Upload
roger961
View
197
Download
0
Embed Size (px)
Citation preview
www.diabetes.org 1-800-DIABETES
SAFE AT SCHOOL: HOW POLICY CHANGE ENHANCES THE MEDICAL SAFETY AND
ACCESS TO EQUAL OPPORTUNITY IN EDUCATION
Crystal C. Jackson, Associate DirectorLegal Advocacy, ADA
CDC Diabetes Translation Conference 2008Orlando, FL
www.diabetes.org 1-800-DIABETES
TO PREVENT AND CURE DIABETES
AND TO IMPROVE THE LIVES OF ALL
PEOPLE AFFECTED BY DIABETES
ADA MISSION
www.diabetes.org 1-800-DIABETES
School & Diabetes• Diabetes care is 24/7• Child with diabetes cannot take a break• Smooth transition from home to school • Access to equipment, medication, and
assistance is essential• Development of written care plans
www.diabetes.org 1-800-DIABETES
Why is care at school important?
• To prevent short-term complications such as hypoglycemia
• To prevent or delay long-term complications such as heart and kidney disease and blindness
• To ensure that child has the best possible opportunity achieve academic success and safely participate and benefit from all school activities
www.diabetes.org 1-800-DIABETES
Goals of School Diabetes Care• A medically safe
environment for students with diabetes.
• Equal access to educational opportunities and school-related activities.
• Enable academic achievement and enhance quality of life.
www.diabetes.org 1-800-DIABETES
Legal Protections
• Section 504 of the Rehabilitation Act of 1973 (Section 504)
• Americans with Disabilities Act (ADA)
• Individuals with Disabilities Education Act (IDEA)
• State law and regulations
www.diabetes.org 1-800-DIABETES
Common Barriers to Care Despite Legal Protections
• Failure to have trained staff to assist students • School’s lack of knowledge about diabetes• Refusal to administer insulin and glucagon• Lack of coverage during field trips and
extracurricular activities• Refusal to allow self-management where the
student is• Refusing to enroll child or sending child to
“diabetes school”
www.diabetes.org 1-800-DIABETES
School Concerns• Blood glucose testing
– In the clinic– In the classroom
• Insulin administration– Supervision: nurse vs.
student vs. school personnel– Location
• In the clinic• In the classroom• Other
www.diabetes.org 1-800-DIABETES
Reality Check• School nurse not available at all places at all
times.• Reality is that most schools do not have a full-
time school nurse.• Even a full-time school nurse does not solve the
whole problem.• ADA supports a safe model that utilizes trained
school personnel in the absence of a school nurse.
www.diabetes.org 1-800-DIABETES
All school staff members need to have a basic knowledge of diabetes and know who to contact for help.
SAFE AT SCHOOL CAMPAIGN PRINCIPLES
Students should be permitted to provide self-care wherever they are at school or school-related activities.
What IsDiabetes
School nurse is primary provider of diabetes care, but other school personnel must be trained to perform diabetes care tasks when the school nurse is not present.
www.diabetes.org 1-800-DIABETES
American Academy of PediatricsAmerican Association of Clinical EndocrinologistsAmerican Association of Diabetes EducatorsAmerican Diabetes AssociationAmerican Dietetic AssociationChildren with DiabetesDisability Rights Education and Defense FundJuvenile Diabetes Research FoundationLawson Wilkins Pediatric Endocrine SocietyPediatric Endocrinology Nursing Society
SAFE AT SCHOOL PRINCIPLES ENDORSED BY:
www.diabetes.org 1-800-DIABETES
SAS AND ADA APPROACH
• Educate school personnel about diabetes and legal obligations.
• Negotiate using resources such as NDEP guide, Florida guidelines.
• Litigate if necessary – OCR, due process, courts
• Legislate if all else fails and clear legal barriers exist.
www.diabetes.org 1-800-DIABETES
SAFE AT SCHOOL EFFORTS RESULTING
IN POLICY CHANGE• School diabetes care legislation passed in 17
states.• U.S. Department of Justice settlement with two
major day care providers.• U.S. Department of Education agreements
resulting in improved standards of care for students with diabetes.
• Lawsuit settlement with California Department of Education (federal law vs. state law)
www.diabetes.org 1-800-DIABETES
School diabetes care laws enacted in 18 states
School diabetes care law legislation active in 5 states
LEGISLATE
Consider changing state law or policies if current laws and policies do not provide students with diabetes the protection they need
www.diabetes.org 1-800-DIABETES
Arizona
Connecticut
North Carolina
Kentucky
West Virginia
Virginia
Board of Nursing Action:
Nevada
Colorado
SCHOOL DIABETES CARE LAWSHawaii
Montana
Washington
Oregon
California
Oklahoma
South Carolina
Tennessee
Texas
Nebraska
Utah
Indiana
www.diabetes.org 1-800-DIABETES
School Diabetes Legislation Pending in:
Massachusetts
New Jersey
Rhode Island
“Advocate for children with diabetes at local, state and national levels.”
Sign up at the ADA Action Center: www.diabetes.org/advocacy
Pennsylvania
Illinois
www.diabetes.org 1-800-DIABETES
Litigate• File complaint with U.S. Department of Education,
Office of Civil Rights.
• School district or state due process/grievance procedure/hearing.
• File complaint in state court.
• File complaint in federal court.
www.diabetes.org 1-800-DIABETES
CDE Lawsuit Settlement• California Department of Education Legal
Advisory• Permits non-medical school employees to
administer insulin when a nurse is not available• California school districts must meet
requirements of federal law – even if nurse is not available
• Prohibits sending students to a particular school as a condition of receiving medication and care
www.diabetes.org 1-800-DIABETES
But not all policy change involves a fight…..
www.diabetes.org 1-800-DIABETES
Examples of Collaboration Resulting in Policy Change
• Colorado School Diabetes Resource Nurse Model
• Colorado Board of Nursing Rule Change• Utah Glucagon Legislation• Proposed Utah Board of Nursing Rule
Change
www.diabetes.org 1-800-DIABETES
Safety + Access = Success!!!