Student Diabetes Lawsuit from Violation of Section 504

Inadequate Care for Diabetic Students Leads to Class Action Lawsuit

January 9, 2009 — In October 2005, the public interest organization Disability Rights Education and Defense Fund (DREDF) filed a class action lawsuit on behalf of four children with diabetes and their parents. The suit was filed under federal disability civil rights and special education laws against the California Department of Education (CDE) and two California school districts. The American Diabetes Association (ADA), plaintiff in the case, alleged that schools had failed to provide adequate health care for diabetic students. They further alleged that the state failed to ensure school districts met their legal obligations to provide care for diabetic students.

In August 2007, the ADA and CDE reached a comprehensive settlement to ensure that students with diabetes would be safe at school and have the same educational opportunities as their peers. The CDE issued a Legal Advisory of guidelines for the rights of students with diabetes and the health care services they are entitled to at school. The Legal Advisory clearly defined that if a student needed insulin during the school day or during a school related activity, trained non-medical employees could administer insulin if the school nurse was unavailable.

The settlement stated that insulin may be administered to students with diabetes under Section 504 and the IDEA by the following people, preferably in the following order:

  1. The student, with authorization of the student’s licensed healthcare provider and parent/guardian.
  2. A school nurse or school physician employed by the Local Education Agency (LEA).
  3. An appropriately licensed school employee such as a registered nurse or licensed vocational nurse, supervised by a school physician.
  4. A contracted registered nurse or licensed vocational nurse from a private agency or registry, or by contract with a public health nurse through the county health department.
  5. A parent/guardian who chooses to administer the insulin.
  6. A designee of the parent/guardian who volunteers to administer the insulin and who is not a school employee.
  7. An unlicensed voluntary school employee with appropriate training in emergencies only (such as epidemics or public disasters).
  8. A voluntary school district employee who is unlicensed but has been adequately trained to administer insulin pursuant to the student’s treating physician’s orders.

The California School Nurses Organization (CSNO) filed suit over the settlement, particularly over item 8, stating that patient safeguards contained in the California Nursing Practice Act clearly specify that only a licensed nurse or physician may administer medication in a school setting with the following exceptions:

  • Where a student self-administers the medication;
  • The parent or parent designee, such as a relative or close friend not employed by the school district administers the medication; or,
  • There is a public disaster or epidemic.

On November 15, 2008, the California Superior Court overturned the agreement between the CDE and ADA that allowed unlicensed school personnel to administer insulin to students with diabetes who have Section 504 or individual education plans. The end result of this ruling is the requirement that nurses be present on campuses to help monitor and administer insulin to diabetic students that are unable to do it themselves. Unfortunately, in California, there are nearly 14,000 school children with diabetes and only 2,800 school nurses spread across 9,800 California schools. Because of this discrepancy, it is of even greater importance for parents to remain involved, making sure that their child is safe and having their needs met as required by Section 504.

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