In Case You Missed It: California Ruling On Access To Insulin For Students

In Case You Missed It: California Ruling On Access To Insulin For Students | The LOOP Blog

Recently, our News to Infuse newsletter team sat down with Dr. Francine Kaufman to discuss a California Supreme Court ruling that trained non-licensed school personnel can assist California’s students in administering insulin if needed. Because this issue is so important, and because the ruling impacts the daily care of more than 10,000 students living with diabetes in California, we also wanted to share this interview with our LOOP readers. If you have a child in a California public school, talk to your school officials and healthcare team about plans for administering insulin to your child.

Q. Hello, Dr. Kaufman. We hear that you have some exciting news to share with our readers about a great success story in your home state of California.

A. Yes, I would like to share some information that is part of the American Diabetes Association Press release from August 12, 2013. As you all know diabetes is a disease that must be managed 24/7, which means children must manage their diabetes while they are in school. Some children with diabetes are not able to self-administer the insulin they need – either by injection, pen or pump – and, up until now, in most schools in California, only a licensed health care professional could assist in giving them this life-saving medication. But there has been a serious problem with this – there is only one school nurse for every 2,200 California students and nearly half of the state’s school districts do not have a single nurse on staff. There simply aren’t enough school nurses to meet the needs of the approximately 14,000 children with diabetes in California’s public schools.

Q. That is amazing, so many children without support at school to keep their diabetes in control. Can you tell us some more about the history behind today’s landmark decision?

A. Nearly eight years ago, the American Diabetes Association (ADA) sued the California Department of Education (CDE) and several school districts because children with diabetes were not getting the care they needed. In 2007, the case was successfully settled with guidance from CDE that a school employee who isn’t a nurse could volunteer to be trained to administer insulin when a nurse isn’t available. However, after the settlement, several nursing organizations – the American Nurses Association, the California School Nurses Organization and the California Nurses Association – sued CDE, arguing that, under their interpretation of state law, no one except a licensed health care professional could administer insulin to a student.

The ADA stepped in to represent children with diabetes. A trial and appellate court disagreed with the ADA, ruling state law prohibits school employees who are not nurses from administering insulin. The California Supreme Court agreed to review this decision and heard oral arguments on May 29, 2013.

On August 12, 2013 the California Supreme Court ruled that trained, non-licensed school personnel can assist California’s students so that they can receive the insulin they need to survive – and thrive – at school. Our students will be able to receive insulin any time they need it, even if a nurse isn’t there. It’s also important for their parents, who will no longer face risking their child’s health and safety every time they send a son or daughter to school, or have to quit their job or jeopardize their employment because of the constant need to provide care when a nurse is not available.

Q. That is great news. This will certainly help those 14,000 children and others to be able to do the things other children are able to do since they will have someone at school to help them with their insulin.

A. Yes, this decision is vital for California students with diabetes. It means they will no longer be placed in situations that endanger their health, safety and access to educational opportunities. Today’s decision does not in any way lessen the role of school nurses, who play a critical role in the health of all students, including those with diabetes. However, the decision does mean schools will now have a plan to provide care when a nurse is not available. The Court has recognized all children have the right to be safe at school.

Q. Dr. Kaufman, I understand that you have been involved with this challenge for many years. How did it affect you as a healthcare professional providing care to children with diabetes?

A. Yes, I have been involved in this for many years. I once wrote a study protocol for using an insulin pump in children. I knew that there would be issues without support during school and had to address that in my study design. Some of you may have heard about this study – the children only wore the pump overnight and came off of it in the morning before school so that the study could be completed.

Thank you, Dr. Kaufman, for sharing this wonderful event with our readers.

Extracted from the ADA Press Release 8/12/13 by Francine Kaufman, MD

Editor’s Note: Visit the ADA website to read more about the California Supreme Court ruling.

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