STORAGE NAME: h0597b.HPP
DATE: 3/12/2025
1
FLORIDA HOUSE OF REPRESENTATIVES
BILL ANALYSIS
This bill analysis was prepared by nonpartisan committee staff and does not constitute an official statement of legislative intent.
BILL #: CS/HB 597
TITLE: Diabetes Management In Schools
SPONSOR(S): Smith
COMPANION BILL: SB 772 (Calatayud)
LINKED BILLS: None
RELATED BILLS: None
Committee References
Education Administration
9 Y, 0 N, As CS
Health Professions & Programs
Education & Employment
SUMMARY
Effect of the Bill:
The bill expands diabetes management in public schools by authorizing public schools to acquire and maintain a
supply of undesignated glucagon for use on students with diabetes experiencing hypoglycemic emergencies. Public
schools are authorized to obtain the glucagon through a prescription from a county health department or health
care provider or through arrangements with manufactures or suppliers.
The bill outlines storage, maintenance, and administration requirements for the acquired glucagon and provides
immunity to the school district and its employees along with the glucagon supplier so long as any injury is not the
result of gross negligence or deliberate misconduct.
Fiscal or Economic Impact:
Public schools that choose to act under the authority granted by the bill may incur costs associated with
implementing provisions of the bill.
JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
ANALYSIS
EFFECT OF THE BILL:
The bill revises current law regulating diabetic management services in public schools for students with diabetes
by authorizing public schools to annually request a prescription for glucagon from a county health department or
health care provider licensed to issue prescriptions to enable the school to acquire and maintain a supply of
undesignated glucagon to treat a student with diabetes who experiences a hypoglycemic emergency or whose
prescribed glucagon is not available on site or has expired.
The bill authorizes a licensed pharmacist to dispense undesignated glucagon to public schools. The schools may
also enter into arrangements with manufacturers of glucagon or other suppliers of glucagon to obtain the products
free of charge or at fair market or reduced prices and may obtain monetary donations or apply for grants to
purchase glucagon.
The bill requires a school’s undesignated glucagon to be stored in a location that is immediately accessible to the
school nurse and other school personnel who have been trained to administer glucagon. A public school employee
or agent trained in the administration of glucagon is responsible for the storage, maintenance, and administration
of glucagon stocked by a school in accordance with the manufacturer's instructions. The undesignated glucagon
must be authorized and made available for administration to students with diabetes as prescribed in the student's
diabetes management plan or health care provider's orders and written accommodations plan.
The bill requires a public school employee to call for emergency assistance and notify a school nurse and the
student's parent or guardian or emergency contact immediately after the administration of the undesignated
glucagon. JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
2
The bill provides that a school district and its employees and agents who acquire, maintain, and administer
undesignated glucagon, and the undesignated glucagon prescriber or furnisher, are not liable for any injury or loss
to person or property which allegedly results from an act or omission associated with procuring, maintaining,
accessing, or using undesignated glucagon as prescribed in the bill, unless the injury is the result of an act or
omission that constitutes gross negligence or willful or wanton misconduct. (Section 1).
The effective date of the bill is July 1, 2025. (Section 2).
RULEMAKING:
Current law authorizes the State Board of Education (SBE), in cooperation with the Department of Health, to adopt
rules relating to the management and care of diabetes by students in school. The bill modifies provisions of law
under the SBE’s rulemaking authority, thus allowing the SBE to make rules to implement the bill.
Lawmaking is a legislative power; however, the Legislature may delegate a portion of such power to executive
branch agencies to create rules that have the force of law. To exercise this delegated power, an agency must
have a grant of rulemaking authority and a law to implement.
FISCAL OR ECONOMIC IMPACT:
LOCAL GOVERNMENT:
The bill may have an insignificant, indeterminate, negative fiscal impact on school districts. Schools that choose to
exercise this authority may incur costs related to acquiring and storing glucagon to treat students with diabetes.
RELEVANT INFORMATION
SUBJECT OVERVIEW:
Diabetic Management Services in Public Schools
Diabetes is a disease that impairs the body’s ability to produce or properly use insulin, a hormone that is needed to
convert food into energy.
1 This causes blood sugar, also known as blood glucose, to be too high, which over time
can cause other health problems, such as heart disease, nerve damage, eye problems, and kidney disease.
2
In Florida’s public schools, 7,006 students were reported to have type 1 diabetes and 917 had type 2 diabetes
during the 2020–2021 school year, totaling 7,923 students managing diabetes in a school setting. Of these, 3,588
required glucose monitoring, 3,060 required carbohydrate counting, and 3,304 required insulin administration
while at school.
3
In Florida, students with diabetes, with written consent from their healthcare provider and parent, are permitted
to self-manage their medication, supplies, and equipment based on the student’s diabetes medical management
plan
4 without additional assistance or supervision.
5 Students may manage and care for their diabetes while in
school, participating in school-sponsored activities, or in transit to or from school or school sponsored activities to
the extent authorized by the parent and physician.
6
School districts are required to have personnel, whether licensed nurses or trained school staff, assigned to each
school a student with diabetes would otherwise attend if he or she did not have diabetes. These personnel must be
available to provide necessary diabetes care throughout the school day and during school-sponsored activities.
7
1 Rule 6A-6.0253, F.A.C.
2 National Institute of Diabetes and Digestive and Kidney Disease, Health Information, https://www.niddk.nih.gov/health-
information/health-statistics/diabetes-statistics (last visited March 6, 2025).
