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Parents sue over state directive to school nurses on insulin dosing

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A group of parents has filed a complaint claiming the state departments of Public Health and Education violated the Americans with Disabilities Act by instructing school nurses that they are prohibited from taking input from parents and guardians on insulin doses for students. 

Jonathan R. Chappell, of Wallingford, the attorney who filed the complaint with the U.S. Attorney’s Office in New Haven, said a federal prosecutor instructed officials in New York in January 2017 to relent on a similar order. 

Chappell, with Feldman, Perlstein & Greene in Farmington, said the prohibition prevents parents or guardians of children with Type I diabetes from being able to advise school nurses when they think a child may need to temporarily alter their prescribed dose of insulin. 

“The issue of making parental input and making somewhat minor adjustments to the administration of insulin is very important and it’s, I think, a public safety issue,” he said Thursday. 

Chappell, himself a diabetic, estimated that he had parents or guardians for 20 to 25 students participating in his complaint, but he is still recruiting more complainants. 

He said he’s heard from families from all over the state, including a group he met with at the Wallingford Public Library.  

Officials with the departments of Public Health and Education couldn’t be reached for comment Thursday afternoon. 

The complaint, filed Oct. 29., says the DOE and DOH began informing school nurses prior to the beginning of the current school year that they can longer consider input from parents or guardians when changing doses of medication. 

Some parents involved with the lawsuit received responses, via email, from the two state agencies indicating the policy shift was based on a 2015 law that a registered nurse can only take direction from a licensed physician, advanced practical registered nurse, or physician’s assistant, according to the lawsuit. 

Chappell said the state should make an exception for diabetes because it qualifies as a disability under the ADA, which requires that reasonable accommodations be made. 

He also said that insulin doses sometimes need to be altered to help those with diabetes regulate their blood sugar levels. 

Chappell said doctors will even sometimes state in documents to school officials that parents or guardians can advise when modifications are needed, but set limits on how much. 

“We certainly don’t want kids spending the school day in the school nurse’s office pinballing between high and low blood sugar if we can avoid it,” he said. 

The lawsuit also states that hyperglycemia, or high blood sugar, can lead to blurred vision, fatigue, or even diabetic ketoacidosis, a life-threatening condition. “Poorly managed diabetes” can also damage blood vessels, eyes, kidney, gums, and teeth. 

Blood sugar levels can fluctuate for a variety of reasons, including food intake, physical activity, medications, physical growth, physical or emotional stress, injury, and illness.

Chappell expressed optimism about his case, pointing out that Preet Bharara, then U.S. attorney for the Southern District of New York, wrote a letter of finding in January 2017 that New York officials were wrong to issue a similar directive. 

New York officials agreed to amend their directive and allowed parents or guardians to temporarily adjust dosages for their children. 

Chappell is hoping for a similar outcome in Connecticut, and said that filing complaint with the U.S. Attorney’s Office’s Civil Division can get to the outcome faster than a federal lawsuit.



Twitter: @reporter_savino

Fight for parental control of insulin treatments in school

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