The Care of Students with Diabetes Act: Who's Behind This?

1. The Care of Students with Diabetes Act will bring Illinois into compliance with federal law.

Federal statutes, such as Section 504 of The Rehabilitation Act of 1973, codified as 29 U.S.C. § 794, prohibit discrimination against schoolchildren with disabilities, including children with diabetes. (See also The Americans with Disabilities Act of 1990 and the ADA Amendments Act of 2008, 42 U.S.C § 12101 et seq.) The federal Individuals with Disabilities Education Improvement Act of 2004, 20 U.S.C. § 1400 et seq. requires schools to provide special education and related services to students with disabilities.

Under federal regulations, children with diabetes are entitled to aid and services related to their healthcare needs even if the diabetes does not affect their ability to learn. 34 C.F.R. § 104.37(a). In conjunction with parents, schools must develop individualized plans for students with diabetes as set forth in the implementing regulations found at 34 C.F.R. §§ 104.34-104.36 and 28 C.F.R. § 35.130(b). In the diabetes context, healthcare related aid and services that schools must provide include a means for students to check their blood sugar level and receive their needed medications during the school day. Schools do not have to provide medical services that only a physician is legally allowed to perform.

2. The Care of Students with Diabetes Act will extend to children with diabetes the type of care that is already extended to children with asthma, allergies, and other chronic diseases.

With other chronic diseases, Illinois schoolchildren can self-administer medication (such as by using an asthma inhaler or treating an allergic reaction with an epinephrine auto-injector). According to an Illinois statute, 105 ILCS 5/22-30, a school must permit “self administration of medication by a pupil with asthma or the use of an epinephrine auto-injector by a pupil.” The information about a student’s medication must be kept on file with the school nurse or, in the absence of a school nurse, the school’s administrator.

3. Other states already accord the type of protections to students with diabetes that The Care of Students with Diabetes Act would provide to Illinois students.

Sixteen states allow a student with diabetes to provide some sort of self-care to himself or herself either through diabetes specific legislation or legislation relating to chronic care (Alabama, California, Connecticut, Hawaii, Indiana, Massachusetts, Nebraska, New Jersey, Oklahoma, Rhode Island, South Carolina, Tennessee, Texas, Utah, Washington, and Wyoming.)[1] The statutes address various issues such as the location in which the self-care is performed, whether the student is permitted to self-test blood glucose levels, whether the student is permitted to administer insulin or glucagon, and what type of diabetes care equipment the student is permitted to carry or possess.

Seventeen states permit administration of insulin by non-nurses in schools (Arizona, Colorado, Georgia, Hawaii, Indiana, Iowa, Maine, Maryland, Michigan, Nebraska, North Carolina, North Dakota, Oklahoma, Oregon, Texas, Virginia, and Wisconsin).[2] The first such state law to specifically address children with diabetes was adopted in Virginia in 1999. A follow-up survey of parents of children with diabetes and schools in Virginia, “Safe at School: A Virginia Experience” 30 Diabetes Care 1396-1398 (June 2007), demonstrated that students could be cared for safely by a combination of medical and trained nonmedical personnel.

4. An effort is already made to educate teachers about other medical conditions.

Illinois law already encourages teachers and school personnel to gain a greater understanding of how to recognize and deal with health problems that might affect students including prevalent student health conditions (see 105 ILCS 5/3-11, AIDS, 105 ILCS 5/34-18.8, and suicide, 105 ILCS 5/34-18.7). Illinois also law recommendeds that teachers become proficient in life-saving techniques. Since 2005, 105 ILCS 5/3-11 has expressly authorized superintendents to devote one of a school district’s four “professional educational experience" days to First Aid training for teachers, including cardiopulmonary resuscitation or defibrillator training.

Another Illinois law, 105 ILCS 110/3, states that school boards should “encourage all teachers and other school personnel to acquire, develop, and maintain the knowledge and skills necessary to properly administer life-saving techniques.” By statute, such techniques include the Heimlich maneuver, rescue breathing, emergency first aid, and cardiopulmonary resuscitation (CPR).

Title 23 of the Illinois Administrative Code, which encompasses the State Board of Education’s adopted rules for public schools, provides that: “Each [school] district shall adopt an emergency procedure to be followed in cases of injury or sudden illness to students and/or staff.” 23 Ill. Admin. Code § 1.530(c).

Training school employees to recognize diabetes-related problems is in keeping with professional standards. The Illinois Department of Health and Human Services already recommends that the training of school employees should include instruction on diabetes monitoring, management, and emergency procedures. Illinois Department of Health and Human Services, Diabetes in Children, A Resource Guide for School Health Personnel (April 2002). Since some schools fail to follow the recommendations, however, an Illinois statute specifically addressing diabetes care is needed.

5. Other health activities are encouraged in school and day care.

Under Illinois law, coaches provide medical aid to athletes that requires skills equal to those that unlicensed people aiding children with diabetes would use. According to 105 Ill. Comp. Stat. 110/3, school personnel who coach school athletic programs and extracurricular activities should be encouraged to “acquire, develop, and maintain the knowledge and skills necessary to properly administer first aid and cardiopulmonary resuscitation.” Additionally, as stated in 210 Ill. Comp. Stat. 74/15, physical fitness facilities, which include facilities at a public or private elementary or secondary school that are used by a hundred people or more, must have at least one individual trained in the use of an automated external defibrillator (AED) on the staff of the facility and present at the facility when it is in use.

If a child is in day care, an unlicensed person can help that child and can administer medication to the child, including medication for diabetes. Illinois regulations, 89 Ill. Admin. Code § 406.14(e) and 89 Ill. Admin. Code § 408.70(c), allow a caregiver in the day care setting to administer medication to a child even if they are not licensed health care professionals. In order for the caregiver to administer medication, the child’s parent or guardian must sign a written statement stating that the caregiver is permitted to administer such medication. Nowhere in the day care regulations is there a requirement that a nurse or doctor be on site.

6. Are there protections for teachers who do not want to serve as a volunteer aide?

The Care of Students with Diabetes Act protects teachers who choose not to volunteer to be trained as a diabetes care aide. Section 40 of the Act states: “A school employee shall not be subject to any penalty, sanction, reprimand, discharge, demotion, denial of a promotion, withdrawal of benefits, or other disciplinary action for choosing not to volunteer to serve as a diabetes care aide.” In other states with similar laws, there is no evidence that teachers have been retaliated against.

7. The Care of Students with Diabetes Act does not introduce additional liabilities for the school or teachers.

Schools and teachers are responsible for students under their care. 105 ILCS 5/24-24. School districts are liable for taking a course of action that displays willful or wanton disregard for a student’s safety. Henrich v. Libertyville High Sch., 186 Ill.2d 381, 389 (1998).

By clearly identifying what a school must do to assist and accommodate a student with diabetes, The Care of Students with Diabetes Act clarifies schools’ responsibilities to help them avoid liability. The voluntary training required under the Act enables school employees to more appropriately deal with the needs of children with diabetes. In the absence of such training, teachers sometimes take actions that harm students. In Illinois and elsewhere, teachers have heard the beep of a child’s insulin pump, thought it was a pager or cell phone, and forcibly pulled the infusion set out of the child’s body. In another case, a girl’s insulin pump was confiscated by an assistant principal, leading to a $10,000 settlement and the requirement that diabetes training guides be distributed to all schools and that students with diabetes be informed of their rights.

Moreover, Section 45 of the Act provides specific protection from liability:
“(a) A school or a school employee is not liable for civil or other damages as a result of conduct, other than willful or wanton misconduct, related to the care of a student with diabetes.
(b) A school employee shall not be subject to any disciplinary proceeding resulting from an action taken in compliance with this Act, unless the action constitutes willful or wanton misconduct.”

8. Major medical groups recognize that unlicensed individuals can competently provide diabetes care.

Leading groups agree that non-medical personnel can provide aid and oversight for children with diabetes in school. Allowing unlicensed but properly trained individuals to be involved in the health management of a child with diabetes is neither a new approach nor one that exposes the district to new and unforeseen liability. The clearest example of this is the National Institutes of Health and the Centers for Disease Control and Prevention publication Helping the Student with Diabetes Succeed, A Guide for School Personnel, NIH Publication 03-5217 (June 2003), which details how unlicensed individuals can serve as diabetes care aids in the schools.

