Florida Senate - 2010 CS for SB 896
By the Committee on Health Regulation; and Senators Peaden,
Jones, Fasano, Sobel, Lawson, Detert, Storms, and Wilson
588-03758-10 2010896c1
1 A bill to be entitled
2 An act relating to the treatment of students who have
3 diabetes; providing definitions; requiring the
4 Department of Health to develop guidelines, with the
5 assistance of certain entities, for the training of
6 diabetes personnel; providing criteria for the
7 training; requiring the Department of Health to adopt
8 the guidelines by a specified date; requiring each
9 district school board and the governing body of each
10 private and charter school to provide training to a
11 minimum number of school employees; providing that a
12 school employee is not subject to any penalty or
13 disciplinary action for refusing to serve as a member
14 of the trained diabetes personnel; requiring a school
15 nurse to coordinate the training; requiring the school
16 nurse or another health care professional to provide
17 the training; requiring the school nurse to provide
18 followup training and supervision; requiring the
19 school nurse or another qualified health care
20 professional to provide bus drivers with training in
21 the recognition of hypoglycemia and hyperglycemia and
22 actions to take in response to an emergency situation;
23 requiring the parent or legal guardian of a student
24 who has diabetes to submit a copy of the student’s
25 diabetes medical management plan to the school;
26 requiring a school nurse or trained diabetes personnel
27 to perform certain functions regarding a student’s
28 care of his or her diabetes; requiring a school nurse
29 or one member of the trained personnel to be on site
30 and available to provide care to students who have
31 diabetes during regular school hours and at school
32 sponsored programs and activities; prohibiting a
33 school district from restricting the assignment of a
34 student who has diabetes to a particular school;
35 providing that a member of the trained diabetes
36 personnel is not engaging in the practice of nursing
37 and is exempt from state law or rule restricting the
38 activities of a person who is not a health care
39 professional; requiring a school to allow a student
40 who has diabetes to manage and care for his or her
41 diabetes; providing civil immunity from disciplinary
42 action or liability for a school employee, nurse,
43 physician, or school district for activities
44 authorized under the act; requiring each district
45 school board and the governing body of each charter
46 and private school to report to the Department of
47 Education by a specified date regarding their
48 compliance to the act; providing an effective date.
49
50 WHEREAS, diabetes is a serious, chronic disease that
51 impairs the body’s ability to use food as energy, and
52 WHEREAS, diabetes must be managed 24 hours a day in order
53 to avoid the potentially life-threatening, short-term
54 consequences of blood glucose levels that are too high,
55 hyperglycemia, or too low, hypoglycemia, and to avoid or delay
56 the serious, long-term complications of high blood glucose
57 levels, which include blindness, amputation, heart disease, and
58 kidney failure, and
59 WHEREAS, in order to manage their disease, students who
60 have diabetes must have access to the means to balance food,
61 medications, and physical activity level while at school and at
62 school-related activities, and
63 WHEREAS, diabetes is generally a self-managed disease and
64 many diabetic students are able to perform most of their own
65 diabetes-care tasks, and these students should be permitted to
66 do so in the school setting, and
67 WHEREAS, some students, because of age, inexperience, or
68 other factors need help with some or all of diabetes care tasks
69 and all diabetic students will need help if a diabetes emergency
70 occurs, and
71 WHEREAS, the school nurse is the preferred person in the
72 school setting to provide or facilitate care for a student who
73 has diabetes, but many schools in Florida do not have a full
74 time nurse or a school nurse may not always be available on
75 site, and
76 WHEREAS, because diabetes management is needed at all
77 times, additional school personnel who have completed training
78 coordinated by the school nurse and who provide care under the
79 supervision of the school nurse need to be prepared to perform
80 diabetes-care tasks at school and all school-related activities
81 when a school nurse is not available in order for students who
82 have diabetes to be medically safe and to have the same access
83 to educational opportunities as do all students in Florida, NOW,
84 THEREFORE,
85
86 Be It Enacted by the Legislature of the State of Florida:
87
88 Section 1. Care of students who have diabetes.—
89 (1) DEFINITIONS.—As used in this section, the term:
90 (a) “Diabetes medical management plan” means a document
91 developed by the student’s personal health care professional
92 which sets out the health services needed by the student at
93 school and is signed by the student’s personal health care
94 professional and parent or legal guardian.
95 (b) “Glucagon” means a hormone that immediately raises
96 blood glucose levels for severe hypoglycemia.
97 (c) “School” means any primary or secondary public school,
98 charter school, or private school located within the state.
99 (d) “School employee” means a person employed by:
100 1. A school;
101 2. A local health department that assists a school under
102 this section; or
103 3. Another entity with which a school has contracted to
104 perform its duties under this section.
105 (e) “Trained diabetes personnel” means a group of school
106 employees who volunteer and have successfully completed the
107 training required under subsection (3). Such employee need not
108 be a health care professional.
109 (2) TRAINING OF DESIGNATED SCHOOL EMPLOYEES.—
110 (a) The Department of Health shall develop guidelines, with
111 the assistance of the following entities, for the training of
112 school employees in the care needed for students who have
113 diabetes:
114 1. The Department of Education;
115 2. The American Diabetes Association;
116 3. The American Association of Diabetes Educators; and
117 4. The Florida Association of School Nurses.
