6A-6.0251: Use of Epinephrine Auto-Injectors.
PURPOSE AND EFFECT: The purpose and effect of this rule amendment is to address self-administration of medication by students with certain health conditions enrolled in the public school system.
SUMMARY: Section 1002.20(3), Florida Statutes, was amended to add self-administration of pancreatic enzyme medication by students with cystic fibrosis (SB 166) as well as management of students with diabetes (HB 747). The approved legislation requires rulemaking in cooperation with the Florida Department of Health (FDOH). Therefore, Rule 6A-6.0251, F.A.C., is being amended in cooperation with FDOH to define terminology and to address management of students with certain health conditions. The rule title is being changed to include inhaler use by students with asthma, the use of epinephrine auto-injectors by students with life-threatening allergies, use of pancreatic enzyme medication by students with cystic fibrosis, and management of students with diabetes.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION: The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the agency. Pursuant to the Department’s economic analysis of the rule, as required by the Office of Fiscal Accountability and Regulatory Reform, it has been determined that legislative ratification is not required.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
RULEMAKING AUTHORITY: 1002.20(3)(h)-(k) FS.
LAW IMPLEMENTED: 1002.20(3)(h)-(k) FS.
A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: September 20, 2011, 8:30 a.m.
PLACE: Valencia Community College, West Campus, 1800 South Kirkman Road, Building HSB, Room 105, Orlando, Florida
Bambi Lockman, Chief, Bureau of Exceptional Education and Student Services, K-12 Public Schools, Department of Education, 325 West Gaines Street, Room 614, Tallahassee, Florida, (850)245-0475
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Bambi Lockman, Chief, Bureau of Exceptional Education and Student Services, K-12 Public Schools, Department of Education, 325 West Gaines Street, Room 614, Tallahassee, Florida, (850)245-0475
THE FULL TEXT OF THE PROPOSED RULE IS:
(Substantial rewording of Rule 6A-6.0251 follows. See Florida Administrative Code for present text.)
6A-6.0251 Management Use of Chronic Health Conditions Epinephrine Auto-Injectors.
(1) Definitions.
(a) Self-Administration. Self-administration shall mean that a student with anaphylaxis, asthma, cystic fibrosis, or diabetes is able to self-manage medication, supplies, and equipment in the manner directed by a licensed healthcare provider without additional assistance or direction in accordance with Section 1002.20(3), F.S.
(b) Anaphylaxis. Anaphylaxis is a medical term for life-threatening allergic reactions that may occur when individuals with allergies are exposed to specific allergens. Anaphylaxis is a collection of symptoms affecting multiple systems in the body.
(c) Asthma. Asthma is an inflammatory disorder of the airways that impairs breathing. Asthma management is classified according to severity and control of asthma symptoms.
(d) Pancreatic insufficiency. Pancreatic insufficiency includes the diagnosis of cystic fibrosis, a disease that affects the lungs and digestive system.
(e) Diabetes. 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. Diabetes management includes routine and emergency care of students with diabetes.
(f) Medical Management Plan. A Medical Management Plan means medical authorization that includes medication orders from a student’s healthcare provider to meet the medical needs of a student with a chronic health condition during school and school-sponsored activities.
(g) Individualized Health Care Plan (IHCP). An IHCP is a plan of action developed by a registered nurse (RN) in collaboration with the student, parent/guardian, health care team, and school personnel for the management of actual and potential health care needs in the school setting, on field trips, and during school-sponsored activities. The IHCP is child-specific in accordance with Section 1006.062, F.S., and includes a written format for nursing assessment (health status, risks, concerns, and strengths), nursing diagnosis, interventions, delegation, expected outcomes, and goals to meet the needs of a student with a chronic health condition.
(h) Emergency Action Plan (EAP). An EAP is a child-specific action plan for anticipated health emergency (ies) in the school setting. The EAP is a component of the IHCP developed in accordance with Section 1006.062, F.S., and Rule 64F-6.004, F.A.C. The EAP shall specify when the emergency number (911) will be called and describe a plan of action if the student needs assistance or is unable to self-administer medication or self-manage treatment as prescribed.
(i) School Health Services Plan. The School Health Services Plan means the document jointly developed by the local school district and county health department that describes the health services to be provided, responsibility of provision of health services, and anticipated expenditures to provide health services as required in Section 381.0056(5), F.S.
(2) A student shall be allowed to carry and self-administer medication, supplies, and equipment in accordance with Section 1002.20(3), F.S., based on the student’s medical management plan from the healthcare provider as well as written parent/guardian consent.
(3) An RN shall develop an annual IHCP that includes an EAP, in collaboration with the student, parent/guardian, health care team, and school personnel for a student with a chronic health condition as specified in Section 1002.20(3), F.S., that includes: anaphylaxis, asthma, cystic fibrosis, and diabetes. The IHCP includes an assessment of the student’s ability to safely and effectively self-manage their health condition while in school, participating in school-sponsored activities, or in transit to or from school or school-sponsored activities.
(4) In accordance with Section 1002.20(3), F.S., the school district shall ensure that procedures are in place to protect the safety of all students from the misuse or abuse of medication, supplies, or equipment.
(5) In accordance with Section 1002.20(3)(j), F.S., a school district may not restrict assignment of a student with diabetes.
(6) School districts are encouraged to develop and implement strategies for training school personnel in the management of students with allergies, asthma, cystic fibrosis, and diabetes in accordance with Section 1006.062, F.S., and the local School Health Services Plan.
(7) The Department of Education, in collaboration with the Department of Health, shall identify, develop, and provide sources for training and technical assistance for school districts. School districts shall provide training to school personnel responsible for the routine or emergency care of students with chronic health conditions including anaphylaxis, asthma, cystic fibrosis, and diabetes.
Rulemaking Authority 1002.20(3)(h)-(k) 1003.492(2) FS. Law Implemented 1002.20(3)(h)-(k) 1003.491, 1003.492, 1003.493 FS. History–New