APPENDIX A
Raynor Country Day School
Policy on Diabetes Management
Raynor Country Day School is committed to complying fully with the Americans with Disabilities Act ("ADA") and any other applicable laws and regulations pertaining to children with disabilities.
Children with diabetes Type I or Type II who attend Raynor Country Day School may require assistance with diabetes management. The management regime of every child with diabetes may be different and, for this reason, it is the view of Raynor Country Day School that one Policy cannot dictate the particular protocol followed by Raynor Country Day School for all individuals. Raynor Country Day School will make an individual assessment of the special needs of each child with diabetes on a case-by-case basis and will work with families to provide reasonable accommodations to children with diabetes in accordance with applicable laws. Successful participation and accommodation of the children depends on an actively cooperative relationship and ongoing communication between the parents or guardians of the children and the school.
Parents or guardians who wish to enroll a prospective child with diabetes for school or camp should submit a complete application for the child at least one month ahead of the scheduled start date for school, camp, or other school activity or two weeks for daily events such as field trips, to permit adequate time for the staff to meet with the parents or guardians of the child to examine the individual needs of the child on a case-by-case basis and to take appropriate steps to comply with pertinent laws.
Within two weeks of the child's admission to a particular school session or program, Raynor Country Day School will send to the parents or guardians an application packet identical to that provided to all children including a copy of this Policy, a Diabetes Management Plan Form, a Physical Examination Form, and a Release. A reasonable time (i.e., twenty (20) business days) prior to the beginning of any session or program, the parents or guardians of a child with diabetes will send the Health Supervisor at Raynor Country Day School a completed Diabetes Management Plan Form, typewritten in easy to understand terms, detailing care necessary for the child's safety; a completed Physical Exam Form, and a signed general release identical to the release required of all children regardless of disability.
For current children who should require treatment for diabetes for the first time during any session, parents or guardians of these children should immediately notify Raynor Country Day School, submit the completed Management Plan Form as set forth above, and comply with the remaining aspects of this Policy with sufficient time to allow Raynor Country Day School to make good faith efforts for admission to and/or continuation of the session consistent with this Policy.
Because each child's care is different and the activity levels of each child may be different, this policy should not be construed to prevent Raynor Country Day School from working with health care professionals and the child's guardians and/or parents in an effort to expedite the child's admission or improve the child's experience.
Parents or guardians will be available at Raynor Country Day School's request to attend and participate on the first day of a session with the child and, if deemed necessary by either party, to attend a prior run through of the first day, and to continue to meet with and advise the staff working with the child about their proper diabetes care. Parents will be available by phone or have other emergency contacts (which may include the child's health care provider) available by phone each day that the child is participating in a session to answer questions from Raynor Country Day School or the child regarding the child's management of diabetes care and to approve particular actions related to proper care when necessary.
Parents or guardians will provide specific information and training about the child's diabetes and particular needs related to diabetes care to Raynor Country Day School, and will permit the child's personal health care providers to share information with Raynor Country Day Camp staff and other health care personnel when necessary to assure the child's safety and compliance with the child's Diabetes Management Plan.
Parents or guardians will promptly inform Raynor Country Day School of relevant changes in the child's health status. The parents or guardians will provide, along with instructions about proper maintenance or use of all items, all supplies and equipment necessary for the child's safe participation in all activities.
Parents or guardians will provide and properly maintain all supplies and equipment for the child's diabetes and assist with proper disposal of equipment and supplies. Parents or guardians will provide written permission to undertake the steps indicated on the child's Diabetes Management Plan and Physical Exam Form, and will provide all applicable releases in writing two weeks before a child joins any session or program at Raynor Country Day School.
Training Camp Personnel
In accordance with applicable law, including those regulations enforced by the applicable Department of Public Health, if a child with diabetes applies for any session or program, Raynor Country Day School will arrange for either the Health Supervisor (or a certified diabetic educator) to provide basic training to the appropriate personnel at Raynor Country Day School. That basic training will include a general overview of diabetes and typical health care needs of individuals with disabilities, recognition of common symptoms of hypoglycemia and hyperglycemia, and ways to get help quickly. The person assigned to do the training will also provide assistance and respond to inquiries from parents about any matter or concern related to the care or treatment for a child with diabetes.