118 (b) Training shall be provided annually commensurate with
119 the school employee’s role in the student’s care. Training
120 guidelines shall include instruction in:
121 1. Recognizing and treating hypoglycemia and hyperglycemia.
122 2. Understanding the appropriate actions to take when blood
123 glucose levels are outside of the target ranges indicated by
124 student’s diabetes medical management plan.
125 3. Understanding the instructions from the student’s
126 personal health care professional concerning drug dosage,
127 frequency, and the manner of administration of the student’s
128 medication for his or her treatment of diabetes.
129 4. Performing finger sticks to check blood-glucose levels,
130 checking urine ketone levels, and recording the results of those
131 checks.
132 5. Administrating glucagon and insulin and the recording of
133 doses used.
134 6. Understanding how to perform basic insulin pump
135 functions.
136 7. Recognizing complications that require emergency
137 assistance.
138 8. Understanding the recommended schedules and food intake
139 for meals and snacks, the effect of physical activity upon
140 blood-glucose levels, and the proper actions to be taken if a
141 student’s schedule is disrupted.
142 9. Understanding and operating continuous glucose monitors.
143 (c) The Department of Health shall adopt by rule the
144 guidelines outlined in this subsection by August 1, 2010.
145 (d) Each district school board and the governing body of
146 each private school and charter school shall ensure that the
147 training outlined in this subsection is provided to a minimum of
148 three school employees at each school attended by a student who
149 has diabetes.
150 (e) A school employee may not be subject to any penalty or
151 disciplinary action for refusing to serve as a member of the
152 trained diabetes personnel.
153 (f) The training outlined in this subsection shall be
154 coordinated by a school nurse and provided by the school nurse
155 or another health care professional having expertise in the care
156 of persons who have diabetes. Such training shall take place
157 before the commencement of each school year, or as needed when a
158 student who has diabetes is newly enrolled at a school or a
159 student is newly diagnosed as having diabetes. The school nurse
160 shall provide followup training and supervision.
161 (g) The school nurse or another qualified health care
162 professional shall provide training to each bus driver who is
163 responsible for the transportation of a student who has diabetes
164 in the recognition of hypoglycemia and hyperglycemia and actions
165 to take in response to emergency situations.
166 (3) DIABETES MEDICAL MANAGEMENT PLAN.—The parent or legal
167 guardian of a diabetic student who seeks diabetes care while at
168 school should submit to the school a diabetes medical management
169 plan that, upon receipt, shall be reviewed and implemented by
170 the school.
171 (4) REQUIRED CARE.—
172 (a) In accordance with the request of a parent or legal
173 guardian of a student who has diabetes and the student’s
174 diabetes medical management plan, the school nurse or, in the
175 absence of the school nurse, trained diabetes personnel shall
176 perform functions, including, but not limited to, responding to
177 blood-glucose levels that are outside the student’s target
178 range; administering glucagon; administering insulin or
179 assisting a student in administering insulin through the
180 student’s insulin delivery system; providing oral diabetes
181 medications; checking and recording blood glucose levels and
182 ketone levels or assisting a student with such checking and
183 recording; and following instructions regarding meals, snacks,
184 and physical activity.
185 (b) The school nurse or at least one member of the trained
186 diabetes personnel must be on site and available to provide care
187 to each student who has diabetes as set forth in this subsection
188 during regular school hours, school-sponsored care programs,
189 field trips, and extracurricular activities and on buses when
190 the bus driver has not completed the necessary training.
191 (c) A school district may not restrict the assignment of a
192 student who has diabetes to a particular school on the basis
193 that the student has diabetes, that the school does not have a
194 full-time school nurse, or that the school does not have trained
195 diabetes personnel.
196 (d) The activities set forth in this subsection do not
197 constitute the practice of nursing and are exempt from any
198 applicable state law or rule that restricts what activities may
199 be delegated to or performed by a person who is not a licensed
200 health care professional.
201 (5) INDEPENDENT MONITORING AND TREATMENT.—Upon written
202 request of the parent or legal guardian and authorization by the
203 student’s diabetes medical management plan, a school shall
204 permit a student to attend to the management and care of his or
205 her diabetes, which may include:
206 (a) Performing blood-glucose level checks;
207 (b) Administering insulin through the insulin-delivery
208 system that the student uses;
209 (c) Treating hypoglycemia and hyperglycemia;
210 (d) Possessing on the student’s person at any time any
211 supplies or equipment necessary to monitor and care for the
212 student’s diabetes; and
213 (e) Otherwise attending to the management and care of the
214 student’s diabetes in the classroom, in any area of the school
215 or school grounds, or at any school-related activity.
216 (6) IMMUNITY FROM CIVIL LIABILITY.—A physician, nurse,
217 school employee, or school district is not liable for civil
218 damages or subject to disciplinary action under professional
219 licensing rules or school disciplinary policies as a result of
220 the activities authorized by this section when such acts are
221 committed as an ordinarily reasonably prudent person would have
222 acted under the same or similar circumstances.
223 (7) REPORTING REQUIRMENT.—Each district school board and
224 the governing body of each charter school and private school
225 shall annually report to the Department of Education, by August
226 15, 2011, and each August 15 thereafter, on whether students who
227 have diabetes are enrolled in the school and provide information
228 showing compliance with this section. The report must comply
229 with the federal Family Education Rights and Privacy Act, 20
230 U.S.C. s. 1232g.
231 Section 2. This act shall take effect July 1, 2010.