The guide states that “effective school-based diabetes management requires two things:

---All school staff members who have responsibility for a student with diabetes should receive training that provides a basic understanding of the disease and the student’s needs, how to identify medical emergencies, and which school staff members to contact with questions in case of an emergency.

---A small group of school staff should receive training from a qualified health care professional such as a physician or a nurse in student-specific routine and emergency care so that a staff member is available for younger or less-experienced students who require assistance with their diabetes management (e.g., administering insulin, checking their blood glucose, or choosing an appropriate snack) and for all students with diabetes in case of an emergency. This group may be comprised of the school nurse and other school staff who are not health care professionals.”

The above principles—which provide the foundation of The Care of Students with Diabetes Act—are endorsed by American Academy of Pediatrics, American Association for Health Education, American Association of Diabetes Educators, American Diabetes Association, American Dietetic Association, American Medical Association, Barbara Davis Center for Childhood Diabetes, Centers for Disease Control and Prevention, Indian Health Service, Juvenile Diabetes Research Foundation International, Lawson Wilkins Pediatric Endocrine Society, National Association of Elementary School Principals, National Association of School Nurses, National Association of Secondary School Principals, National Association of State Boards of Education, National Diabetes Education Program, National Education Association Health Information Network, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, and U.S. Department of Education.

9. Monitoring and treating themselves in the classroom is better for children.

A study, “Brief Report: Glycemic Control, Quality of Life and School Experiences Among Students with Diabetes,” 31 Journal of Pediatric Psychology 764-769, 767-68 (2005), found that children with fewer restrictions on self-care behaviors are better able to control their diabetes. Another study, “Children with Diabetes: Perceptions of Supports for Self Management,” 73 Journal of School Health 216-222, 220 (2003), found that a lack of flexibility not only correlates to poor maintenance of diabetes, but is also a substantial source of anxiety to the student.

These studies also indicate that self treatment is important because it allows the student to quickly and conveniently monitor glucose levels and administer treatments. The flexibility for students to self treat their diabetes in the classroom or outside of the classroom in a private setting decreases anxiety and correlates with an increase in proper diabetes management. The proper management of glucose levels significantly decreases the risk of developing diabetes related complications later in life.

10. Training lay persons to administer glucagon in an emergency is standard and potentially lifesaving practice.

A person with diabetes suffering from severe low blood sugar (hypoglycemia) needs glucagon, a hormone, to be administered, much as epinephrine is administered to a child with a severe allergic reaction (anaphylaxis). In cases of severe hypoglycemia, a person’s body begins to shut down---first the person cannot swallow, then the person cannot breathe, then the person may start seizing. This is an emergency that requires glucagon to be given immediately. It is important to call 911 but school staff cannot wait for a nurse or paramedic to arrive. Students face significant, irreparable brain damage, if not death, if they are left untreated, unconscious, and seizing for an extended amount of time. Not having a person on school grounds trained in the emergency administration of exposes the school to liability.

The glucagon injection was developed for easy and safe use by lay persons. Family members, caregivers, and friends can be trained in how to administer glucagon. Thirty-three states explicitly or implicitly permit the administration of glucagon by a non-nurse school employee (Arizona, Arkansas, California, Colorado, Delaware, Florida, Hawaii, Indiana, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska, Nevada, New York, North Carolina, North Dakota, Oklahoma, Oregon, Rhode Island, South Carolina, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming).[3]

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Relevant Federal Statutes & Regulations

Section 504 of the Rehabilitation Act, codified as 29 U.S.C. § 794

Section 794: Nondiscrimination under Federal grants and programs

(a) Promulgation of rules and regulations
No otherwise qualified individual with a disability in the United States, as defined in section 705(20) of this title, shall, solely by reason of her or his disability, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance or under any program or activity conducted by any Executive agency or by the United States Postal Service. The head of each such agency shall promulgate such regulations as may be necessary to carry out the amendments to this section made by the Rehabilitation, Comprehensive Services, and Developmental Disabilities Act of 1978. Copies of any proposed regulation shall be submitted to appropriate authorizing committees of the Congress, and such regulation may take effect no earlier than the thirtieth day after the date on which such regulation is so submitted to such committees.

(b) "Program or activity" defined For the purposes of this section, the term "program or activity" means all of the operations of -

(1)(A) a department, agency, special purpose district, or other instrumentality of a State or of a local government; or

(B) the entity of such State or local government that distributes such assistance and each such department or agency (and each other State or local government entity) to which the assistance is extended, in the case of assistance to a State or local government;

(2)(A) a college, university, or other postsecondary institution, or a public system of higher education; or

(B) a local educational agency (as defined in section 7801 of title 20), system of vocational education, or other school system;

(3)(A) an entire corporation, partnership, or other private organization, or an entire sole proprietorship -

(i) if assistance is extended to such corporation, partnership, private organization, or sole proprietorship as a whole; or

(ii) which is principally engaged in the business of providing education, health care, housing, social services, or parks and recreation; or

(B) the entire plant or other comparable, geographically separate facility to which Federal financial assistance is extended, in the case of any other corporation, partnership, private organization, or sole proprietorship; or

(4) any other entity which is established by two or more of the entities described in paragraph (1), (2), or (3); any part of which is extended Federal financial assistance.

Title II of the Americans with Disabilities Act, codified as 42 U.S.C. § 12131

§ 12131. Definitions

As used in this subchapter:

(1) Public entity. The term “public entity” means—

(A) any State or local government;

(B) any department, agency, special purpose district, or other instrumentality of a State or States or local government; and

(C) the National Railroad Passenger Corporation,
and any commuter authority (as defined in section 24102 (4) [1] of title 49).

(2) Qualified individual with a disability. The term “qualified individual with a disability” means an individual with a disability who, with or without reasonable modifications to rules, policies, or practices, the removal of architectural, communication, or transportation barriers, or the provision of auxiliary aids and services, meets the essential eligibility requirements for the receipt of services or the participation in programs or activities provided by a public entity.

§ 12132. Discrimination

Subject to the provisions of this subchapter, no qualified individual with a disability shall, by reason of such disability, be excluded from participation in or be denied the benefits of the services, programs, or activities of a public entity, or be subjected to discrimination by any such entity

Title III of the Americans with Disabilities Act, codified as 42 U.S.C. § 12181

§ 12181. Definitions

As used in this subchapter:

(1) Commerce. The term “commerce” means travel, trade, traffic, commerce, transportation, or communication—

(A) among the several States;

(B) between any foreign country or any territory or possession and any State; or

(2) Commercial facilities. The term “commercial facilities” means facilities—

(A) that are intended for nonresidential use; and

(B) whose operations will affect commerce.

Such term shall not include railroad locomotives, railroad freight cars, railroad cabooses, railroad cars described in section 12162 of this title or covered under this subchapter, railroad rights-of-way, or facilities that are covered or expressly exempted from coverage under the Fair Housing Act of 1968 [1] (42 U.S.C. 3601 et seq.).

(3) Demand responsive system. The term “demand responsive system” means any system of providing transportation of individuals by a vehicle, other than a system which is a fixed route system.

(4) Fixed route system. The term “fixed route system” means a system of providing transportation of individuals (other than by aircraft) on which a vehicle is operated along a prescribed route according to a fixed schedule.

(5) Over-the-road bus. The term “over-the-road bus” means a bus characterized by an elevated passenger deck located over a baggage compartment.

(6) Private entity. The term “private entity” means any entity other than a public entity (as defined in section 12131 (1) of this title).

