Diabetes Care

September 2013

Important Information about Diabetes Care at School in California
The California School Diabetes Care Lawsuit:
Questions And Answers For California Parents And Guardians

August 2013

DREDF and co-counsel Reed Smith, LLP, successfully represented the American Diabetes Association by winning an important victory for children with diabetes and other medical conditions in the California Supreme Court.

The court in American Nurses Ass’n. v. Torlakson, 57 Cal. 4th 570 (2013) ruled that California state law permits trained non-medical school personnel to administer insulin to students with diabetes who are not able to self-administer. This decision ended nearly six years of litigation and reverses two lower court rulings that had agreed with the position taken by nursing organizations that only a licensed health care professional could administer insulin to California students.

This is important for several reasons, including that given the limited numbers of nurses employed in California public schools, restricting medication administration to a nurse meant that students with diabetes and other conditions risked going without needed medications during the school day.

Another reason the decision is important is that it has a very broad impact in California, beyond schools and insulin. For a summary of how it applies to various settings and different medications, please see:
DREDF’s eNewsletter

New resources are:

The link to these documents and other important information about the California Supreme Court decision can also be found at http://www.diabetes.org/caschoollitigation.

The documents below outline the terms of the Settlement, describe the rights of public school students with diabetes at school and explain how to make sure children with diabetes receive adequate health care in school.

September 2011

Important Information About Diabetes Care at School for 2011-2012

July 2010

DREDF and Reed Smith, LLP continue representation of American Diabetes Association in Petition for Review to the Supreme Court of California to Appeal Decision Preventing Non-Medical School Personnel from Administering Insulin to Children in California Public Schools (7.7.10)

April 2009

DREDF and Reed Smith LLP Earn Victory with Stay of California Court Ruling on Insulin in Public Schools

Representing the American Diabetes Association (ADA), DREDF has been fighting for years to ensure that children with diabetes can receive the care they need including insulin administration, in California public schools. Our efforts include legislative advocacy and a lawsuit filed in federal court in 2005 against the California Department of Education (CDE). That lawsuit was settled in 2007, with the CDE agreeing to issue a Legal Advisory explaining the rights of students with diabetes and reminding school districts of their obligation to offer and provide health related services and accommodations to students with diabetes to honor these rights. One portion of the Advisory stated that unlicensed school personnel are allowed to administer insulin to students when a nurse is not available. In October 2007, four nurse organizations sued to overturn this part of the Legal Advisory, and in November 2008 a trial court judge ruled in their favor. Left unchallenged, the court ruling would have required CDE to change the Legal Advisory to remove any references to unlicensed personnel administering insulin.

Following the court ruling, ADA and CDE filed an appeal of the court ruling. In April 2009, the California court of appeals ruled that the trial court’s ruling is “stayed” during the appeal. While this is not a decision on the merits of the case, it does mean that the trial court’s ruling has no effect until the appeal is decided. Therefore, the original Legal Advisory remains in place, and California school districts are permitted to train unlicensed personnel to administer insulin under the circumstances discussed in the Legal Advisory.

CDE confirms on its website that during the stay, “the entire Legal Advisory therefore remains in effect.”

More detailed answers to questions about the lawsuit (PDF), and tips for working with school districts to receive needed care, are also available.

December 2008

Leading Pediatric Endocrinologist Supports use of Trained Unlicensed Personnel at School

November 14, 2008

The American Diabetes Association issues action alert regarding administration of insulin in schools

November 24, 2008

Los Angeles Times Columnist Analyzes Impact of Nurses Suit on Students with Diabetes

LA Times columnist Steve Lopez interviews two children with Type 1 diabetes and describes how they manage their health during the school day—and how their families cope—in the absence of school nurses.
Read the LA Times column.

August 2008

With the start of a new school year fast approaching, the fight continues to ensure that children with diabetes in California get the care they need while at school. Given the state’s serious fiscal crisis and its effect on local school budgets, we expect that some school districts may be more reluctant this year to agree to provide needed diabetes care. We want to let parents, health care professionals, and advocates know the status of school diabetes litigation in California and how to secure the care that children require.

In August 2007 the California Department of Education (CDE) issued a Legal Advisory to all California public schools to inform them of the legal rights of students with diabetes, including related aids and health services, based on federal and state laws. Several nursing organizations have sued the CDE for telling schools through the Legal Advisory that it is permissible for trained non-licensed school personnel to administer insulin where a nurse is not available in order to comply with federal law. These nursing organizations claim that only nurses can administer insulin to children at school who cannot self-administer. The lawsuit between the nursing organizations and the CDE has not been resolved, and the court has not ruled that the Legal Advisory is invalid. The CDE stands by its 2007 settlement and the Legal Advisory (including its statements about insulin administration). Students with diabetes still have the right to receive insulin at school per the Legal Advisory.

Read one family’s story.