NYT Article: "Many Schools Failing on Type 1 Diabetes Care"

Original article from The New York Times here.
AUTHOR: Catherine Saint Louis @Catherine6

With twin boys ready for school, Jason and Jessica Pollard braced for paperwork, parent-teacher meetings and shopping trips for supplies. But they were not prepared for the reception their son, Owen, then 5, received from school administrators.

Officials at their neighborhood kindergarten and a nearby private academy said he would not be allowed to attend because he has Type 1 diabetes. The Pollards, doctors in Seattle, were flabbergasted.

One headmaster said that Owen would never be accepted because of his disability. “It took everything in me not give him the middle finger,” said Dr. Jessica Pollard, a pediatric oncologist.

The Pollards are hardly the first family to face this kind of discrimination. Too many schools are failing to provide the growing number of students who have Type 1 diabetes with the routine care they need, such as insulin shots or blood sugar monitoring, federal regulators and diabetes experts say. And often, parents do not know they have the legal right to insist on it.

Please refer to The New York Times for the full article.


@Lorraine, I am surprised that in 2015 many schools discriminate against students with diabetes. I can understand school staff being initially afraid if taking on the diabetes care training and then worrying about personal liability if something goes wrong. But the article cites that school personnel are legally protected “As long as they are acting in good faith.”

I’m not the parent of a T1D but I’ve read from many parents like yourself that have successfully negotiated school accommodation for student with diabetes with 504 plans and such. This article seems to paint a bleaker picture than the aggregate of comments I’ve read here.

Lorraine, is your experience aligned with this NYT article? Is it really as bad as the article portrays?

There is a terrible disconnect between the law and those who implement the law.

Let me explanation based on a situation i faced. As the article states we have laws that require basic care for students. Likewise, we have teachers who often teach under contracts and are showing their basic aggravation with pay, and recognition issues.

Finally, we have schools who are required to educate children and also require costs as much as possible. Now let’s mix this up.

The students need care, almost everyone acknowledges that. The teachers often say hey, we are not medical professionals, we will not give injections or take blood, after all our classrooms are busy enough.

Schools have a legal oblicaiton to provide care, teaching contracts and state law that says you cannot force a teacher do this and no money to employ others to do it.

It is a terrible mess.

The two solutions are given schools money to employ these personnel and or require teachers to do it. Both actions are unpopular. There is no free lunch and this will not be free either. As support stuff increase, class sizes up. If teachers do accept the larger lass sizes, then school systems are not required to higher school nurses.

The best result would be to increase category spending to hit school nurses. IT is the only way it will work out.


i am type 1 and a teacher. being type 1 i think i would feel totally comfortable liaising with a t1´s parents and helping out with care-injections and bg testing and low treating. But this is only because i am t1. if someone had asked me pre type1 life, i would be hesitant to take on such responsibility. i always think of how lucky i am to be the t1 and not a caregiver to a child with t1!

and yes, they say you wouldnt be liable, but in a place like the US, i wouldnt believe that my life wouldnt be ruined if something happened to a t1 student who i volunteered to help.


@Terry4 - I am glad you asked these questions. Yes, my experience is aligned with this article and yes, it is as bad as the article portrays.

I know of many, many families who work with amazing school nurses and administration and these students are kept safe by caring people who understand and own the specific and detailed care plan of a student with type 1 diabetes. However, for as many of these success stories, I hear of as many stories of people getting resistance, being told school personnel cannot fulfill their medical requirements, and other, more egregious forms of discrimination.

Over the ten school years with which we have coordinated care at school, I could categorize our experiences in three groups: 1) amazing, knowledgable care, 2) outdated, inadequate and ineffective care, and 3) outright incompetence combined with hostility and blatant discrimination.

Caleb started at a preschool which was part of a parochial school which was assigned a public school district nurse. The nurse was not responsible for the preschool, however, Caleb’s diabetes was cared for as if she was. This care was more traditional - requiring him to leave the classroom for any care needs - but it was attentive and adequate.