(7) Public accommodation. The following private entities are considered public accommodations for purposes of this subchapter, if the operations of such entities affect commerce—

(A) an inn, hotel, motel, or other place of lodging, except for an establishment located within a building that contains not more than five rooms for rent or hire and that is actually occupied by the proprietor of such establishment as the residence of such proprietor;

(B) a restaurant, bar, or other establishment serving food or drink;

(D) an auditorium, convention center, lecture hall, or other place of public gathering;

(E) a bakery, grocery store, clothing store, hardware store, shopping center, or other sales or rental establishment;

(F) a laundromat, dry-cleaner, bank, barber shop, beauty shop, travel service, shoe repair service, funeral parlor, gas station, office of an accountant or lawyer, pharmacy, insurance office, professional office of a health care provider, hospital, or other service establishment;

(G) a terminal, depot, or other station used for specified public transportation;

(H) a museum, library, gallery, or other place of public display or collection;

(I) a park, zoo, amusement park, or other place of recreation;

(J) a nursery, elementary, secondary, undergraduate, or postgraduate private school, or other place of education;

(K) a day care center, senior citizen center, homeless shelter, food bank, adoption agency, or other social service center establishment; and

(L) a gymnasium, health spa, bowling alley, golf course, or other place of exercise or recreation.

(8) Rail and railroad. The terms “rail” and “railroad” have the meaning given the term “railroad” in section 20102 (1) [1] of title 49.

(9) Readily achievable. The term “readily achievable” means easily accomplishable and able to be carried out without much difficulty or expense. In determining whether an action is readily achievable, factors to be considered include—

(A) the nature and cost of the action needed under this chapter;

(B) the overall financial resources of the facility or facilities involved in the action; the number of persons employed at such facility; the effect on expenses and resources, or the impact otherwise of such action upon the operation of the facility;

(C) the overall financial resources of the covered entity; the overall size of the business of a covered entity with respect to the number of its employees; the number, type, and location of its facilities; and

(D) the type of operation or operations of the covered entity, including the composition, structure, and functions of the workforce of such entity; the geographic separateness, administrative or fiscal relationship of the facility or facilities in question to the covered entity.

(10) Specified public transportation. The term “specified public transportation” means transportation by bus, rail, or any other conveyance (other than by aircraft) that provides the general public with general or special service (including charter service) on a regular and continuing basis.

(11) Vehicle. The term “vehicle” does not include a rail passenger car, railroad locomotive, railroad freight car, railroad caboose, or a railroad car described in section 12162 of this title or covered under this subchapter.

§ 12182. Prohibition of discrimination by public accommodations

(a) General rule. No individual shall be discriminated against on the basis of disability in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of any place of public accommodation by any person who owns, leases (or leases to), or operates a place of public accommodation.

(b) Construction

(1) General prohibition

(A) Activities

(i) Denial of participation It shall be discriminatory to subject an individual or class of individuals on the basis of a disability or disabilities of such individual or class, directly, or through contractual, licensing, or other arrangements, to a denial of the opportunity of the individual or class to participate in or benefit from the goods, services, facilities, privileges, advantages, or accommodations of an entity.

(ii) Participation in unequal benefit It shall be discriminatory to afford an individual or class of individuals, on the basis of a disability or disabilities of such individual or class, directly, or through contractual, licensing, or other arrangements with the opportunity to participate in or benefit from a good, service, facility, privilege, advantage, or accommodation that is not equal to that afforded to other individuals.

(iii) Separate benefit It shall be discriminatory to provide an individual or class of individuals, on the basis of a disability or disabilities of such individual or class, directly, or through contractual, licensing, or other arrangements with a good, service, facility, privilege, advantage, or accommodation that is different or separate from that provided to other individuals, unless such action is necessary to provide the individual or class of individuals with a good, service, facility, privilege, advantage, or accommodation, or other opportunity that is as effective as that provided to others.

(iv) Individual or class of individuals For purposes of clauses (i) through (iii) of this subparagraph, the term “individual or class of individuals” refers to the clients or customers of the covered public accommodation that enters into the contractual, licensing or other arrangement.

(B) Integrated settings

Goods, services, facilities, privileges, advantages, and accommodations shall be afforded to an individual with a disability in the most integrated setting appropriate to the needs of the individual.

Notwithstanding the existence of separate or different programs or activities provided in accordance with this section, an individual with a disability shall not be denied the opportunity to participate in such programs or activities that are not separate or different.

(D) Administrative methods

An individual or entity shall not, directly or through contractual or other arrangements, utilize standards or criteria or methods of administration—

(i) that have the effect of discriminating on the basis of disability; or

(ii) that perpetuate the discrimination of others who are subject to common administrative control.

(E) Association

It shall be discriminatory to exclude or otherwise deny equal goods, services, facilities, privileges, advantages, accommodations, or other opportunities to an individual or entity because of the known disability of an individual with whom the individual or entity is known to have a relationship or association.

(2) Specific prohibitions

(A) Discrimination. For purposes of subsection (a) of this section, discrimination includes—

(i) the imposition or application of eligibility criteria that screen out or tend to screen out an individual with a disability or any class of individuals with disabilities from fully and equally enjoying any goods, services, facilities, privileges, advantages, or accommodations, unless such criteria can be shown to be necessary for the provision of the goods, services, facilities, privileges, advantages, or accommodations being offered;

(ii) a failure to make reasonable modifications in policies, practices, or procedures, when such modifications are necessary to afford such goods, services, facilities, privileges, advantages, or accommodations to individuals with disabilities, unless the entity can demonstrate that making such modifications would fundamentally alter the nature of such goods, services, facilities, privileges, advantages, or accommodations;

(iii) a failure to take such steps as may be necessary to ensure that no individual with a disability is excluded, denied services, segregated or otherwise treated differently than other individuals because of the absence of auxiliary aids and services, unless the entity can demonstrate that taking such steps would fundamentally alter the nature of the good, service, facility, privilege, advantage, or accommodation being offered or would result in an undue burden;

(iv) a failure to remove architectural barriers, and communication barriers that are structural in nature, in existing facilities, and transportation barriers in existing vehicles and rail passenger cars used by an establishment for transporting individuals (not including barriers that can only be removed through the retrofitting of vehicles or rail passenger cars by the installation of a hydraulic or other lift), where such removal is readily achievable; and

(v) where an entity can demonstrate that the removal of a barrier under clause (iv) is not readily achievable, a failure to make such goods, services, facilities, privileges, advantages, or accommodations available through alternative methods if such methods are readily achievable.

(B) Fixed route system

(i) Accessibility It shall be considered discrimination for a private entity which operates a fixed route system and which is not subject to section 12184 of this title to purchase or lease a vehicle with a seating capacity in excess of 16 passengers (including the driver) for use on such system, for which a solicitation is made after the 30th day following the effective date of this subparagraph, that is not readily accessible to and usable by individuals with disabilities, including individuals who use wheelchairs.

(ii) Equivalent service If a private entity which operates a fixed route system and which is not subject to section 12184 of this title purchases or leases a vehicle with a seating capacity of 16 passengers or less (including the driver) for use on such system after the effective date of this subparagraph that is not readily accessible to or usable by individuals with disabilities, it shall be considered discrimination for such entity to fail to operate such system so that, when viewed in its entirety, such system ensures a level of service to individuals with disabilities, including individuals who use wheelchairs, equivalent to the level of service provided to individuals without disabilities.

(i) a failure of a private entity which operates a demand responsive system and which is not subject to section 12184 of this title to operate such system so that, when viewed in its entirety, such system ensures a level of service to individuals with disabilities, including individuals who use wheelchairs, equivalent to the level of service provided to individuals without disabilities; and

(ii) the purchase or lease by such entity for use on such system of a vehicle with a seating capacity in excess of 16 passengers (including the driver), for which solicitations are made after the 30th day following the effective date of this subparagraph, that is not readily accessible to and usable by individuals with disabilities (including individuals who use wheelchairs) unless such entity can demonstrate that such system, when viewed in its entirety, provides a level of service to individuals with disabilities equivalent to that provided to individuals without disabilities.

(D) Over-the-road buses

(i) Limitation on applicability Subparagraphs (B) and (C) do not apply to over-the-road buses.

(ii) Accessibility requirements For purposes of subsection (a) of this section, discrimination includes

(I) the purchase or lease of an over-the-road bus which does not comply with the regulations issued under section 12186 (a)(2) of this title by a private entity which provides transportation of individuals and which is not primarily engaged in the business of transporting people, and

(II) any other failure of such entity to comply with such regulations.

(3) Specific construction. Nothing in this subchapter shall require an entity to permit an individual to participate in or benefit from the goods, services, facilities, privileges, advantages and accommodations of such entity where such individual poses a direct threat to the health or safety of others. The term “direct threat” means a significant risk to the health or safety of others that cannot be eliminated by a modification of policies, practices, or procedures or by the provision of auxiliary aids or services.

