California Supreme Court issues landmark decision on diabetes care in school

On August 12, 2013, the California Supreme Court decided the case of Amercan Nurses Association v. Torlakson, a case litigated by the American Diabetes Association (ADA) involving diabetes care in California public schools. (link to decision)

The case came before the California Supreme Court after nearly eight years of litigation, which began with a class action lawsuit brought by the ADA that was resolved by a settlement agreement allowing trained non-medical school personnel to administer insulin when a nurse is not available.  That provision of the settlement was challenged in the current lawsuit by several nursing organizations.  The California Supreme Court agreed with the ADA’s position that state law allows school personnel, who are not nurses, to volunteer and be trained to help children with the insulin they need to survive and thrive at school.

As Chair of Legal Advocacy for the ADA for the past three years, and a member of the Legal Advocacy Subcommittee since 2004, Alan Yatvin has been involved in the decision making and strategy of the litigation.  Following the issuance of the decision, Alan was interviewed by the Wall Street Journal:

California Court Rules Unlicensed School Staff Can Give Insulin

Decision Has Potential to Serve as a National Precedent

By JIM CARLTON

SAN FRANCISCO—The California Supreme Court ruled Monday that school staff without health-care licenses can administer insulin and other prescription drugs to students, overturning lower-court decisions in a case that has the potential to serve as a national precedent.

The ruling, which comes as many other states grapple with the issue amid a reduction in campus nurses, is a setback for the American Nurses Association. The group has waged a six-year legal battle against the California Department of Education over its 2007 legal advisory allowing teachers and other untrained school employees to administer insulin. The nurses claimed only they or other licensed professionals were qualified to do so in the absence of a parent or legal guardian at the school.

The legal advisory was issued in a settlement the state education department entered in response a 2005 federal lawsuit by parents of some diabetic students who alleged their schools failed to administer insulin when nurses weren’t available.

Some parents applauded the high court’s ruling. With just 2,800 school nurses for six million public-school students in California—including 14,000 with diabetes, according to state estimates cited by the high court—these parents said not allowing someone else to administer insulin imposed hardships.

“As a working parent, I either left my job to help my child or employed a nanny who could provide that service when my child was too young to administer his own doses,” said Laura Mecoy, mother of a now-19-year-old diabetic son in Manhattan Beach, Calif.

Officials at the American Nurses Association, a Silver Spring, Md.-based trade group which led a coalition of nursing groups in pursuing the California case, said the court’s ruling could encourage other states to follow California’s lead in not requiring training to administer the drugs.

“Our biggest concern is this is a slippery slope,” said Maureen Cones, an attorney for the nurses’ association who argued the case. “We don’t want physical therapy given by the gym teacher, for example.” Ms. Cones added her group is considering its legal options, including a possible appeal to the U.S. Supreme Court.

Tom Torlakson, state superintendent of public instruction, said in a statement: [T]he fact remains that not every student has access to a school nurse and, for some of them, that has been a very real obstacle to attending school and learning with their peers. I hope this decision removes that obstacle.”

Nationwide, 22 states allow unlicensed school personnel to administer insulin, including some—such as Arizona, Georgia, and Missouri—that began permitting it in just the past year, following a decline in campus nurses in recent years, said Alan Yatvin, chairman of the legal advocacy subcommittee for the American Diabetes Association. The group intervened to defend the state in the case.

“There never are going to be enough nurses,” Mr. Yatvin said.

(c) Wall Street Journal 2013

Learn more about the decision and its impact for school children by clicking here:

American Diabetes Association logo

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