Appendix A: California Department of Education (CDE) K.C. Settlement Agreement and Legal Advisory
sugar derived from food) through the bloodstream to the cells. In a person with diabetes, the
body either does not produce insulin, or enough insulin (type 1 diabetes), or cannot use insulin
properly (type 2 diabetes). All persons with type 1 diabetes and some with type 2 must take
insulin to avoid serious short- and long-term health problems. (See generally U.S. Dept. of
Health & Human Services, Helping the Student with Diabetes Succeed: A Guide for School
Personnel (2010) p. 1 < http://www.ndep.nih.gov/media/youth_ schoolguide.pdf > [as of Aug.
12, 2013] (DHHS Guide).) State law requires that nurses administer all medications, including
insulin, in hospitals and other licensed health care facilities. (Bus. & Prof. Code, § 2725.3.)
Outside of such facilities, however, insulin is normally administered by laypersons according to
a physician ’ s directions, most often by the diabetic persons themselves or by friends or family
members.
Public school students with diabetes who cannot self-administer insulin are normally
entitled to have it administered to them at no cost. This is a result of section 504 of the
Rehabilitation Act of 1973 (29 U.S.C. § 794) (Section 504), title II of the Americans with
Disabilities Act (42 U.S.C. § 12131 et seq.), and the Individuals with Disabilities Education Act
(20 U.S.C. § 1400 et seq.) (IDEA). (See 28 C.F.R. § 35.104 (2013); 34 C.F.R. § 300.8(c)(9)(i)
(2013) [defining diabetes as a disability].) Public schools must offer to students covered by these
laws a free and appropriate public education that includes related aids and services, such as
medical services, designed to meet their individual educational needs. (See 20 U.S.C. §
1400(d)(1)(a), 34 C.F.R. § 104.33(a), (b)(1) (2012) .) Under these laws, diabetic students pay for
insulin, supplies and equipment but not the cost of administering insulin. (See 34 C.F.R.
104.33(c)(1) [“the provision of a free education is the provision of educational and related
BP 2006 – Provision of Healthcare Services
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Desert Mountain Special Education Local Plan Area (DMSELPA) (rev. 11/16)
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