Individuals with Disabilities Education Improvement Act (IDEA)

§ 1400. Short title; findings; purposes

(a) Short title

This chapter may be cited as the “Individuals with Disabilities Education Act”.

(b) Omitted

Congress finds the following:

(1) Disability is a natural part of the human experience and in no way diminishes the right of individuals to participate in or contribute to society. Improving educational results for children with disabilities is an essential element of our national policy of ensuring equality of opportunity, full participation, independent living, and economic self-sufficiency for individuals with disabilities.

(2) Before the date of enactment of the Education for All Handicapped Children Act of 1975 (Public Law 94–142), the educational needs of millions of children with disabilities were not being fully met because—

(A) the children did not receive appropriate educational services;

(B) the children were excluded entirely from the public school system and from being educated with their peers;

(D) a lack of adequate resources within the public school system forced families to find services outside the public school system.

(3) Since the enactment and implementation of the Education for All Handicapped Children Act of 1975, this chapter has been successful in ensuring children with disabilities and the families of such children access to a free appropriate public education and in improving educational results for children with disabilities.

(4) However, the implementation of this chapter has been impeded by low expectations, and an insufficient focus on applying replicable research on proven methods of teaching and learning for children with disabilities.

(5) Almost 30 years of research and experience has demonstrated that the education of children with disabilities can be made more effective by—

(A) having high expectations for such children and ensuring their access to the general education curriculum in the regular classroom, to the maximum extent possible, in order to—

(i) meet developmental goals and, to the maximum extent possible, the challenging expectations that have been established for all children; and

(ii) be prepared to lead productive and independent adult lives, to the maximum extent possible;

(B) strengthening the role and responsibility of parents and ensuring that families of such children have meaningful opportunities to participate in the education of their children at school and at home;

(C) coordinating this chapter with other local, educational service agency, State, and Federal school improvement efforts, including improvement efforts under the Elementary and Secondary Education Act of 1965 [20 U.S.C. 6301 et seq.], in order to ensure that such children benefit from such efforts and that special education can become a service for such children rather than a place where such children are sent;

(D) providing appropriate special education and related services, and aids and supports in the regular classroom, to such children, whenever appropriate;

(E) supporting high-quality, intensive preservice preparation and professional development for all personnel who work with children with disabilities in order to ensure that such personnel have the skills and knowledge necessary to improve the academic achievement and functional performance of children with disabilities, including the use of scientifically based instructional practices, to the maximum extent possible;

(F) providing incentives for whole-school approaches, scientifically based early reading programs, positive behavioral interventions and supports, and early intervening services to reduce the need to label children as disabled in order to address the learning and behavioral needs of such children;

(G) focusing resources on teaching and learning while reducing paperwork and requirements that do not assist in improving educational results; and

(H) supporting the development and use of technology, including assistive technology devices and assistive technology services, to maximize accessibility for children with disabilities.

(6) While States, local educational agencies, and educational service agencies are primarily responsible for providing an education for all children with disabilities, it is in the national interest that the Federal Government have a supporting role in assisting State and local efforts to educate children with disabilities in order to improve results for such children and to ensure equal protection of the law.

(7) A more equitable allocation of resources is essential for the Federal Government to meet its responsibility to provide an equal educational opportunity for all individuals.

(8) Parents and schools should be given expanded opportunities to resolve their disagreements in positive and constructive ways.

(9) Teachers, schools, local educational agencies, and States should be relieved of irrelevant and unnecessary paperwork burdens that do not lead to improved educational outcomes.

(10) (A) The Federal Government must be responsive to the growing needs of an increasingly diverse society.

(B) America’s ethnic profile is rapidly changing. In 2000, 1 of every 3 persons in the United States was a member of a minority group or was limited English proficient.

(D) With such changing demographics, recruitment efforts for special education personnel should focus on increasing the participation of minorities in the teaching profession in order to provide appropriate role models with sufficient knowledge to address the special education needs of these students.

(11) (A) The limited English proficient population is the fastest growing in our Nation, and the growth is occurring in many parts of our Nation.

(B) Studies have documented apparent discrepancies in the levels of referral and placement of limited English proficient children in special education.

(C) Such discrepancies pose a special challenge for special education in the referral of, assessment of, and provision of services for, our Nation’s students from non-English language backgrounds.

(12) (A) Greater efforts are needed to prevent the intensification of problems connected with mislabeling and high dropout rates among minority children with disabilities.

(B) More minority children continue to be served in special education than would be expected from the percentage of minority students in the general school population.

(C) African-American children are identified as having mental retardation and emotional disturbance at rates greater than their White counterparts.

(D) In the 1998–1999 school year, African-American children represented just 14.8 percent of the population aged 6 through 21, but comprised 20.2 percent of all children with disabilities.

(E) Studies have found that schools with predominately White students and teachers have placed disproportionately high numbers of their minority students into special education.

(13) (A) As the number of minority students in special education increases, the number of minority teachers and related services personnel produced in colleges and universities continues to decrease.

(B) The opportunity for full participation by minority individuals, minority organizations, and Historically Black Colleges and Universities in awards for grants and contracts, boards of organizations receiving assistance under this chapter, peer review panels, and training of professionals in the area of special education is essential to obtain greater success in the education of minority children with disabilities.

(14) As the graduation rates for children with disabilities continue to climb, providing effective transition services to promote successful post-school employment or education is an important measure of accountability for children with disabilities.

(d) Purposes. The purposes of this chapter are—

(1) (A) to ensure that all children with disabilities have available to them a free appropriate public education that emphasizes special education and related services designed to meet their unique needs and prepare them for further education, employment, and independent living;

(B) to ensure that the rights of children with disabilities and parents of such children are protected; and

(C) to assist States, localities, educational service agencies, and Federal agencies to provide for the education of all children with disabilities;

(2) to assist States in the implementation of a statewide, comprehensive, coordinated, multidisciplinary, interagency system of early intervention services for infants and toddlers with disabilities and their families;

(3) to ensure that educators and parents have the necessary tools to improve educational results for children with disabilities by supporting system improvement activities; coordinated research and personnel preparation; coordinated technical assistance, dissemination, and support; and technology development and media services; and

(4) to assess, and ensure the effectiveness of, efforts to educate children with disabilities.

Federal Regulations

34 CFR § 104.33 - Free appropriate public education.

(a) General. A recipient that operates a public elementary or secondary education program or activity shall provide a free appropriate public education to each qualified handicapped person who is in the recipient's jurisdiction, regardless of the nature or severity of the person's handicap.

(b) Appropriate education.

(1) For the purpose of this subpart, the provision of an appropriate education is the provision of regular or special education and related aids and services that (i) are designed to meet individual educational needs of handicapped persons as adequately as the needs of nonhandicapped persons are met and (ii) are based upon adherence to procedures that satisfy the requirements of 104.34, 104.35, and 104.36.

(2) Implementation of an Individualized Education Program developed in accordance with the Education of the Handicapped Act is one means of meeting the standard established in paragraph (b)(1)(i) of this section.

(3) A recipient may place a handicapped person or refer such a person for aid, benefits, or services other than those that it operates or provides as its means of carrying out the requirements of this subpart.
If so, the recipient remains responsible for ensuring that the requirements of this subpart are met with respect to any handicapped person so placed or referred.

(1) General. For the purpose of this section, the provision of a free education is the provision of educational and related services without cost to the handicapped person or to his or her parents or guardian, except for those fees that are imposed on non-handicapped persons or their parents or guardian. It may consist either of the provision of free services or, if a recipient places a handicapped person or refers such person for aid, benefits, or services not operated or provided by the recipient as its means of carrying out the requirements of this subpart, of payment for the costs of the aid, benefits, or services. Funds available from any public or private agency may be used to meet the requirements of this subpart. Nothing in this section shall be construed to relieve an insurer or similar third party from an otherwise valid obligation to provide or pay for services provided to a handicapped person.

(2) Transportation. If a recipient places a handicapped person or refers such person for aid, benefits, or services not operated or provided by the recipient as its means of carrying out the requirements of this subpart, the recipient shall ensure that adequate transportation to and from the aid, benefits, or services is provided at no greater cost than would be incurred by the person or his or her parents or guardian if the person were placed in the aid, benefits, or services operated by the recipient.

(3) Residential placement. If a public or private residential placement is necessary to provide a free appropriate public education to a handicapped person because of his or her handicap, the placement, including non-medical care and room and board, shall be provided at no cost to the person or his or her parents or guardian.

(4) Placement of handicapped persons by parents. If a recipient has made available, in conformance with the requirements of this section and 104.34, a free appropriate public education to a handicapped person and the person's parents or guardian choose to place the person in a private school, the recipient is not required to pay for the person's education in the private school. Disagreements between a parent or guardian and a recipient regarding whether the recipient has made a free appropriate public education available or otherwise regarding the question of financial responsibility are subject to the due process procedures of 104.36.

(d) Compliance. A recipient may not exclude any qualified handicapped person from a public elementary or secondary education after the effective date of this part. A recipient that is not, on the effective date of this regulation, in full compliance with the other require-ments of the preceding paragraphs of this section shall meet such requirements at the earliest practicable time and in no event later than Sept. 1, 1978.

34 CFR § 104.34 - Educational setting.

(a) Academic setting. A recipient to which this subpart applies shall educate, or shall provide for the education of, each qualified handicapped person in its jurisdiction with persons who are not handicapped to the maximum extent appropriate to the needs of the handicapped person. A recipient shall place a handicapped person in the regular educational environment operated by the recipient unless it is demonstrated by the recipient that the education of the person in the regular environment with the use of supplementary aids and services cannot be achieved satisfactorily. Whenever a recipient places a person in a setting other than the regular educational environment pursuant to this paragraph, it shall take into account the proximity of the alternate setting to the person's home.

(b) Nonacademic settings. In providing or arranging for the provision of nonacademic and extracurricular services and activities, including meals, recess periods, and the services and activities set forth in 104.37(a)(2), a recipient shall ensure that handicapped persons participate with nonhandicapped persons in such activities and services to the maximum extent appropriate to the needs of the handicapped person in question.

Comparable facilities. If a recipient, in compliance with paragraph (a) of this section, operates a facility that is identifiable as being for handicapped persons, the recipient shall ensure that the facility and the services and activities provided therein are comparable to the other facilities, services, and activities of the recipient.

34 CFR § 104.35 - Evaluation and placement.

(a) Preplacement evaluation.
A recipient that operates a public elementary or secondary education program or activity shall conduct an evaluation in accordance with the requirements of paragraph (b) of this section of any person who, because of handicap, needs or is belived to need special education or related services before taking any action with respect to the initial placement of the person in regular or special education and any subsequent significant change in placement.

(b) Evaluation procedures.
A recipient to which this subpart applies shall establish standards and procedures for the evaluation and placement of persons who, because of handicap, need or are believed to need special education or related services which ensure that: (1) Tests and other evaluation materials have been validated for the specific purpose for which they are used and are administered by trained personnel in conformance with the instructions provided by their producer; (2) Tests and other evaluation materials include those tailored to assess specific areas of educational need and not merely those which are designed to provide a single general intelligence quotient; and (3) Tests are selected and administered so as best to ensure that, when a test is administered to a student with impaired sensory, manual, or speaking skills, the test results accurately reflect the student's aptitude or achievement level or whatever other factor the test purports to measure, rather than reflecting the student's impaired sensory, manual, or speaking skills (except where those skills are the factors that the test purports to measure).

(c) Placement procedures.
In interpreting evaluation data and in making placement decisions, a recipient shall (1) draw upon information from a variety of sources, including aptitude and achievement tests, teacher recommendations, physical condition, social or cultural background, and adaptive behavior, (2) establish procedures to ensure that information obtained from all such sources is documented and carefully considered, (3) ensure that the placement decision is made by a group of persons, including persons knowledgeable about the child, the meaning of the evaluation data, and the placement options, and (4) ensure that the placement decision is made in conformity with 104.34.

Reevaluation. A recipient to which this section applies shall establish procedures, in accordance with paragraph (b) of this section, for periodic reevaluation of students who have been provided special education and related services. A reevaluation procedure consistent with the Education for the Handicapped Act is one means of meeting this requirement.

34 CFR § 104.36 - Procedural safeguards.

A recipient that operates a public elementary or secondary education program or activity shall establish and implement, with respect to actions regarding the identification, evaluation, or educational placement of persons who, because of handicap, need or are believed to need special instruction or related services, a system of procedural safeguards that includes notice, an opportunity for the parents or guardian of the person to examine relevant records, an impartial hearing with opportunity for participation by the person's parents or guardian and representation by counsel, and a review procedure. Compliance with the procedural safeguards of section 615 of the Education of the Handicapped Act is one means of meeting this requirement.

34 CFR § 104.37 - Nonacademic services.

(a) General.

(1) A recipient to which this subpart applies shall provide non-academic and extracurricular services and activities in such manner as is necessary to afford handicapped students an equal opportunity for participation in such services and activities.

(2) Nonacademic and extracurricular services and activities may include counseling services, physical recreational athletics, transportation, health services, recreational activities, special interest groups or clubs sponsored by the recipients, referrals to agencies which provide assistance to handicapped persons, and employment of students, including both employment by the recipient and assistance in making available outside employment.

(b) Counseling services.

A recipient to which this subpart applies that provides personal, academic, or vocational counseling, guidance, or placement services to its students shall provide these services without discrimination on the basis of handicap. The recipient shall ensure that qualified handicapped students are not counseled toward more restrictive career objectives than are nonhandicapped students with similar interests and abilities.

(1) In providing physical education courses and athletics and similar aid, benefits, or services to any of its students, a recipient to which this subpart applies may not discriminate on the basis of handicap. A recipient that offers physical education courses or that operates or sponsors interscholastic, club, or intramural athletics shall provide to qualified handicapped students an equal opportunity for participation.

(2) A recipient may offer to handicapped students physical education and athletic activities that are sep-arate or different from those offered to nonhandi-capped students only if separation or differentiation is consistent with the requirements of 104.34 and only if no qualified handicapped student is denied the opportunity to compete for teams or to participate in courses that are not separate or different.

28 CFR § 35.130 General prohibitions against discrimination.

(a) No qualified individual with a disability shall, on the basis of disability, be excluded from participation in or be denied the benefits of the services, programs, or activities of a public entity, or be subjected to discrimination by any public entity.

(b) (1) A public entity, in providing any aid, benefit, or service, may not, directly or through contractual, licensing, or other arrangements, on the basis of disability --

(i) Deny a qualified individual with a disability the opportunity to participate in or benefit from the aid, benefit, or service;

(ii) Afford a qualified individual with a disability an opportunity to participate in or benefit from the aid, benefit, or service that is not equal to that afforded others;

(iii) Provide a qualified individual with a disability with an aid, benefit, or service that is not as effective in affording equal opportunity to obtain the same result, to gain the same benefit, or to reach the same level of achievement as that provided to others;

(iv) Provide different or separate aids, benefits, or services to individuals with disabilities or to any class of individuals with disabilities than is provided to others unless such action is necessary to provide qualified individuals with disabilities with aids, benefits, or services that are as effective as those provided to others;

(v) Aid or perpetuate discrimination against a qualified individual with a disability by providing significant assistance to an agency, organization, or person that discriminates on the basis of disability in providing any aid, benefit, or service to beneficiaries of the public entity's program;

(vi) Deny a qualified individual with a disability the opportunity to participate as a member of planning or advisory boards;

(vii) Otherwise limit a qualified individual with a disability in the enjoyment of any right, privilege, advantage, or opportunity enjoyed by others receiving the aid, benefit, or service.

(2) A public entity may not deny a qualified individual with a disability the opportunity to participate in services, programs, or activities that are not separate or different, despite the existence of permissibly separate or different programs or activities.

(3) A public entity may not, directly or through contractual or other arrangements, utilize criteria or methods of administration:

(i) That have the effect of subjecting qualified individuals with disabilities to discrimination on the basis of disability;

(ii) That have the purpose or effect of defeating or

substantially impairing accomplishment of the objectives of the public entity's program with respect to individuals with disabilities; or

(iii) That perpetuate the discrimination of another public entity if both public entities are subject to common administrative control or are agencies of the same State.

(4) A public entity may not, in determining the site or location of a facility, make selections --

(i) That have the effect of excluding individuals with disabilities from, denying them the benefits of, or otherwise subjecting them to discrimination; or

(ii) That have the purpose or effect of defeating or substantially impairing the accomplishment of the objectives of the service, program, or activity with respect to individuals with disabilities.

(5) A public entity, in the selection of procurement contractors, may not use criteria that subject qualified individuals with disabilities to discrimination on the basis of disability.

(6) A public entity may not administer a licensing or certification program in a manner that subjects qualified individuals with disabilities to discrimination on the basis of disability, nor may a public entity establish requirements for the programs or activities of licensees or certified entities that subject qualified individuals with disabilities to discrimination on the basis of disability. The programs or activities of entities that are licensed or certified by a public entity are not, themselves, covered by this part.

(7) A public entity shall make reasonable modifications in policies, practices, or procedures when the modifications are necessary to avoid discrimination on the basis of disability, unless the public entity can demonstrate that making the modifications would fundamentally alter the nature of the service, program, or activity.

(8) A public entity shall not impose or apply eligibility criteria that screen out or tend to screen out an individual with a disability or any class of individuals with disabilities from fully and equally enjoying any service, program, or activity, unless such criteria can be shown to be necessary for the provision of the service, program, or activity being offered.

(c) Nothing in this part prohibits a public entity from providing benefits, services, or advantages to individuals with disabilities, or to a particular class of individuals with disabilities beyond those required by this part.

(d) A public entity shall administer services, programs, and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities.

(e) (1) Nothing in this part shall be construed to require an individual with a disability to accept an accommodation, aid, service, opportunity, or benefit provided under the ADA or this part which such individual chooses not to accept.

(2) Nothing in the Act or this part authorizes the representative or guardian of an individual with a disability to decline food, water, medical treatment, or medical services for that individual.

(f) A public entity may not place a surcharge on a particular individual with a disability or any group of individuals with disabilities to cover the costs of measures, such as the provision of auxiliary aids or program accessibility, that are required to provide that individual or group with the nondiscriminatory treatment required by the Act or this part.

(g) A public entity shall not exclude or otherwise deny equal services, programs, or activities to an individual or entity because of the known disability of an individual with whom the individual or entity is known to have a relationship or association.

Relevant State Statutes & Administrative Code — Illinois

105 ILCS 5/22-30
(Students with Asthma and Allergies)
(Source: P.A. 94-792, eff. 5-19-06.)

Sec. 22-30. Self-administration of medication.

(a) In this Section:

"Epinephrine auto-injector" means a medical device for immediate self-administration by a person at risk of anaphylaxis.

"Medication" means a medicine, prescribed by (i) a physician licensed to practice medicine in all its branches, (ii) a physician assistant who has been delegated the authority to prescribe asthma medications by his or her supervising physician, or (iii) an advanced practice registered nurse who has a written collaborative agreement with a collaborating physician that delegates the authority to prescribe asthma medications, for a pupil that pertains to the pupil's asthma and that has an individual prescription label.

"Self-administration" means a pupil's discretionary use of his or her prescribed asthma medication.

(b) A school, whether public or nonpublic, must permit the self-administration of medication by a pupil with asthma or the use of an epinephrine auto-injector by a pupil, provided that:

(1) the parents or guardians of the pupil provide to the school written authorization for the self-administration of medication or use of an epinephrine auto-injector; and

(2) the parents or guardians of the pupil provide to the school a written statement from the pupil's physician, physician assistant, or advanced practice registered nurse containing the following information:

(A) the name and purpose of the medication or epinephrine auto-injector;

(B) the prescribed dosage; and

(C) the time or times at which or the special circumstances under which the medication or epinephrine auto-injector is to be administered. The information provided shall be kept on file in the office of the school nurse or, in the absence of a school nurse, the school's administrator.

(c) The school district or nonpublic school must inform the parents or guardians of the pupil, in writing, that the school district or nonpublic school and its employees and agents are to incur no liability, except for willful and wanton conduct, as a result of any injury arising from the self-administration of medication or use of an epinephrine auto-injector by the pupil. The parents or guardians of the pupil must sign a statement acknowledging that the school district or nonpublic school is to incur no liability, except for willful and wanton conduct, as a result of any injury arising from the self-administration of medication or use of an epinephrine auto-injector by the pupil and that the parents or guardians must indemnify and hold harmless the school district or nonpublic school and its employees and agents against any claims, except a claim based on willful and wanton conduct, arising out of the self-administration of medication or use of an epinephrine auto-injector by the pupil.

(d) The permission for self-administration of medication or use of an epinephrine auto-injector is effective for the school year for which it is granted and shall be renewed each subsequent school year upon fulfillment of the requirements of this Section.

(e) Provided that the requirements of this Section are fulfilled, a pupil with asthma may possess and use his or her medication or a pupil may possess and use an epinephrine auto-injector (i) while in school, (ii) while at a school-sponsored activity, (iii) while under the supervision of school personnel, or (iv) before or after normal school activities, such as while in before-school or after-school care on school-operated property.

105 ILCS 5/3-11 (Health Care Training for Teachers)
(Source: P.A. 95-969, eff. 1-1-09; 96-431, eff. 8-13-09.)

Sec. 3-11. Institutes or inservice training workshops. In counties of less than 2,000,000 inhabitants, the regional superintendent may arrange for or conduct district, regional, or county institutes, or equivalent professional educational experiences, not more than 4 days annually. Of those 4 days, 2 days may be used as a teacher's workshop, when approved by the regional superintendent, up to 2 days may be used for conducting parent-teacher conferences or up to 2 days may be utilized as parental institute days as provided in Section 10-22.18d. A school district may use one of its 4 institute days on the last day of the school term. "Institute" or "Professional educational experiences" means any educational gathering, demonstration of methods of instruction, visitation of schools or other institutions or facilities, sexual abuse and sexual assault awareness seminar, or training in First Aid (which may include cardiopulmonary resuscitation or defibrillator training) held or approved by the regional superintendent and declared by him to be an institute day, or parent-teacher conferences. With the concurrence of the State Superintendent of Education, he or she may employ such assistance as is necessary to conduct the institute. Two or more adjoining counties may jointly hold an institute. Institute instruction shall be free to holders of certificates good in the county or counties holding the institute, and to those who have paid an examination fee and failed to receive a certificate.

In counties of 2,000,000 or more inhabitants, the regional superintendent may arrange for or conduct district, regional, or county inservice training workshops, or equivalent professional educational experiences, not more than 4 days annually. Of those 4 days, 2 days may be used for conducting parent-teacher conferences and up to 2 days may be utilized as parental institute days as provided in Section 10-22.18d. A school district may use one of those 4 days on the last day of the school term. "Inservice Training Workshops" or "Professional educational experiences" means any educational gathering, demonstration of methods of instruction, visitation of schools or other institutions or facilities, sexual abuse and sexual assault awareness seminar, or training in First Aid (which may include cardiopulmonary resuscitation or defibrillator training) held or approved by the regional superintendent and declared by him to be an inservice training workshop, or parent-teacher conferences. With the concurrence of the State Superintendent of Education, he may employ such assistance as is necessary to conduct the inservice training workshop. With the approval of the regional superintendent, 2 or more adjoining districts may jointly hold an inservice training workshop. In addition, with the approval of the regional superintendent, one district may conduct its own inservice training workshop with subject matter consultants requested from the county, State or any State institution of higher learning.

Such teachers institutes as referred to in this Section may be held on consecutive or separate days at the option of the regional superintendent having jurisdiction thereof.

Whenever reference is made in this Act to "teachers institute", it shall be construed to include the inservice training workshops or equivalent professional educational experiences provided for in this Section.

Any institute advisory committee existing on April 1, 1995, is dissolved and the duties and responsibilities of the institute advisory committee are assumed by the regional office of education advisory board.

Districts providing inservice training programs shall constitute inservice committees, 1/2 of which shall be teachers, 1/4 school service personnel and 1/4 administrators to establish program content and schedules.

The teachers institutes shall include teacher training committed to (i) peer counseling programs and other anti-violence and conflict resolution programs, including without limitation programs for preventing at risk students from committing violent acts, and (ii) educator ethics and teacher-student conduct. Beginning with the 2009-2010 school year, the teachers institutes shall include instruction on prevalent student chronic health conditions.

105 ILCS 5/34-18.7 and 18.8 (Health Care Training for School Employees)
(Source: P.A. 86-900.)

Sec. 34-18.7. Adolescent and teen suicide detection and intervention. School guidance counselors, teachers and other school personnel who work with pupils in grades 7 through 12 shall be trained to identify the warning signs of suicidal behavior in adolescents and teens and shall be taught various intervention techniques. Such training shall be provided within the framework of existing in-service training programs offered by the Board. (Source: P.A. 85-297.)

Sec. 34-18.8. AIDS training. School guidance counselors, nurses, teachers and other school personnel who work with pupils may be trained to have a basic knowledge of matters relating to acquired immunodeficiency syndrome (AIDS), including the nature of the disease, its causes and effects, the means of detecting it and preventing its transmission, the availability of appropriate sources of counseling and referral, and any other information that may be appropriate considering the age and grade level of such pupils. The Board of Education shall supervise such training. The State Board of Education and the Department of Public Health shall jointly develop standards for such training.

105 ILCS 110/3 (Medical/Emergency Training for School Employees)
(Source: P.A. 95-43, eff. 1-1-08; 95-764, eff. 1-1-09; 96-128, eff. 1-1-10.)

Sec. 3. Comprehensive Health Education Program. The program established under this Act shall include, but not be limited to, the following major educational areas as a basis for curricula in all elementary and secondary schools in this State: human ecology and health, human growth and development, the emotional, psychological, physiological, hygienic and social responsibilities of family life, including sexual abstinence until marriage, prevention and control of disease, including instruction in grades 6 through 12 on the prevention, transmission and spread of AIDS, sexual assault awareness in secondary schools, public and environmental health, consumer health, safety education and disaster survival, mental health and illness, personal health habits, alcohol, drug use, and abuse including the medical and legal ramifications of alcohol, drug, and tobacco use, abuse during pregnancy, sexual abstinence until marriage, tobacco, nutrition, and dental health. The program shall also provide course material and instruction to advise pupils of the Abandoned Newborn Infant Protection Act. The program shall include information about cancer, including without limitation types of cancer, signs and symptoms, risk factors, the importance of early prevention and detection, and information on where to go for help. Notwithstanding the above educational areas, the following areas may also be included as a basis for curricula in all elementary and secondary schools in this State: basic first aid (including, but not limited to, cardiopulmonary resuscitation and the Heimlich maneuver), heart disease, diabetes, stroke, and the prevention of child abuse, neglect, and suicide.

The school board of each public elementary and secondary school in the State shall encourage all teachers and other school personnel to acquire, develop, and maintain the knowledge and skills necessary to properly administer life-saving techniques, including without limitation the Heimlich maneuver and rescue breathing. The training shall be in accordance with standards of the American Red Cross, the American Heart Association, or another nationally recognized certifying organization. A school board may use the services of non-governmental entities whose personnel have expertise in life-saving techniques to instruct teachers and other school personnel in these techniques. Each school board is encouraged to have in its employ, or on its volunteer staff, at least one person who is certified, by the American Red Cross or by another qualified certifying agency, as qualified to administer first aid and cardiopulmonary resuscitation. In addition, each school board is authorized to allocate appropriate portions of its institute or inservice days to conduct training programs for teachers and other school personnel who have expressed an interest in becoming qualified to administer emergency first aid or cardiopulmonary resuscitation. School boards are urged to encourage their teachers and other school personnel who coach school athletic programs and other extracurricular school activities to acquire, develop, and maintain the knowledge and skills necessary to properly administer first aid and cardiopulmonary resuscitation in accordance with standards and requirements established by the American Red Cross or another qualified certifying agency. . . .

105 ILCS 5/24-24 (Responsibility for Students)
(Source: P.A. 88-346; 88-670, eff. 12-2-94; 89-184, eff. 7-19-95.)

Sec. 24-24. Maintenance of discipline. Subject to the limitations of all policies established or adopted under Section 14-8.05, teachers, other certificated educational employees, and any other person, whether or not a certificated employee, providing a related service for or with respect to a student shall maintain discipline in the schools, including school grounds which are owned or leased by the board and used for school purposes and activities. In all matters relating to the discipline in and conduct of the schools and the school children, they stand in the relation of parents and guardians to the pupils. This relationship shall extend to all activities connected with the school program, including all athletic and extracurricular programs, and may be exercised at any time for the safety and supervision of the pupils in the absence of their parents or guardians.

Nothing in this Section affects the power of the board to establish rules with respect to discipline; except that each board shall establish a policy on discipline, and the policy so established shall provide, subject to the limitations of all policies established or adopted under Section 14-8.05, that a teacher, other certificated employee, and any other person, whether or not a certificated employee, providing a related service for or with respect to a student may use reasonable force as needed to maintain safety for the other students, school personnel or persons or for the purpose of self defense or the defense of property, shall provide that a teacher may remove a student from the classroom for disruptive behavior, and shall include provisions which provide due process to students. The policy shall not include slapping, paddling or prolonged maintenance of students in physically painful positions nor shall it include the intentional infliction of bodily harm.

The board may make and enforce reasonable rules of conduct and sportsmanship for athletic and extracurricular school events. Any person who violates such rules may be denied admission to school events for not more than one year, provided that written 10 days notice of the violation is given such person and a hearing had thereon by the board pursuant to its rules and regulations. The administration of any school may sign complaints as agents of the school against persons committing any offense at school events.

210 ILCS 74 (Health Care Training for Coaches)

Sec. 1. Short title.

This Act may be cited as the Physical Fitness Facility Medical Emergency Preparedness Act.

Sec. 5.5. Automated external defibrillator.

"Automated external defibrillator" or "AED" means an automated external defibrillator as defined in the Automated External Defibrillator Act. (P.A. 93-910, eff. 1-1-05.)

Sec. 5.25. Physical fitness facility.

(a) "Physical fitness facility" means the following:

(1) Any of the following indoor facilities that is

(i) owned or operated by a park district, municipality, or other unit of local government, including a home rule unit, or by a public or private elementary or secondary school, college, university, or technical or trade school and (ii) supervised by one or more persons, other than maintenance or security personnel, employed by the unit of local government, school, college, or university for the purpose of directly supervising the physical fitness activities taking place at any of these indoor facilities: a swimming pool; stadium; athletic field; football stadium; soccer field; baseball diamond; track and field facility; tennis court; basketball court; or volleyball court; or similar facility as defined by Department rule. (Source: P.A. 93-910, eff. 1-1-05.)

(1.5) Any of the following outdoor facilities that is

(i) owned by a municipality, township, or other unit of local government, including a home rule unit, or by a public or private elementary or secondary school, college, university, or technical or trade school and (ii) supervised by one or more persons, other than maintenance or security personnel, employed by the unit of local government, school, college, or university for the purpose of directly supervising the physical fitness activities taking place at any of these facilities: a swimming pool; athletic field; football stadium; soccer field; baseball diamond; track and field facility; tennis court; basketball court; or volleyball court; or similar facility as defined by Department rule.

The term does not include any facility during any activity or program organized by a private or not-for-profit organization and organized and supervised by a person or persons other than the employees of the unit of local government, school, college, or university.

(2) Except as provided in subsection (b), any other indoor or outdoor establishment, whether public or private, that provides services or facilities focusing on cardiovascular exertion or gaming as defined by Department rule.

(b) "Physical fitness facility" does not include a facility serving less than a total of 100 individuals. For purposes of this Act, "individuals" includes only those persons actively engaged in physical exercise that uses large muscle groups and that substantially increases the heart rate. In addition, the term does not include (i) a facility located in a hospital or in a hotel or motel, (ii) any outdoor facility owned or operated by a park district organized under the Park District Code, the Chicago Park District Act, or the Metro-East Park and Recreation District Act, or (iii) any facility owned or operated by a forest preserve district organized under the Downstate Forest Preserve District Act or the Cook County Forest Preserve District Act or a con-servation district organized under the Conservation District Act. The term also does not include any facility that does not em-ploy any persons to provide instruction, training, or assistance for persons using the facility. (P.A. 96-873, eff. 1-21-10.)