In kindergarten I was greeted with a school nurse who literally looked up to the sky, slumped her shoulders and sighed saying, “I thought I was getting rid of that this year,” when I told her my son with diabetes was enrolled in her school. She begrudgingly agreed to Caleb’s care plan, but her execution demonstrated a lack of understanding of how to care for a student who uses an insulin pump. Her knowledge was outdated and Caleb was put at risk. He was denied a school snack that all other students were allowed rather than given a bolus for it. He was nearly put on a school bus with a blood sugar of 54 and insulin on board. These are just a couple of examples. After months of trying to educate, this nurse retired in the middle of a meeting with myself and administration. In this scenario, we did have the support of administration; we had difficulty with training.

We were then blessed with an amazing nurse who embraced Caleb’s care needs and met them. She worked with us to implement a plan over the course of three years that allowed for Caleb’s increasing autonomy in care. She found opportunities and made suggestions to help him help himself. She went to Caleb’s classroom when he needed assistance so he would not miss instruction by going to the health office repeatedly throughout the day. I’m happy to say there are many other stories like this one, and this one should indeed be the norm.

When Caleb left that school, we were presented with a new administration and nurse who were immediately on the defensive. Although initially agreeing to all requested accommodations, the stipulations of Caleb’s 504 plan were not followed. Caleb was left to care for himself and the nurse served as an information gatherer only. This resulted in emergency intervention on my part several times. I attempted to work with and educate the school nurse. I was hung up on, ignored and told I was overprotective and unreasonable. I was met with increasing levels of hostility as I tried to work with the principal, the school psychologist, the nursing director and the assistant superintendent. I naively believed during this period that this was all a misunderstanding and continued to hold out my hand to try and work with people to help them understand Caleb’s specific needs. When I was presented with a letter by the superintendent stating that a full review of Caleb’s care was complete and found to be appropriate and I was determined to be overreactive and abusive to the staff, I retained legal counsel. It was expensive, time-consuming and emotionally draining. All this time, I did not travel more than 15 minutes from my home and ensured that I always had cell service. Caleb was allowed the ability to call me from his classroom and his care was 100% given by me through that communication. We had no support from the people assigned to care for him. Although his teacher was very supportive of us and understood and was compassionate about the difficulties we were experiencing, she was not qualified nor responsible for his medical care.

With legal counsel, we were finally given some attention. We filed a claim with the Office of Civil Rights and the nurse was removed from Caleb’s school for her refusal to care for him. This was after seven months - most of the school year. This was an agonizing hell that I wish no one ever had to endure. Unfortunately, this is only an example of what people go through, and there are stories that are worse.

We are still presented with situations for field trips and after school activities where we receive a hint of push back regarding providing care for Caleb. The initial reaction is something like, “well we’ve never done that before.” However, since having retained counsel, we have never been denied proper care for Caleb. At his current age, our requirements are fairly minimal. For example, for after school activities, we just need to know that there is someone who is qualified in glucagon training available for him should he need it. He otherwise has access to me if he needs help with a dosing decision.

I find that people more often than not do not know their rights. 504 plans are discouraged - “it’s not necessary.” Parents don’t know better, and they believe they aren’t necessary and their children are left unprotected.

This article brings much needed attention to this real issue of discrimination. Families need to know their rights and understand what they can do to ensure they are met. Often the discrimination does not come from ill intentions, but a lack of understanding. It can be hard to get people to change their way of thinking. But to keep our kids safe, we as parents need to advocate and educate for our children’s needs, no matter how challenging that may be.

The American Diabetes Association’s Safe at School Campaign is the place to start for people who need help.


I’m Type 2 on insulin and a teacher, plus former Scoutmaster, Cubmaster and soccer coach. I can understand the concern of potential liability; however, that liability risk is there in your everyday job as well. The “protection” comes in the “training” you get prior, and acting within that training. Believe me, my heart skipped a beat when two 12-yr-old scouts started to run off a trail toward a tree perched on the edge of a cliff for a better view of a scenic canyon. I stopped them (that same tree toppled into the canyon the following week, killing the hiker that thought it was a good place for pictures!).
I was never approached to volunteer to help any CWD over the years; the two students I encountered with Type 1 were when I was teaching in high school, and thus, were self-managing. I don’t think I would have jumped at the opportunity; however, I would certainly have offered to help in the event that no one else had, so that the student would not be (illegally) turned away.

1 Like

Is it really fair to force someone to inject a child with insulin? The hazards of screwing up the dose are pretty bad (especially if you don’t fully understand it). The schools ask for volunteers to do it, when no one volunteers what are we supposed to do? How would you feel if you sent a kindergartner to the hospital, or worse? Perhaps it isn’t always a situation where legal liability is an issue, but people’s own ignorant based morals. It’s just a situation that sucks, it really does. When I started school, my mom had to come in twice a day to check my blood and give me insulin since there wasn’t a nurse there 5 days a week. Then I learned how to do it myself. Welcome to all the “other” things about diabetes.

I don’t feel that it’s discrimination in all cases of this article. If there is no one in the school who will willingly do it, and the school cannot afford a full time nurse, are we suggesting that we make someone inject a child? How about we talk about an economy and culture that requires both parents to work? Or an economy that doesn’t allow there to be a nurse at a school at all times? I think there areway bigger issues (for another time) that are fueling these problems.


Of course, there are a lot of bigger issues, but at the end of the day, it is the school’s legal responsibility to figure it out - cost of doing business. My kids went to a school that did not have a full-time nurse, but found money for a surplus of administrators. The lack of a nurse finally nearly cost one child his life, so a nurse was hired. Sorry, but the safety and the rights of every child have to come first, even in an economy that makes it difficult.


Schools, I thought, had to have the interest of the student body as a whole in mind, not a few children with diabetes. What happens when they start cutting programs to take care of a couple students? Furthermore, in a perfect world, every school funds things they shouldn’t and can move money around. That’s not the case. The only administration in my elementary school was the secretary. We didn’t have a principal, the 2nd grade teacher was the head teacher. We had 1 nurse that travelled around to all the district’s elementary schools and the middle school. But, as I said, the bigger issues are for another time, and just suggesting that the schools must figure it out without suggesting that the parent’s try to do the same doesn’t make sense to me.

1 Like

No one should be forced to do anything. All students in the United States are entitled to a free appropriate public education under section 504. Disabilities of all kids must be provided reasonable accommodations. In the case of diabetes, this can translate to different things. But at the core, accommodations must exist so that all children are kept safe. That is the responsibility of the school, not the parent.

For a child with diabetes that means that they have access to someone who is trained in their care. Who that is, is determined by the administration of the school, not the parent. No one should be forced; a capable person should be determined and properly trained.

Schools are required to provide every child an education that is safe. It’s not a matter of the majority, it’s a matter of each student’s needs being accommodated so that they are afforded the same opportunity to education as any other child regardless of their disability. There are lots of school systems who share nurses like you’ve described, and accommodations have been made to ensure that students with diabetes always have access to someone trained in their care. Sometimes it takes creativity, but it’s managed and the safety of all children, including those with diabetes, is maintained.


@Lorraine, thank you for providing a descriptive and balanced account of what it’s like to parent a child with diabetes safely through a school. You have raised my awareness of this important issue. I didn’t realize how bad it can sometimes be. It raises my hackles like the inappropriate and inadequate care sometimes given to people with diabetes at hospitals.

I admire your pluck in engaging the services of a lawyer to continue your advocacy when forced. The United States was founded on the principle of majority rule while still providing robust protection of individual rights. The first ten amendments to our constitution, celebrated as the Bill of Rights, specifically enumerate personal rights that even the majority cannot violate.

Thank you for opening my eyes.


I think there is a big difference between public school and a small business. Your using a 4 year old child to state your case and his parents certainly have the resources to absolutely find the perfect daycare (you can call it a academy or school if you like ;-). I know someone who has been assisting one child through the public school system here (going on 6 years now ) this state has a law called no child left behind and that’s for any reason.

A business is only required to make a reasonable accommodation and I suspect it would be a burden for a daycare center to hire a Nurse for one customer unless that customer was willing to pick up the added expense. People even pay extra for children that are not potty trained and some schools will not take a child that’s not. This case sounds like it was really about the money…JMHO

I’m a business owner and there is no way I would inject someone with insulin or any other substance and I’m sure my liability insurance would never ever agree to it…Note: I think a public school system can probably handle this kind of liability much better…

Actually, the article is written by a New York Times reporter. None of the examples are mine.

If you are referring to the 4 year old mentioned in the Head Start program, I believe such programs receive federal funding, and as such, would be subject to the protections of Section 504. My experience and knowledge is based in elementary education and above, so I cannot speak more definitely about preschool education or daycare. However, the ADA has a very helpful page on this subject and speaks to situations where an undue financial burden, like you mention, can be evidenced.


