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Children with Diabetes are Children with Special Needs

November is National Diabetes Awareness Month, and at Sussan, Greenwald & Wesler we want to focus attention on the many children and adolescents who have diabetes. As parents and caregivers know all too well, it is a serious and lifelong disease that must be managed 24 hours a day, 7 days a week, including the hours spent at school. Under Section 504 of the Americans with Disabilities Act, it is illegal for schools to discriminate against students with diabetes. In addition, the State of New Jersey has a number of laws that protect students with diabetes.

One New Jersey state law requires school districts to ensure that students with diabetes “are able to manage their disease while at school and to ensure the health and safety of the student and the school community.” N.J.S.A. 18A:40-12.11-21

The purpose and beliefs which underlie this law are that:

• Diabetes requires management 24 hours a day.

• Students with diabetes must balance food, medications, and physical activity while at school.

• School nurses coordinate care and educate school staff to provide a safe, therapeutic environment for students with diabetes.

Diabetes can interfere with a student’s ability to learn.

At a minimum, New Jersey law requires an Individualized Health Care Plan and an Emergency Health Care Plan for a student with diabetes. Under this law, the school district’s nurse:

• Coordinates the provision of care

• Educates all personnel about diabetes

• Trains volunteer delegates for glucagon administration

• Serves as a conduit for sharing of medical information and communications with parents

• Develops and updates the student

• Develops and updates the student s IHP/IEHPs/ IHP/IEHP

However, because the typical IHP’s are thin and include far less than is required under this statute, parents should consider obtaining a Section 504 Plan for their child with diabetes.

Section 504 is a civil rights law that prohibits discrimination against individuals with disabilities. It ensures that students with medical or other disabilities have equal access to educational programs. Students who qualify for a Section 504 Plan may receive a written, legally-enforceable plan that includes accommodations and modifications for use during the school day and during extracurricular activities.

Students qualify for a Section 504 Plan when they have a mental or physical impairment that substantially limits one of more major life activities. For a student with diabetes, major life activities might include:

• Maintaining blood glucose levels

• Concentrating

Section 504 plans are developed by persons knowledgeable about the student, about the meanings of evaluation data, and about placement and accommodation options. That should include the parents and the child’s endocrinologist or other medical providers.

Potential accommodations in a Section 504 Plan might include

• Noting the symptoms of hypoglycemia for that student and the recommended treatment
• Symptoms of hyperglycemia for that student and recommended treatment
• Frequency of glucose testing
• Insulin and glucagon orders
• Times of meals/snacks and exercise
• Guidance for participation in sports and exercise
• Accommodations for activities including trips and parties
• Medical issues that might impact learning
• Communication protocols (between parents, healthcare providers, school nurse)
• Education of direct-contact personnel
• Permits student to:

° Carry necessary equipment and materials such as syringes
° Check blood glucose levels as needed in classrooms, gym, or other areas
° Administer insulin as needed
° Treat hypoglycemia or hyperglycemia
° Oversight of self-care by the school nurse should be outlined in the student’s IHP

• Schools must notify bus drivers about a student with diabetes on the bus
• How to treat hypoglycemia
• Emergency protocols and how to contact parents
• District transportation coordinators are required to ensure that all bus drivers are trained in the functions of their positions.
• District transportation coordinators should be educated and informed about diabetes and relevant student needs.

If you have questions about your child’s need for an educational program based on diabetes, we are here to help. Please contact us at (609) 409-3500 to speak with an attorney or to set up a consultation.