Everyone Who Has Diabetes Deserves Fair Treatment throughout

Everyone Who Has Diabetes Deserves Fair Treatment throughout their life in daycare at school 1 at work in other parts of daily life

Legal Protections for People with Diabetes • Recognize that discrimination is often based on fears and misunderstandings – not always on facts! • Diabetes is considered a disability under federal law 2

What is Needed to Achieve Best Practice? Availability of trained personnel and school nurse Access to immediate routine and emergency treatment Self-management and self-possession anywhere, anytime for mature and capable students Available diabetes related supplies and medication Full participation in all school-sponsored activities Blood glucose in target range for examinations These are some examples of what your patient needs in place at school in order to be safe, healthy and well positioned to achieve academic success. 3

School Diabetes Management Considerations Identifying and training school staff to provide care when appropriate. Adherence to insulin schedule/regimen. Staying current on diabetes technologies and therapies. Glucagon administration. Ensuring a school nurse, other school health services staff member or trained school staff member accompanies student on field trip to meet diabetes needs as prescribed by DMMP Allowing capable and mature students to self-manage anywhere, anytime in the school setting. Addressing staff concerns, fears, and misunderstandings about diabetes management 4

Federal and State Laws to the Rescue These laws can help level the playing field and ensure a safe and fair school environment for children with diabetes Federal laws • Americans with Disabilities Act (ADA) • Section 504 of the Rehabilitation Act of 1973 (504) • Individuals with Disabilities in Education Act (IDEA) State laws, regulations and guidelines 5

Maryland Laws 6

ADA and 504 - Civil Rights Laws PROHIBIT DISCRIMINATION ON THE BASIS OF DISABILITY. ALSO PROHIBIT NOT LIMITED TO RETALIATION FOR ASSERTING THE RIGHT NOT TO BE DISCRIMINATED AGAINST. DISABILITIES THAT AFFECT LEARNING/ ACADEMIC PROGRESS. 8

Americans with Disabilities Act (ADA) Covered schools: • public, private, schools and day care centers • religious institutions are covered only IF they receive federal funds Requirements: Not covered: • Schools must: make reasonable changes in practices and policies to: • avoid discrimination • afford equal opportunity, unless doing so imposes an undue burden. 9

Section 504 Covered schools: Requirements Schools must: 10 • All public schools and private schools (including religious schools) that receive federal financial assistance. • Identify children with disabilities. • Provide free and appropriate public education (FAPE).

Section 504 & ADA Requirements – Schools must: 11 • Educate children with disabilities with other students as much as possible. • Allow parental participation in decisions. • Provide equal opportunity to participate in nonacademic and extracurricular activities.

Navigating the 504/IEP Process Parents/guardians should contact school’s 504/IEP coordinator. School may initiate if suspects a need for special education or related services. An evaluation for eligibility under 504 or IDEA will be conducted by school staff knowledgeable about the child along with information from the diabetes care providers. Once an eligibility determination has been made, the 504/IEP team will convene to develop a written plan. 12

College Boards PSAT, AP Tests Must provide documentation which may include 504 plan Complete Student Eligibility Form 13 Typical accommodations for students with diabetes include frequent breaks, longer breaks, access to food or supplies and snacks

School Plans for Diabetes Management Plan What it covers Who writes it DMMP “Doctor’s Orders” – details all aspects of routine and emergency diabetes care. Health care team. Education plans - details both health care and educated related aids, services, accommodations, and special education services the student may need. 504 team 504 Plan IEP Plan 14 IEP team IHP School nursing care plan - specifies how diabetes care as prescribed in the DMMP will be delivered in the school School nurse Quick Reference Resource/Tool for school staff - how to recognize and treat hypo or hyperglycemia School nurse

Safe at School Online Resources 13 Diabetes Care Task Training Modules for school personnel available or FREE at: www. diabetes. org/schooltraining Shopdiabetes. org (under “Advocacy”) 1 -800 -DIABETES (1 -800 -342 -2383) for assistance 15

Role of the School Nurse Conduct nursing appraisal/assessment; develop individualized health plan/emergency plan Implement routine/emergency care; Provide care coordination; lead the school diabetes care team Train school health services staff/school staff; delegate nursing tasks in accordance with the Maryland Nurse Practice Act; identify and train nonmedical school staff to assist with diabetes care as appropriate Communicate wit h health care provider, family, student and school staff regarding the needs of students with diabetes; reinforce individualized diabetes education and information for the student and family Advocate equal access to FAPE (fair access to public education ), monitor implementation of DMMP Contribute to education planning as a member of the 504 and /IEP team 16