Elizabeth (shown above with her insulin pump)
is one of 14,000 kids in California public schools
with type 1 diabetes. Her mother goes to school
each day to give her insulin at lunchtime.
Photo: Islets of Hope
California nurses associations are still fighting hard to rescind certain federal and state rights of children with diabetes four years after a precedent-setting lawsuit was filed by three California families.
On Thursday, October 8th, the California Assembly Select Committee on Child and Adolescent health will hold its second hearing on the care of kids with diabetes in public schools.
The hearing will weigh the rights of diabetic children to attend public school against the nursing shortage in California.
In October 2005, the first class action suit in the United States alleging discrimination against school children with diabetes was filed. The complaint reported on California public schools that were refusing to admit or care for kids who have type 1 diabetes.
The suit asserted that children with type 1 diabetes are protected under the Americans With Disabilities Act and have the right to a "free and appropriate education."
In a landmark legal decision in 2007, a federal court judge agreed.
While parents of kids with diabetes, many of whom had quit their jobs to provide care all day at school for their children cheered the decision, four nurses associations sued to overturn part of the decision that allowed nurses to train and delegate routine and emergency care to non-medical personnel when a nurse was not available.
In November 2008 trial court judge, Lloyd Connelly, ruled in favor of the nurses' associations. His ruling even required schools without nurses that had been voluntarily providing care for diabetic kids to stop all care unless it was now administered by a registered nurse. Connelly's ruling revoked the rights of the 14,000 students with type 1 diabetes in California public schools to attend school safely.
In April 2009, a court of appeals "stayed" the trial court's ruling. This meant that until a final legal decision is rendered all California schools are required to ensure the safety of kids with diabetes at school including help with administration of insulin and glucagon, a hormone that can save the life of a child who has lost consciousness from low blood sugar.
But California nurses associations continue to fight the law and school nurses are still not complying with a court order to delegate duties when they are not available. They insist that giving insulin is a medical procedure and only a licensed nurse is qualified to provide medical care.
Yet throughout the state, nurses are still illegally requiring children as young as age four to calculate, prepare, and inject insulin without any assistance from an adult. Even when a child uses an insulin pump and does not require shots, nurses are still refusing to train others to provide assistance to kids who are too young to count much less use a higher level of math to figure out their own insulin doses.
California has the second worst student-to-nurse ratio in the nation and has long been in violation of ratio standards required by federal and state laws. In some Southern California school districts there is only one nurse for as many as 12,000 or more students.
Parents should be advised that for now, California law, does require schools to provide care through a nurse, or to train volunteer, non-medical personnel at school to help with diabetes care when a nurse is not available.
Even though all California public schools are required to provide assistance to kids with diabetes, many schools remain confused by the discrepancies between what California law requires them to do, and what the nurses associations have told them they are permitted to do.
Nursing associations have stated they will continue to refuse to comply with this law insisting the real answer is to hire more nurses. While most parents agree that more nurses are needed, they argue in a state that is already bankrupt, closing courts, and handing out IOUs, more nurses are not coming any time soon.
Many parents, who themselves provide diabetes care and are not nurses, believe that the issue is not about safety, but that their children are being used as a legal pawn in a decade-long fight to push the state to hire more school nurses.
So once again this year, as children head back to school, parents of young children with diabetes, are also heading back to school to ensure their child's safety. Until a final ruling, which could take year or longer, the right to a "free and appropriate public education" continues to come at a huge cost to kids with diabetes.
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