1. LEGAL CONSIDERATIONS
12/2008

2. Goal: Optimal Student Health and Learning
Protecting students’ legal rights is a
vital piece of a comprehensive plan.
This training component is one of thirteen components created
specifically for school nurses and non-medical school personnel who
perform diabetes care tasks at school.
These components are:
• Diabetes Basics
• Diabetes Medical Management Plan
• Hypoglycemia
• Hyperglycemia
• Blood Glucose Monitoring
• Glucagon Administration
• Insulin Basics
• Insulin by Syringe and Vial
• Insulin by Pen
• Insulin by Pump
• Ketones
• Nutrition and Physical Activity
• Legal Considerations
This unit is Legal Considerations.

3. Needs of Children With Diabetes in School Setting...
A medically safe environment for students with diabetes
Equal access to educational and school-sponsored opportunities
Needs of children with diabetes in school setting:
Students with diabetes need a medically safe environment.
Students with diabetes must have the same access to educational and school-sponsored opportunities as do students without diabetes.

4. Federal Laws: Equal Access
Section Section 504 of the Rehabilitation Act of 1973
ADA - Americans with Disabilities Act
IDEA - Individuals with Disabilities Education Act
Three Federal laws address the school’s responsibilities to ensure access for students with disabilities:
Section 504 of the Rehabilitation Act of 1973 (Section 504)
Americans with Disabilities Act (ADA)
Individuals with Disabilities Education Act (IDEA)
The purpose of this training is not to fully describe these laws, but rather to talk generally about how they might impact care provided for a student with diabetes.

5. Federal Protections
Prohibits discrimination against people with disabilities by public schools and most private schools
Students must be given equal opportunity
Related aids and services are required to meet the individual needs of a student with a disability
This slide provides an overview of the framework for planning and implementing accommodations for students with disabilities under 504, Americans with Disabilities Act and IDEA.
One or more of these laws applies to all schools, except a private religious school that doesn’t receive any federal funding.
These laws provide for:
Related aids and services designed to meet the individual needs of the student
Free, appropriate public education (FAPE)
Equal opportunity
Section 504 and ADA prohibit discrimination against children with disabilities by schools and/or day care centers.
IDEA also requires special education for students whose diabetes or other disability adversely affects education performance (for example, this might be the case for a student who often experiences high and low blood glucose levels at school or who has to miss a lot of school because of diabetes related complications).

6. Written Plans Diabetes Medical Management Plan (DMMP)
Individualized Health Care Plan (IHP)
Quick Reference Emergency Plan
504 Plan
Individualized Education Program (IEP)
It is important to make sure that the school personnel, parents/guardians, and the student agree on how the Diabetes Medical Management Plan (DMMP) will be implemented and what accommodations and related aids and services may be needed for the student. This information is included in a Section 504 Plan, Individualized Education Program (IEP), or other education plan.
The information in the DMMP can be used in developing either a Section 504 plan or an IEP, but is not a substitute for a Section 504 Plan or IEP.
The Individualized Health Care Plan (IHP) is developed by the school nurse to implement the DMMP. The IHP communicates the nursing management strategies for the student in the school setting.
The Quick Reference Emergency Plan is a quick reference plan developed by the school nurse that describes the individual student’s symptoms and treatment of hypoglycemia and hyperglycemia.
A “504 Plan” is the term commonly used for the written plan developed under Section 504 of the Rehabilitation Act. An Individualized Education Program (IEP) is required for students who receive special education and related services under the Individuals with Disabilities Education Act (IDEA).

7. Needs Addressed by 504 Plan/IEP
Location and timing of blood glucose monitoring and insulin administration
Identity of trained diabetes personnel
Location of diabetes supplies
Free access to water and restroom
Nutritional needs, meals and snacks
Full participation in all school-sponsored activities
Access to blood glucose checks and treatment supplies during exams
Alternative times for academic exams if student is experiencing hypoglycemia or hyperglycemia
Absences without penalty for doctors’ appointments and diabetes-related illness
Maintenance of confidentiality and student’s right to privacy
The 504 or IEP plan should address accommodations needed for both routine and non-routine school activities and settings, even for relatively infrequent events, like standardized testing or overnight field trips. Listed on the slide are examples of the types of things that might be addressed.
Anticipating such events and proactively addressing them when the plan is written will not only ensure the student’s safety and full participation, but also help to avoid misunderstanding and potential conflict between the school, parent/guardian, and/or health care providers.
A sample 504 plan can be accessed on the American Diabetes Association Website at: