BACK-TO-SCHOOL
with DiABETES
Crystal Jackson
Government Relations & Legal Advocacy
American Diabetes Association
Summer 2004
1
GOALS
• Schools must provide a medically safe environment
for students with diabetes.
• Students with diabetes must have the same access
to educational opportunities as do other students.
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Common Issues Facing Students
With Diabetes
• Failure to have trained staff to assist students with
diabetes.
• Refusal to administer insulin.
• Refusal to administer glucagon.
• Lack of coverage during field trips and
extracurricular activities.
• Refusal to permit blood glucose checks outside of
the health clinic or office.
• Refusal to allow a student to attend the school at all.
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Section 504 & Other Federal Laws
• Section 504 of the Rehabilitation Act of 1973
(Section 504)
• Americans with Disabilities Act (ADA)
• Individuals with Disabilities in Education Act
(IDEA)
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Section 504
• A civil rights law that prohibits discrimination on
the basis of disability.
• Who is covered? Child with a physical or mental
impairment that substantially limits one of more
of major life activities, has a record of such an
impairment, or is regarded as having such an
impairment.
• What schools? All public schools and private
schools that receive federal financial assistance.
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Schools Must:
• Identify children with disabilities.
• Provide free and appropriate public education
(FAPE).
• Educate children with disabilities with other
students as much as possible.
• Allow parental participation in decisions.
• Provide children with disabilities with an equal
opportunity to participate in nonacademic and
extracurricular activities.
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ADA
• Prohibits discrimination against individuals with
disabilities.
• Covered children: same standard as 504
• Covered schools: public, private, day care centers
-- except those run by religious institutions
• School required to make reasonable changes in its
practices and policies to avoid discrimination and
to afford equal opportunity unless doing so would
impose an undue burden.
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IDEA
• A child with diabetes is covered if he or she needs special
education and related services in order to benefit from an
education. Diabetes must adversely interfere with academic
performance.
• School must provide special education program and related
services. Children must be educated in the least restrictive
environment.
• Team that includes parents, special education experts, and
school staff develop Individualized Education Program (IEP)
which outlines plan to achieve specific educational goals.
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504/IEP Plan: Possible Contents
• Recognition and prompt treatment of hypoglycemia and
hyperglycemia by trained school personnel during school day,
field trips, and extracurricular activities.
• Immediate access to diabetes supplies and equipment.
• Unrestricted access to snacks, water and bathroom.
• Classroom blood glucose monitoring.
• Adherence to care schedule (routine blood glucose testing,
insulin administration, meals and snacks eaten on time).
• Reasonable time/instruction to make up assignments and tests
missed due to diabetes.
• No penalties for absences due to diabetes (illness/doctor’s
appointments).
• Identify trained school personnel.
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Is Your Child Prepared?
School Checklist
• Work with your child’s health care team to develop a
Diabetes Medical Management Plan (DMMP).
• Meet with school before school begins to discuss
implementation of DMMP.
• Develop or update Section 504 Plan or Individualized
Education Program, if eligible.
• Approach in spirit of cooperation.
• Provide supplies, snacks, quick-acting form of glucose.
• Encourage your child to wear a medical ID jewelry.
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Diabetes Medical Management Plan
(DMMP)
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Document developed by family and health care provider
Signed by health care provider
Describes your child’s diabetes care regimen
Information may include:
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Date of diagnosis
Current health status
Emergency contact information
Student’s willingness and ability to perform self-care
List of diabetes equipment and supplies
Orders for bg monitoring, insulin, glucagon, ketone checks, meal
and snack plan, exercise
– Typical signs, symptoms, and prescribed treatment for
hyperglycemia and hypoglycemia
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DMMP
• DMMP should be reviewed and updated each
school year.
• Update upon change of your child’s diabetes
regimen, level of self-management or change in
school circumstances (i.e. change in schedule).
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Back-to-School Preparation
Strategy
• Educate
• Negotiate
• Litigate
• Legislate
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Educate the Educators
• Schedule meeting with school administrators and key staff
members before the beginning of school year to discuss the
implementation of your child’s Diabetes Medical Management
Plan and to develop Section 504 Plan or Individualized
Education Program.
• Familiarize yourself and school staff members with the ADA
Position Statement on Care of Children with Diabetes in the
School and Day Care Setting.
