Article in The Wall Street Journal Online
In the weeks after Andi Smith's 13-month-old son, William, was diagnosed with Type 1 diabetes, the mother of two was dealt another blow: Her day-care providers refused to treat his condition. So for six months, Ms. Smith, a veterinary assistant, dashed out on her lunch break to give her son his insulin shot."I broke down and I thought, 'I can't keep doing this,' " Ms. Smith said.
Calling every day care she could find within a 20-minute radius of her Thornton, Colo., home, the only answer the 33-year-old received was no.
"No, we can't even do testing. No, we don't do shots," said Ms. Smith. "You really feel slapped in the face, when you tell them it is illegal and they say they don't care. Talk about feeling like your kid is a leper."
Under the Americans With Disabilities Act, children with diabetes cannot be excluded from public and private day-care centers based on their condition. In 1996, the Justice Department reached a settlement with the nation's biggest day-care chain—KinderCare Learning Centers—in which the provider agreed to care for children with diabetes.
In practice, however, parents of diabetic toddlers are excluded regularly, parents and advocates say. Many centers cite state and local laws that require certification for administering medicine like insulin as a reason. Small home-based child-care operations with limited staff and resources argue that taking care of diabetics would disrupt their programs and interfere with the other children.
I find this topic really interesting for a variety of reasons. Back when I was growing up, D management was less intensive (I think, anyway) and most schools had actual nurses on staff. These two things combined meant that most issues could be readily handled. There also weren't cell phones, so if school couldn't reach my mom, they had to handle the situation.
But now, with pumps and CGMs and carb counting, management is more intensive (for the better, of course, because this has resulted in T1s have fewer complications), BUT this means that more of a burden is placed on school staff. Couple this with the fact that many schools no longer have an on-site nurse, and you can see how things can quickly become problematic. Day care centers have even fewer resources and trained staff.
I think there is an answer, though. And there needs to be one. Many children with very severe health conditions qualify for certain state and federally-funded programs (generally through Medicaid) that can provide trained staffing support in the community. While a child with diabetes would not require such intensive staffing, why can't there be some sort of model that provides community-based medical care to children with chronic health conditions, such as type 1 diabetes, that require some degree of monitoring and administration of medication? Realistically, one such trained staff person could handle several children within a single center, supervising the care they receive, administering insulin, etc. I am sure there are some states that provide such care in day care centers, but it's clearly not widespread.
I am curious to hear how other parents have handled situations within day care centers or camps where their child was maybe the only one with T1D.