Any staff who are working directly with children with diabetes will have received training that enables Raynor Country Day School to provide all care required to comply with applicable law. Such training includes (but may not be limited to) an overview of diabetes, general information on how to recognize signs and symptoms of hypoglycemia and hyperglycemia, diabetic care practices related to glucose monitoring and regulating glucagon and insulin administration, including by insulin pump. In addition, depending on the unique needs of the child, training may include information about dietary requirements for diabetics in general and particular information about dietary requirements for particular children, and training and guidance from parents or guardians of children about any reasonable accommodations needed by a child as identified in each child's Diabetes Management Plan (which is to be provided by the parent or guardian to Raynor Country Day School at least twenty (20) business days prior to any session) and related documents. Parents or guardians must provide information and training necessary for staff to be trained with regard to any unique needs of their child.
Monitoring Blood Sugar Levels
Parents or guardians will check the child's blood sugar levels each morning before the child arrives at Raynor Country Day School to ensure they are within the established "target range" in the child's diabetes Medical Management Plan. Parents or guardians agree to be available to be contacted as deemed necessary to provide information, assistance, or guidance so that Raynor Country Day School satisfies each child's Diabetes Management Plan. If the child self-identifies, or camp staff recognizes symptoms of hyperglycemia or hypoglycemia, the staff will assist the child to check blood sugar and treat the symptoms. Raynor Country Day School will assess the level of assistance or supervision that is reasonable depending on the individual needs of the child in the particular situation and provide whatever assistance is appropriate in the situation consistent with the Plan and applicable law.
Further, parents or guardians will furnish all appropriate meals and snacks for the child, and will ensure that the carbohydrate content falls within the proper amounts set forth in the Diabetes Management Plan so that the totals will be predetermined and calculated by the parents. Carbohydrate values will be calculated and provided on labels on each food item provided by the parents so that the staff may monitor the appropriate use of insulin and insulin pumps or other equipment to administer insulin.
At the onset of any symptom of hyperglycemia or hypoglycemia, the child will notify the staff that the child needs to have a glucose test. Should the staff or nurse notice any symptom(s) of hyperglycemia or hypoglycemia, the staff or nurse will take steps reasonably consistent with the Diabetes Management Plan.
Insulin and Insulin Pumps
Children with diabetes are responsible for arriving at Raynor Country Day School with all necessary supplies. Children may carry their own medical supplies and snacks in a safe fashion that meets local code or safety standards for the care and disposal of medical supplies so that these supplies are in close proximity to the child. To that end, children with insulin pumps are expected to come to Raynor Country Day School with a fully functional pump, back-up insulin and syringes, and glucose tablets for low sugar episodes, and any other equipment necessary for that child. When the child cannot hold these supplies, the supplies will be held at the administrative office, health office or by a staff member.
Nothing in this process shall prevent Raynor Country Day School from exercising its discretion for the benefit of the child. This policy is not intended to provide fixed rules for dealing with all care involving diabetes; however, the policy sets a minimum standard for ADA compliance. This policy is not intended to serve as a contract with any individual child. The policy may be modified and/or updated at any time following prior approval by the Department of Justice during the pendency of the Agreement in the case identified below 1, but may be changed without prior notice by a written statement to individual children. Absent written notice from Raynor Country Day School, no representative of Raynor Country Day School, other than the School Administrator, is authorized to make written or oral representations regarding the statements contained in this Policy. Should you have any questions, the School Administrator or Health Supervisor will be happy to answer your questions or help you get the information you need.
1Settlement Agreement Between the United States of America and Raynor Country Day School, Speonk, New York, D.J. Nos. 202-52-123 & 202-52-124, 2008.