• Seek coverage under appropriate federal laws.
• Be sensitive to the concerns of school personnel, but stand
firm.
• Offer to help facilitate and assist with training when possible.
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Negotiate
• Work through problems and concerns through
education. Most times problems arise due to
ignorance and/or fear.
• Clarify reasons for school’s concerns and objections,
preferably in writing.
• Collaborate with other parents and concerned
individuals and organizations to work for change
• Gather resources to support your position
(applicable laws, medical information, policies in place
in neighboring school districts).
• Obtain expert opinion/letter from your child’s
endocrinologist.
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Litigate
• File complaint with U.S. Department of Education,
Office of Civil Rights.
• School district/state grievance
procedure/hearing.
• File complaint in state court.
• File complaint in federal court.
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Litigate When Necessary
• Office of Civil Rights in the U.S. Department of
Education enforces Section 504 and ADA in
programs that receive assistance from the federal
government.
• The U.S. Department of Justice enforces ADA in
schools and daycares that do not receive federal
funding.
• The Office of Special Education Programs (OSEP)
enforces IDEA. Due process appeals may be
initiated through the state education agency.
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Legislate
• Legislate after attempts to educate,
negotiate, and litigate have not been
successful.
• Consider changing state law if current laws
and policies do not provide students with
diabetes the protection they need
• Realize that systems change slowly. Patience
and perseverance required.
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State Laws And Regulations
• State and local laws and regulations vary regarding
who may perform various aspects of diabetes care.
• Often there is no statewide policy. Rather, policy
is determined district by district.
• Regardless of state and local laws, requirements
of federal laws must be met.
• Some states have passed school diabetes care
legislation.
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State School Diabetes Care
Laws
Virginia
California
Washington
Wisconsin
Tennessee
North Carolina
• Oregon
• Montana
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Pending/Active School Diabetes
Care Legislation
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Connecticut
New Jersey
South Carolina
Rhode Island
New Jersey
Pennsylvania
• Illinois
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What The Laws Covered
• Require staff be trained to assist students
with diabetes at school and on field trips, etc.
• Insulin administration
• Glucagon administration
• Require classroom bg monitoring and allow
diabetes management on school campuses or
at school activities
• Extra absences
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Health and Education Access for
Students with Diabetes Act
• HR3178 introduced to House in October 2003
• Ensures students have access to their diabetes
supplies while at school
• Non-compliance may result in withdraw of
drug free school grants
• Urge your MOC to sign on as a co-sponsor
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School Diabetes Care
Resources
•
Helping the Student with Diabetes Succeed: A Guide for School Personnel
developed by National Diabetes Education Program School Initiative . May be
downloaded from www.ndep.nih.gov or accessed via
www.diabetes.org/advocacy/school.
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Diabetes Care Tasks at School: What Key Personnel Need to Know is a series of
web-based training modules that can be downloaded from the ADA’s website at
www.diabetes.org/schooltraining.
Introduction and support of ADA’s model school bill to state legislatures.
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Comprehensive information may be found on ADA’s website at
www.diabetes.org/advocacy/school.
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ADA’s National Call Center representatives available to assist families
experiencing difficulties at education, negotiation, and litigation stages. Call 1800-DIABETES for school packet and assistance.
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Helping the
Student with
Diabetes Succeed
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Table of Contents
• Introduction
• Diabetes Primer for School Personnel
• Actions for School Personnel, Parents,
and Students
• Tools for Effective Diabetes Management
• School Responsibilities Under Federal
Law
• Appendices
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Diabetes Care
Tasks at School
WHAT KEY PERSONNEL NEED TO KNOW
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Forward
How to Use This Presentation
Diabetes Care Tasks Training Modules
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Diabetes Basics
Hypoglycemia and Hyperglycemia
Blood Glucose Monitoring
Insulin Administration
Glucagon Administration
Ketone Testing
Nutrition and Exercise
Legal Considerations
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How You Can Help
• Educate school policy makers about appropriate
diabetes care at school and how good care
benefits everyone.
• Work together with other parents, interested
individuals and organizations to create policies to
meet our kids’ medical needs and to ensure equal
access.
• Keep the Association informed of any action you
take against school discrimination. Your actions
may help another child. Call 1-800-DIABETES.
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