Protecting the Rights of Students with Diabetes

Children and adults with diabetes are protected by our nation’s disability rights laws, but they often face discrimination on the basis of their disability in decisions about where they may go to school, conditions of employment, or admission or access to the goods, programs, or benefits of state or local governments or businesses offering public accommodations.  The Justice Department’s Civil Rights Division has worked closely with the American Diabetes Association and other advocacy groups on behalf of children and adults with diabetes to ensure they are not subjected to illegal discrimination. The department recently filed two major briefs in federal and state court explaining the department’s strong interest in enforcement of the rights of persons with diabetes, and children in particular. The Civil Rights Division will continue to actively fight discrimination on the basis of disability against adults and children with diabetes in any such situations.     The Department has filed several briefs to enforce the ADA on behalf of children with diabetes, including: On June 7, 2011, the department filed an amicus brief (PDF) in R.K. v. Scott County (6th Cir.), a case filed on behalf of a young boy in Kentucky who uses an insulin pump. The school board refused to train non-medical personnel at the boy’s neighborhood school to help him monitor his insulin pump and carbohydrate intake, and transferred him to another school, away from his siblings and neighborhood friends, so that a nurse could assist him with the insulin administration.  The school district argued that the state nurse practitioner laws prohibited training a school staff member to oversee the child=s administration of insulin. The department’s brief argued that the district court applied the wrong legal standard and that state regulations governing insulin administration are preempted by federal protections for students with disabilities. On May 13, 2011, the department filed an amicus brief (PDF) in American Nurses Association (ANA) v. O’Connell, a case before the California State Supreme Court that challenges a settlement agreement between the American Diabetes Association and the State Superintendant of Education. That agreement allowed professional school employees to be trained to monitor administration of insulin for students with diabetes when a school nurse is not available. Many California schools have no nurses due to budget constraints, and without this agreement some students likely would not receive insulin doses that are medically necessary and required by federal laws protecting students with disabilities.  The ANA filed the case challenging the agreement, arguing that a nurse must be present in all situations to monitor insulin administration. The department’s brief argued that under the conditions described in the settlement, federal law requires that a trained school professional be permitted to administer insulin. The Department also reached a number of agreements with schools and child care centers on behalf of children with diabetes, including: On June 1, 2011, the department reached a settlement agreement with a school in Alexandria, La., to resolve allegations that the school denied a six-year-old girl with Type I diabetes admission after her parents asked the school to supervise her in testing her blood glucose level and administering insulin, in addition to other daily diabetes care practices. Under the agreement, the school agreed to supervise any type of insulin administration for children with diabetes and not to discriminate in decisions about admission and participation in school programs by children with diabetes. On August 30, 2010, the department reached a settlement agreement with a child care center in Hawthorne, Calif., to resolve a complaint filed by parents of a five-year-old boy with Type I diabetes. The complaint alleged that the center refused to allow staff to supervise the child’s use of an insulin pump, insisting instead that one of his parents come to the center at lunch and snack times to supervise him, and refusing to allow him to go on field trips with the other children in his class. The center’s rationale for these policies was that state regulations prohibit the center from providing medical care and supervision of its enrolled children without appropriate authorization from the state licensing board. Under the settlement, the center agreed to, among other things, adopt a diabetes management policy that includes supervising and monitoring children with diabetes while they are consuming food or using blood glucose monitoring tests, insulin pumps, syringes, or other diabetes related medical equipment. On October 20, 2009, a child care center in Castle Rock, Colorado, entered into a settlement agreement with the Department resolving a complaint by a parent of a girl with Type I diabetes. The complaint alleged that the center refused to permit the six-year old to participate in field trips unless she was accompanied by a parent or a trained person hired by the parent. Under the agreement, Pine Hills will evaluate each child=s individual needs and make reasonable modifications to policies that limit participation by children with diabetes. Additional information about the ADA can be found at www.ada.gov.