3 Florida Diabetes Advisory Council, 2023 Florida Diabetes Report, at 17, available at https://www.floridahealth.gov/provider-and-partner-
resources/dac/_documents/2023-dac-report.pdf. (last visited March 6, 2025).
4 A Diabetes Medical Management Plan is a medical authorization for diabetes treatment that includes medication orders from student’s
healthcare provider for routine and emergency care.
5 Rule 6A-6.0253(3), F.A.C.
6 S. 1002.20(3)(j), F.S.
7 Rule 6A-6.0253(2), F.A.C. JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
3
Current law requires the State Board of Education, in collaboration with the Department of Health, to develop rules
regarding the safe management and care of diabetes by students, as well as rules to encourage school personnel to
be trained in routine and emergency diabetes care.
8 Pursuant to these rules, the Department of Education provides
sources for school districts for training school personnel to ensure proper management and care of diabetic
students in schools.
9
Severe Hypoglycemia Treatment
Living with diabetes causes a person’s blood sugar levels to fluctuate. Hypoglycemia, or low blood sugar, is
common for people with diabetes. Most episodes of hypoglycemia are mild and easily treated if they are caught and
addressed early in the episode.
10 When hypoglycemia isn’t treated efficiently, or isn’t responding to first-level
treatments, it can quickly develop into severe hypoglycemia, sometimes referred to as an insulin reaction or insulin
shock, which is a life-threatening condition.
Severe hypoglycemia is an emergency. If left untreated for too long, severe hypoglycemia can lead to brain or organ
damage or even death. A person experiencing severe hypoglycemia may become confused or lose consciousness,
rendering them unable to self-administer medication.
11
Glucagon has been approved by the US Food and Drug Administration for the treatment of severe hypoglycemia.
Glucagon quickly raises blood sugar levels by causing the liver to release stores of glucose into the bloodstream.
Glucagon can be administered through various routes and as such is produced in several different formulations,
including a prefilled injector, an intranasal spray, and a powder which must be reconstituted with sterile water
before being injected. The power formulation of glucagon is commonly found in medical settings; however, the
prefilled injector and intranasal spray are ready-to-use formulations able to be easily administered by a
layperson.
12
Glucagon is safe for use in all ages; the American Diabetes Association advises that all children all children who
take insulin require access to glucagon for treatment of severe hypoglycemia.
13 Side effects from glucagon are mild,
with nausea being the most commonly reported adverse effect. Other, more serious, potential side effects are very
rare, but include hypertension, severe allergic reactions, and rebound hypoglycemia. After glucagon has been
administered, a person should receive further medical treatment and may need to be hospitalized for further
monitoring.
14
OTHER RESOURCES:
Florida Department of Education School Health Services
8 S. 1002.20(3)(j), F.S.
9 Rule 6A-6.0253(4), F.A.C.; see, Florida Department of Education, School Health Services: Health Issues - Guidelines, Resources and Training.
Available at https://www.fldoe.org/schools/k-12-public-schools/sss/sch-health-serv.stml (last visited March 7, 2025).
10 Treatment for mild hypoglycemia usually involves consuming glucose tablets or gel, or a food or beverage that contains fast-acting
carbohydrates such as candy or regular soda, and continuing to monitor blood sugar levels until they have returned to a normal level, per a
health care provider’s directives. See, American Diabetes Association, Signs, Symptoms, and Treatment for Hypoglycemia (Low Blood Glucose).
Available at https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose/symptoms-treatment (last visited March 7, 2025).
11 American Diabetes Association, Severe Hypoglycemia (Severe Low Blood Glucose). Available at https://diabetes.org/living-with-
diabetes/hypoglycemia-low-blood-glucose/severe (last visited March 7, 2025).
12 Morris C.H. & Baker J., Glucagon. (2025). StatPearls Publishing. Available at https://www.ncbi.nlm.nih.gov/books/NBK559195/ (last
visited March 7, 2025). For more information on how to administer glucagon, see, American Diabetes Association, How to Use Glucagon.
Available at https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose/how-use-glucagon (last visited March 7, 2025).
13 Cogen, F., et al. Diabetes Care in the School Setting: A Statement of the American Diabetes Association (2024). Diabetes Care, 47(12):2050-
2061, https://doi.org/10.2337/dci24-0082. Available at https://diabetesjournals.org/care/article/47/12/2050/157411/Diabetes-Care-in-
the-School-Setting-A-Statement-of (last visited March 7, 2025).
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Morris C.H. & Baker J., Glucagon. (2025). StatPearls Publishing. Available at https://www.ncbi.nlm.nih.gov/books/NBK559195/ (last
visited March 7, 2025). JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY
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BILL HISTORY
COMMITTEE REFERENCE ACTION DATE
STAFF
DIRECTOR/
POLICY CHIEF
ANALYSIS
PREPARED BY
Education Administration
Subcommittee
9 Y, 0 N, As CS 3/4/2025 Sleap Dixon
THE CHANGES ADOPTED BY THE
COMMITTEE:
Removed the rulemaking authority for the Department of Health to adopt
rules related to the acquisition and use of undesignated glucagon in public
schools.
Conformed bill language references to public schools with similar
provisions on prescribed substances in public schools.
Health Professions & Programs
Subcommittee
McElroy Osborne
Education & Employment
Committee
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THIS BILL ANALYSIS HAS BEEN UPDATED TO INCORPORATE ALL OF THE CHANGES DESCRIBED ABOVE.
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