_ 3. Student’s Level Of Self-Care And Location Of Supplies And Equipment The following school staff members will be trained to become TDPs by _(date): Trained Diabetes Personnel (TDP): Non-medical school personnel who have been identified by the school nurse, school administrator, and parent who are willing to be trained in basic diabetes knowledge and have received training coordinated by the school nurse in diabetes care, including the performance of blood glucose monitoring, insulin and glucagon administration, recognition and treatment of hypoglycemia and hyperglycemia, and performance of ketone checks, and who will perform these diabetes care tasks in the absence of a school nurse.ġ.1 At least _ staff members will receive training to be Trained Diabetes Personnel (TDP), and either a school nurse or TDP will be available at the site where the student is at all times during school hours, during extracurricular activities, and on school sponsored field trips to provide diabetes care in accordance with this Plan and as directed in the DMMP, including performing or overseeing administration of insulin or other diabetes medications (which, for pump users includes programming and troubleshooting the student’s insulin pump), blood glucose monitoring, ketone checks, and responding to hyperglycemia and hypoglycemia including administering glucagon.ġ.2 Any staff member who is not a TDP and who has primary care for the student at any time during school hours, extracurricular activities, or during field trips shall receive training that will include a general overview of diabetes and typical health care needs of a student with diabetes, recognition of high and low blood glucose levels, and how and when to immediately contact either a school nurse or a TDP.ġ.3 Any bus driver who transports the student must be informed of symptoms of high or low blood glucose levels and provided with a copy the student’s Quick Reference Emergency Plan and be prepared to act in accordance with that Plan.Quick Reference Emergency Plan: plan that provides school personnel with essential information on how to recognize and treat hypoglycemia and hyperglycemia. Schools must do outreach to the parents and child’s health care provider if a DMMP is not submitted by the family This plan is developed and approved by the student’s personal health care team and family. Diabetes Medical Management Plan (DMMP): A plan that describes the diabetes care regimen and identifies the health care needs of a student with diabetes.School accommodations, diabetes care, and other services set out by this Plan will be consistent with the information and protocols contained in the National Diabetes Education Program Helping the Student with Diabetes Succeed: A Guide for School Personnel, June 2010. The goal of this plan is to provide the special education and/or related aids and services needed to maintain blood glucose within this student’s target range, and to respond appropriately to levels outside of this range in accordance with the instructions provided by the student’s personal health care team. Homeroom Teacher: _ Bus Number: _ Objectives/Goals Of This Planĭiabetes can cause blood glucose (sugar) levels to be too high or too low, both of which affect the student’s ability to learn as well as seriously endangering the student’s health both immediately and in the long term. Student’s Name Birth Date Grade Disability Some students will need additional services and accommodations that have not been included in this model plan.] The plan should be individualized to meet the needs, abilities, and medical condition of each student and should include only those items in the model that are relevant to that student. Model 504 Plan For A Student With Diabetes [Note: This model 504 Plan lists a broad range of services and accommodations that mightīe needed by a child with diabetes in school. This sample Section 504 Plan was developed by the American Diabetes Association (ADA) and the Disability Rights Education and Defense Fund, Inc. California Sterilization Compensation Program.
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