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September 9, 2002

School and Daycare

Question from Edgewood, Kentucky, USA:

My five year old nephew, diagnosed with type 1 diabetes a few months ago, has just started first grade, and his mother gave the school nurse and his teacher her written instructions. On the first day of school, he was sent home with a high blood sugar level, and his mother is uncomfortable with leaving him at school all day because it does not seem as though anyone is working to control his blood sugar levels. The district has one nurse who travels between schools so there is not always a nurse present. This means that there is more than likely not going to be a nurse there to give a shot if needed. It seems as if he will be missing a lot of school. Is the school required to accommodate by hiring a full time nurse? Also, he is not allowed to ride the school bus. Is this legal?


The written instructions for the school should ideally be in the form of a 504 plan which outlines your nephew’s diabetes requirement while at school along with both the parents’ and school’s responsibilities. This document is signed by the child’s physician (essentially constituting doctor’s orders), the parents and school personnel.

By law, if your nephew’s doctors states that insulin is to be administered at school, the school cannot waive this responsibility. While the district cannot be mandated to hire a nurse, they must provide reasonable accommodations. In this instance, they would have to designate and train another school employee to administer insulin.

The same premise holds true for the school bus. If the district is unwilling to allow your nephew to ride with the other children, they must provide alternative transportation. They cannot mandate that parents be responsible for transporting him. The laws stipulate that a child with diabetes is entitled to the equal access to all school functions, including extracurricular activities and that reasonable accommodations must be made to assure this access. See The Law, Schools, and Your Child with Diabetes.

Additional comments from David S. Holtzman, Esq.:

I agree the school district is not living up to its responsibilities. I would seek assistance from the State Board of Education to learn your rights and responsibilities. Explain what the situation is and where you think the school district is falling short.