What law currently exists regarding the care of children with diabetes in school?
Currently, there is no consistency in Canada regarding the care of
children with diabetes in schools. Education is handled on a province by
province basis and thus there is no one law governing all schools or all
children with diabetes in Canadian schools.
Despite that fact, some provinces are creating provincial legislation
New Brunswick has had a provincial policy in place for a number of years
that has changed to reflect the individual needs of its students over time.
Quebec also recently enacted its own legislation outlining how children
with diabetes should be cared for in their provincial schools.
In the fall of 2013, the government of British Columbia implemented
a policy specifically to deal with the needs of its students with diabetes. This policy is still undergoing changes and challenges.
With the merging of school boards in Newfoundland and Labrador down to just two, this province has also recently added a policy for children with diabetes in their schools.
In most other schools throughout the country, diabetes is dealt with in one of two ways—they either have parents sign an “Administering Medicine in Schools” form or have them complete an Individual Support Services Plan (ISSP). Neither of these forms truly outline the responsibilities, needs, and roles of the school, the parent or the student.
Why do we need change?
As we all know, diabetes care has changed monumentally over the past 20 years. At one time, children with diabetes were sent to school with only lows to worry about. Small glucometers, multiple daily injections, ketone meters, insulin pumps and CGMs either did not exist or were a rarity. This is not the case today.
Today, we have more technology, more knowledge of what diabetes is all about, and more children than ever who are living with this disease. That sadly does not mean that the school system or the general public is any more aware than they were twenty years ago.
What is being done elsewhere?
The USA offers a unique solution to the problem of diabetes care in schools. Because the disease falls under Section 504 of the American Rehabilitation Act, children in federally funded schools are able to work with their schools to create individual care plans. These plans include things like when and where testing will take place, what do to in case of highs or lows, who will ensure that the child eats all of the food sent to school, allowing a child to test before an exam to ensure they are not cognitively impaired by hypo or hyperglycemia and giving
them the option to retest at a more appropriate time, etc. Should a federally funded school fail to honour what is noted in the “504 Plan”, they can be penalized by the Office of Civil Rights.
But we live in Canada…
In Canada, our education funding works much differently than in the US. We are not able to implement legislation and demand that all province follow through or else. We have seen some interesting changes in policies. The most relevant to us is a legislative change in the province of Ontario.
In January of 2006, Ontario implemented a private members bill called Sabrina’s
Law. This law protects children with life-threatening allergies and demands that a care plan is put in place for each and every child in Ontario who goes to school and has life-threatening allergies.
How does that help children with diabetes?
It doesn’t but it does open a new door. An Individual Health Care Plan (IHCP) would not simply deal with children with diabetes but all children with
life-threatening illnesses chronic. It would follow the guidelines of Sabrina’s Law. Each school would be required to meet with the parents of children with life-threatening, chronic illnesses at the beginning of each school year. They would establish the protocol of dealing with the child’s illness and care. The plan would outline responsibilities of all parties involved. It would provide an Emergency Care Section, a section requiring in-services for all staff members who come in contact with the child, as well as information for supply teachers.
Why would schools want to adopt this plan?
Today we are seeing a significant rise in the number of healthcare issues that schools and personnel have to deal with on a regular basis. To create a policy for each disease is timely and costly. An IHCP would solve that issue while protecting all children.
Write to your Minister of Education and ask that he/she adopt either a Medical Care Plan or more specifically a policy for Children with Diabetes in their schools.
Diabetes Advocacy’s Individual Medical Care Plan for Children with Life-Threatening Illness
1. (1) In this Act,
“life-threatening illness” means any chronic illness or allergy that in certain conditions, when left untreated or improperly treated could lead to death such as diabetes, severe allergies, asthma and epilepsy.
“board” means a district school board or a school authority; (“conseil”)
“consent” means consent given by an individual with the capacity to provide consent to treatment for the purposes of the Health Care Consent Act, 1996; (“consentement”)
“employee” means an employee of a board who regularly works at the school, in the case of a school operated by the board. (“employé”) 2005, c. 7, s. 1 (1).
“administration of medication” does not include the treatment of hypoglycaemia with juice or other glucose sources when a child with diabetes is conscious.
(2) Expressions in this Act related to education have the same meaning
as in the Education Act, unless the context requires otherwise.
Establishment of policy
2. (1) Every board shall establish and maintain a life-threatening
illness policy in accordance with this section.
(3)Contents of life-threatening illness policy
The life-threatening illness policy shall include the following:
1. Strategies that reduce the risk of the illness reaching
2. A communication plan for the dissemination of information on
life-threatening illness to parents, pupils and employees.
3. Regular training on dealing with life-threatening illness for all
employees and others who are in direct contact with pupils on a regular
4. A requirement that every school principal develop an individual plan
for each pupil who has a life-threatening illness.
5. A requirement that every school principal ensure that, upon
registration, parents, guardians and pupils shall be asked to supply
information on life-threatening illness
6. A requirement that every school principal maintain a file for each
pupil with a life-threatening illness of current treatment and other
information, including a copy of any prescriptions and instructions from
the pupil’s physician or nurse and a current emergency contact list.
(4)Contents of individual plan
An individual plan for a pupil with a life-threatening illness shall
be consistent with the board’s policy and shall include:
1. Details informing employees and others who are in direct contact with
the pupil on a regular basis (as well as being available to all supply
personnel) of the type medical care required,
monitoring and treatment guidelines.
2. A readily accessible emergency procedure for the pupil, including
emergency contact information.
3. Storage for epinephrine auto-injectors, Glucagon, and other emergency
4. Storage and accessibility to medical equipment that may be required
to properly maintain treatment of life-threatening illness (such as
access to glucometers, insulin, etc)
(5)Administration of medication
1. Employees may be preauthorized to administer medication or
supervise a pupil while he or she takes medication in response to a
life-threatening illness, if the school has up-to-date treatment
information and the consent of the parent, guardian or pupil, as
Obligation to keep school informed.
2. It is the obligation of the pupil’s parent or guardian and the pupil
to ensure that the information in the pupil’s file is kept up-to-date with the treatment method and emergency care routine that the pupil
3.Emergency administration of medication
(a) If an employee has reason to believe that a pupil is experiencing an
life-threatening illness reaction, the employee may administer an
epinephrine auto-injector, Glucagon or other medication prescribed to
the pupil for the treatment of a life-threatening reaction such as
anaphylactic shock, epileptic seizure or hypoglycemic event, even if
there is no preauthorization to do so under subsection (1).
(a) No action for damages shall be instituted respecting any act done in
good faith or for any neglect or default in good faith in response to
life-threatening illness reaction in accordance with this Act, unless
the damages are the result of an employee’s gross negligence.
(6)Common law preserved
This section does not affect or in any way interfere with the duties
any person may have under common law.
Again, please let us know what you think of this draft .