Appendix A: California Department of Education (CDE) K.C. Settlement Agreement and Legal Advisory
services without cost to the handicapped person or to his or her parents or guardian”]; Cedar
Rapids Community School Dist. v. Garret F. (1999) 526 U.S. 66, 79 [school district must pay for
required services].) A school ’ s obligations to a particular diabetic student are normally set out in
a “Section 504 plan” or an “individualized education program” (IEP).
Approximately one in 400 school-age children nationwide has diabetes, including about
14,000 in California. The goal of diabetes management for children is to avoid both
hyperglycemia (high blood glucose) and hypoglycemia (low blood glucose) by tightly
maintaining blood glucose levels within target ranges determined by their physicians, through
frequent monitoring and multiple daily insulin injections. (DHHS Guide, p. 15.) Accordingly,
diabetic students who depend on insulin injections typically need them during the schoolday,
both at regularly scheduled times and unpredictably to correct for fluctuations in blood glucose.
The need for insulin can arise anytime and anywhere — in the classroom, on field trips or during
school-sponsored activities. To serve this and other student health needs, California has about
2,800 school nurses, averaging one for every 2,200 of the state ’ s approximately 6 million public
school students. While 5 percent of schools have a full-time school nurse, 69 percent have only a
part-time nurse, and 26 percent have no nurse at all. Although some schools allow unlicensed
school personnel to administer insulin, others do not. Some of those that do not appear to have
taken the position, possibly in reliance on 2005 and 2006 advisory statements by the Department
(see post, at p. 21 et seq.), that the Nursing Practice Act (Bus. & Prof. Code, § 2700 et seq.)
permits only licensed health care providers to administer insulin in schools. Moreover, some
nurses have refused to train unlicensed school personnel to administer insulin out of concern for
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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