Provincial Policies for Students with Diabetes at School

(Canada)

Education is the responsibility not of the federal, but of the provincial governments in Canada. As a result, policies and procedures to protect the safety, long term health, education and rights of students with diabetes vary widely from province to province.

The Canadian Pediatric Society’s 2016 status report Are We Doing Enough? evaluates public policies affecting children and youth in Canada. In the section on Management of Type 1 Diabetes in School, they assessed all 13 provinces and territories on how they support students with managing T1D at school, from Poor to Fair to Good. (No one earned an Excellent rating.)

Diabetes@School, a website by the the Canadian Paediatric Society in partnership with the Canadian Paediatric Endocrine Group and Diabetes Canada, provides information on the provinces that received Fair or Good ratings, indicating that they have at least some policies or guidelines in place for students with type 1 diabetes…

Canadian Provinces with Existing Policies

Currently, seven provinces have policies or guidelines that specifically address type 1 diabetes in the school setting.1

  • British Columbia: Provincial Standards: Supporting Students with Type 1 Diabetes in the School Setting (2015)
  • New Brunswick: A Handbook for Type 1 Diabetes Management in Schools (2008)
  • Newfoundland and Labrador: Guidelines for Diabetes Management in Schools (2014)
  • Nova Scotia: Guidelines for Supporting Students with Type 1 Diabetes (and Other Diabetes Requiring Insulin) in Schools(2010)
  • Ontario: Supporting Children and Students with Prevalent Medical Conditions (Anaphylaxis, Asthma, Diabetes, and/or Epilepsy) in Schools (2017)
  • Quebec: School intervention protocol for students with type 1 diabetes (2012)
  • Prince Edward Island: Guidelines for Diabetes Management in Schools (2018)

For links to the above provincial policies, check out Diabetes@School’s Provincial Policies on Diabetes at School.

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What about Alberta?

There are currently no universal policies with regards to students living with diabetes in Alberta, and few local school district policies to address the needs of children and teens with diabetes while at school. Where policies exist, they often cover a range of Significant Health Concerns (allergies, anaphylaxis, epilepsy, and diabetes) and/or focus on administration of medication or emergency procedures. Specifically, Alberta Education has rightly developed emergency procedures for allergies and anaphylaxis, but does not address emergency procedures for diabetes. The tasks required for daily diabetes care (including but not limited to blood glucose checks, recognizing and treating low and high blood glucose, insulin injection, insulin pump use, carb consumption) and the tasks involved in emergency situations (ex. use of glucagon) become the sole responsibility of students and their parents/caregivers.

For more information on existing policies within the CBE: CBE Administrative Regulation No. 6002, Significant Health Concerns (March, 2014)

Teachers in Alberta have access to the following Alberta Education resource: Learn Alberta Medical/Disability Info for Classroom Teachers – Type 1 Diabetes

As a result of the lack of an Alberta-wide, mandated policy specific to diabetes, parents must work directly (and kids are best off if we work effectively) with their child’s school in developing a Care Plan, including daily diabetes tasks, insulin administration, recognizing and treating highs and lows, and emergency procedures. Each school under the Calgary Board of Education (CBE), in consultation with the parents, makes the appropriate arrangements for students with diabetes based on the student’s age/grade, learning strengths and needs. At the beginning of each school year, parents complete and sign a medical needs form which must be approved by the principal. Students with diabetes may or may not receive a medical education code (Physical or Medical Disability, 58), may or may not have an Individual Program Plan (IPP), may or may not have the support of a classroom aide, may or may receive physical assistance with or supervision of diabetes care tasks. These decisions are made by the principal, with input from the student’s parents/guardians (and the student himself, when appropriate).

Resources for Parents to Work with School Staff

The following resources provide guidance to parents on how to work effectively with school staff in developing and implementing a Care Plan, getting school staff up-to-speed on diabetes: what it is and how best to keep your child safe and protect their long term health while at school.

Other Waltzing the Dragon pages:
Diabetes at School: Overview
Roles and Responsibilities for School Care of Diabetes
Training School Staff to Support a Student with Diabetes Writing a Diabetes Care Plan
Implementing a Diabetes Care Plan

Alberta Children’s Hospital Diabetes Clinic: Back to School Tips: Your Child Has Diabetes

Student Care Plan (ACH Diabetes Clinic)   – Injections

Student Care Plan (DiabetesAtSchool.ca) – Injections or Pumps

Videos to watch with or share with school staff: DiabetesAtSchool.ca Video Series

A Letter for School Staff from the Alberta Children’s Hospital Diabetes Clinic

Diabetes Canada (DC) Guidelines for the Care of Students Living with Diabetes at School   

International Diabetes Federation (IDF) Kids and Diabetes in Schools: Info Pack for Teachers, Parents, and Students

Who else is working for change?

The Sir Frederick Banting Legacy Foundation has also released a report on In-School Support for Students Living with Diabetes: Status and Recommendations (Canada) including comparisons with Australia, United Kingdom, United States (September, 2018), which provides more detail on how students are supported, province by province, across Canada. They constructed the report by contacting each province and territory at the Cabinet level to collect information on the scope of diabetes care at school (number of students, number of schools, how many schools had adopted provincial policies or guidelines), the existence of current policies and guidelines (or plans to develop the same) in each province.

They summarized the essential findings, including:

  • In-school support programs are essential
  • Standards are Essential
  • School Level Programs Bring Added Benefits
  • Creating a standard policy or guideline is an essential first step but does not guarantee action.
  • Reasons for the relatively slow pace of standard, statutory policy creation
  • Reasons why achieving universal in-school support is difficult
  • Existing Advocacy Efforts

References:

1. DiabetesAtSchool website https://www.diabetesatschool.ca/tools/policies

This material has been developed from sources that we believe are accurate, however, as the field of medicine (in particular as it applies to diabetes) is rapidly evolving, the information should not be relied upon, as it is designed for informational purposes only. It should not be used in place of medical advice, instruction and/or treatment. If you have specific questions, please consult your doctor or appropriate health care professional.

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