health care
114	professional shall provide training in the recognition of
115	hyperglycemia and hypoglycemia and actions to take in response
116	to emergency situations to all bus drivers responsible for the
117	transportation of a student with diabetes.
118	(f)  School employees shall not be subject to any penalty
119	or disciplinary action for refusing to serve as trained diabetes
120	personnel.
121	(g)  The training guidelines shall be fully developed by
122	July 1, 2010, for purposes of training school employees for the
123	2010-2011 school year and thereafter.
124	(4)  DIABETES MEDICAL MANAGEMENT PLAN.-The parent of a
125	student with diabetes who seeks diabetes care while at school
126	must submit to the school a diabetes medical management plan
127	which, upon receipt, shall be reviewed and implemented by the
128	school.
129	(5)  REQUIRED CARE.-
130	(a)  In accordance with the submission of a student's
131	diabetes medical management plan, a school nurse or, in the
132	absence of a school nurse, trained diabetes personnel shall
133	perform functions, including, but not limited to: responding to
134	blood glucose levels that are outside of a student's target
135	range; administering glucagon; administering insulin or
136	assisting a student in administering insulin through the insulin
137	delivery system the student uses; providing oral diabetes
138	medication; checking and recording blood glucose levels and
139	ketone levels or assisting a student with such checking and
140	recording; and following instructions regarding meals, snacks,
141	and physical activity.
142	(b)  A school nurse or at least one of the trained diabetes
143	personnel shall be on site and available to provide care to each
144	student with diabetes as set forth in paragraph (a) during
145	regular school hours, school-sponsored before-school and after-
146	school programs, fields trips, and extracurricular activities
147	and on buses when the bus driver has not completed the necessary
148	training.
149	(c)  A district school board may not restrict the
150	assignment of a student with diabetes to a particular school
151	based on the fact that the student has diabetes, that the school
152	does not have a full-time school nurse, or that the school does
153	not have trained diabetes personnel.
154	(d)  The activities under paragraph (a) shall not
155	constitute the practice of nursing and shall be exempted from
156	all applicable statutory and regulatory provisions that restrict
157	the activities that may be delegated to or performed by a person
158	who is not a licensed health care professional.
159	(6)  INDEPENDENT MONITORING AND TREATMENT.-Upon written
160	request of the parent and authorization by a student's diabetes
161	medical management plan, a student with diabetes may perform
162	blood glucose checks, administer insulin through the insulin
163	delivery system the student uses, treat hyperglycemia and
164	hypoglycemia, and otherwise attend to the care and management of
165	his or her diabetes in the classroom, in any area of the school
166	or school grounds, and at any school-related activity and
167	possess on his or her person at all times all necessary supplies
168	and equipment to perform these monitoring and treatment
169	functions.
170	(7)  IMMUNITY FROM CIVIL LIABILITY.-No physician, nurse,
171	school employee, or district school board shall be liable for
172	civil damages or be subject to disciplinary action under
173	professional health care licensing regulations or school
174	disciplinary policies as a result of the activities authorized
175	by this section when such acts are committed as an ordinarily
176	prudent person would have acted under the same or similar
177	circumstances.
178	(8)  REPORTING.-Each district school board shall report to
179	the Department of Education annually, on or before August 15,
180	the schools whose enrollment includes students with diabetes and
181	provide information showing compliance with this section. These
182	reports shall be in compliance with the Family Educational
183	Rights and Privacy Act (FERPA), 20 U.S.C. s. 1232g.
184	Section 2.  This act shall take effect upon becoming a law.

CODING: Words stricken are deletions; words underlined are additions.