You’re a peach for reading through my lengthy reply. I deeply appreciate your reply and support.

1 Like

What an interesting and upsetting path you have had with regard to the schools! Shocking that your informed advocacy would be interpreted as abusive! No wonder you retained legal counsel. Our path with my son over the past nine years was fairly smooth, despite the fact that school nursing coverage is appalling in the state of Michigan. We are last in the nation when it comes to student to nurse ratios. Many districts (not schools!) have NO nurse. Our district has 1 nurse for 10,000+ students. Despite this, the secretaries – and in some cases, the principals – have received training and have been wonderful in each building. I admit that I did not not realize that the staff needed to provide for extracurricular activities until fairly recently. My son’s after school activities haven’t been school related for the most part.

We all need to advocate for better nursing coverage, and ultimately, hold schools accountable to the law. Wow, is our work cut out for us as advocates when so many families and schools are unaware of what is required under the Section 504 of the Rehabilitation Act and the Americans With Disabilities Act. Thanks for sharing your story. I’m grateful that the NYT took on this important topic!

Hi John
I’m the New York Times reporter who wrote the original story. Marissa, the 4 year old you’re referring to, was at a federally funded Head Start program, so the program was obligated to find a way to help her with blood checks and insulin. As for her parents, her mother was dying of cancer at the time of her child’s diagnosis. So the grandmother was trying to find a way for her granddaughter to be able to go to school, despite her new diagnosis. Your assessment that the case was about the money was wrong. Read more about the case here if you’d like: http://popperyatvin.com/blog/2015/06/16/marissas-story/


Hi MissMargie:
I am the reporter who wrote the New York Times story. You raise a great point. That non-nurses cannot be forced to help a Type 1 diabetic student. In fact, that’s what happened to the Pollards. The private school said no teachers was willing to get trained or help him. The Justice Department said in other cases where a volunteer never emerged, the school had to get a nurse. So had Owen stayed at UCDS they would have had to get a nurse.
Catherine Saint Louis


@Catherine6, I thank you and the New York Times for covering this story. This story represents another facet of the social ignorance and fear of diabetes that those of us forced to live with this disease face. Your article did a good job of illuminating the discrimination in present day society that even I as an adult living long term with diabetes was not aware.

We face similar ignorance when we’re admitted to the hospital. You’d think that the medical profession would be the last place you’d find ignorance of the medical facts of diabetes but it’s certainly out there and it fundamentally threatens our welfare. Some hospitals, as a matter of policy, strip us of all our diabetes devices (pumps, continuous glucose monitors, meters, syringes and insulin) when we’re admitted despite our otherwise cognitive and physical abilities to continue our personal treatment.

Kudos to you for an excellent piece!


Thanks for weighing in @Catherine6 and also for the link to that other article, which is published by the pro-bono law firm that assisted the girl and her family in the case. In the article, it actually says this:

There was only a part time nurse at the public elementary school building that housed Marissa’s Head Start pre-K, and Pennsylvania law does not allow teachers and staff to volunteer and be trained to inject insulin.

I’m not sure it has a huge bearing on the ultimate thrust of your article, but it seems an added point for the discussion here. Not being able to find a staff person who is willing is understandable, but having a law that eliminates the option is quite something else. That really seems outrageous, and certainly makes it much harder for parents of CWD to find options, especially given how much budget-squeezing public schools are forced to contend with. I’d be curious to know what the actual logic was behind that restriction–e.g., whether it was something teachers or the union wanted in order to prevent them being pressured into doing something they are (not unreasonably) uncomfortable with.


I address the fact the only 29 states permit non nurses to inject insulin and glucagon. That means by default 21 don’t, including PA. That’s long been the case. The American Diabetes Association and others have fought to get states to enact laws to allow non nurses to help in schools. California was the biggest such fight. http://dredf.org/2013-documents/California-School-Diabetes-Lawsuit-Parent-Q-A-Sept-13.pdf The idea behind that restriction is nurses including the American Nurses Association argued that only nurses could help, and that to let non-nurses to help in school would lower the standard of care. They want - and still want - schools to just hire more nurses.