Sec. 15. Automated external defibrillator required.

(a) By the dates specified in Section 50, every physical fitness facility must have at least one AED on the facility premises. The Department shall adopt rules to ensure coordination with local emergency medical services systems regarding the placement and use of AEDs in physical fitness facilities. The Department may adopt rules requiring a facility to have more than one AED on the premises, based on factors that include the following:

(1) The size of the area or the number of buildings or floors occupied by the facility.

(2) The number of persons using the facility, excluding spectators.

(b) A physical fitness facility must ensure that there is a trained AED user on staff during staffed business hours. For purposes of this Act, "trained AED user" has the meaning ascribed to that term in Section 10 of the Automated External Defibrillator Act.

(b-5) The Department shall adopt rules that encourage any non-employee coach, non-employee instructor, or other similarly situated non-employee anticipated rescuer who uses a physical fitness facility in conjunction with the supervision of physical fitness activities to complete a course of instruction that would qualify such a person as a trained AED user, as defined in Section 10 of the Automated External Defibrillator Act.

(b-10) In the case of an outdoor physical fitness facility, the AED must be housed in a building, if any, that is within 300 feet of the outdoor facility where an event or activity is being conducted. If there is such a building within the required distance, the building must provide unimpeded and open access to the housed AED, and the building's entrances shall further provide marked directions to the housed AED. If there is no such building, the person responsible for supervising the activity at the outdoor physical fitness facility shall ensure that an AED is available at the outdoor facility during the time that the event or activity at the facility is being conducted.

(b-15) Facilities described in paragraph (1.5) of Section 5.25 must have an AED on site as well as a trained AED user available only during activities or events sponsored and conducted or supervised by a person or persons employed by the unit of local government, school, college, or university.

(c) Every physical fitness facility must ensure that every AED on the facility's premises is properly tested and maintained in accordance with rules adopted by the Department. (Source: P.A. 95-712, eff. 1-1-09; 96-748, eff. 1-1-10; 96-873, eff. 1-21-10.)

23 IL Administrative Code § 1.530
(Emergency Procedures in Case of Illness or Injury)
(Source: Amended at 33 Ill. Reg. 15193, effective October 20, 2009)

Section 1.530 Health Services
. . . .
c) Each district shall adopt an emergency procedure to be followed
in cases of injury or sudden illness to students and/or staff.

89 IL Administrative Code § 406 and § 408
(Health, Medical Care and Safety)
(Source: Amended at 30 Ill. Reg., effective November 13, 2006)

Section 406.14 Health, Medical Care and Safety

e) Necessary medications shall be administered according to specific written instructions provided by the child's parents or guardians.

1) Prescription medicine labels must bear the child's name, the physician's name, the name of the drug store or pharmacy, prescription number, date of the prescription, and directions for administering.

2) Non-prescription medication may be administered upon written parental permission that specifies the duration and frequency of medication. Such medication shall be administered in accordance with package instructions, and, except for aspirin and aspirin substitutes, shall be labeled with the child's name and dated.

3) There shall be a signed statement by the child's parent or guardian giving permission to the caregiver to administer medication to the child.

4) The caregiver shall maintain a record of the dates, hours and dosages that are given.

5) Medication shall be returned to the parents when it is no longer required. Additionally, medication provided for a child no longer cared for in the facility and medication that has reached its expiration date shall be destroyed.

6) Medical services, such as direct medical care to the child, shall be administered as required by a physician, subject to the receipt of appropriate releases from parents.

Section 408.70 Health, Medical Care and Safety

c) Necessary medications shall be administered according to specific written instructions from the child's parents or guardians.

2) Nonprescription medication provided by the parents may be administered upon written parental permission that specifies the duration and frequency of medication. Such medication shall be administered in accordance with package instructions, and shall be labeled with the child's name and date.

3) There shall be a signed statement by the child's parent or guardian giving permission to the caregiver to administer medication to the child.

4) The caregiver shall maintain a record of the dates, hours and dosages that are given.

6) Medical services, such as direct medical care to the child, shall be administered as required by a physician, subject to the receipt of appropriate releases from parents.

[1] Ala. Code § 16-1-39 (2008); Cal. Educ. Code § 49414.5 (2007); Conn. Gen. Stat. Ann. § 10-220(i), (j) (2007); Haw. Rev. Stat. Ann. § 302A-1164(a)(1),(f) (2007); Ind. Code Ann. § 20-34-5-17(a) (2007); Mass. Gen. Laws. Ann. ch. 71, §54B (1985); Neb. Rev. Stat. Ann. § 79-225(3) (2008); Neb. Rev. Stat. Ann. § 79-225(4) (2008); N.J. Stat. Ann. § 18A:40-12.3(a) (2008)(the overseeing board will permit a student to self-administer medication provided that certain requirements are met); Okla. Stat. Ann. tit. 70, § 1210.196.7(A), (B); 14-000-011 R.I. Code R. § 18.1.1.2 (2008); S.C. Code Ann. § 59-63-80(B) (2005); Tenn. Code Ann. § 49-5-415(d)(7) (2006); Tex. Health & Safety Code Ann. § 168.008 (2007); Utah Code Ann. § 53A-11-604(2)(a)(i) (2006); Utah Code Ann. §§ 53A-11-603(2),(4) (2006); Wash. Rev. Code Ann. § 28A.210.330(1)(a)(iv) (2002); Wyo. Stat. Ann. § 21-4-310.

[2] Ariz. Rev. Stat. Ann. § 15-344(A) (2008); 3 Colo. Code Regs. §716-1(XIII)(8.1) (2008); Ga. Code Ann. § 43-26-56(a) (2007); Haw. Code R. § 16-89-108 (2005); Ind. Code §34-30-14-2 (2007); Iowa Admin. Code r. 281-41.404(256B) (2008); 05-071-40 Me. Code R. §2(C)(i) (2008); Md. Code Regs. 10.27.11.05 (2008); Md. Code Ann., Health Occ. § 8-6A-02 (2008); Mich. Comp. Laws Ann. § 380.1178 (2008); Neb. Rev. Stat. Ann. §71-6723(2) (2008); Neb. Rev. Stat. Ann. §71-6739 (2008); N.C. Gen. Stat. Ann. § 115C-375.1(2006); N.C. Gen. Stat. Ann. § 115C-375.3(2005); N.D. Admin. Code 54-01-03-01(32) (2008); N.D. Admin. Code 54-07-05-09 (2008); Okla. Stat. Ann. tit. 70, §§ 1210.196(C)(4)-1210.196(C)(5); Or. Admin. R. 85-047-0030 (2008); Tex. Health & Safety Code Ann. §§ 168.005(c)(4)-168.005(c)(5) (2007); Va. Code Ann. § 22.1-274(E) (1999); Va. Code Ann. §8.01-225(A)(9) (2006); Va. Code Ann. §54.1-3001(9) (2002); Va. Code Ann. §54.1-2901(A)(26) (2000); Va. Code Ann. §54.1-3408(H) (2007); Wis. Stat. Ann. § 118.29(2)(a)(2) (2001).

[3] Ariz. Rev. Stat. Ann. § 15-344 (2008); 067-00-005 Ark. Code R. §§ A-H (2008); Cal. Educ. Code § 49414.5(a) (2007); 3 Colo. Code Regs. § 716-1(XIII)(8.1) (2008); 3 Colo. Code Regs. § 716-1(XIII)(7.2) (2008); 14-800-817 Del. Code Regs. § 6.1 (2008); Fla. Stat. Ann. § 1006.0652(4)(d) (2008); Haw. Rev. Stat. § 302A-1164(a)(2) (2007)(in an emergency, department employees and agents can volunteer to administer glucagon); Ind. Code § 34-30-14 (2007); Ind. Code § 34-30-15 (2007); Kan. Admin. Regs. § 60-15-104(b)(2) (2005); Kan. Admin. Regs. § 60-15-101(i) (2008); Ky. Rev. Stat. Ann. § 158.838(1)(a) (2005); Ky. Rev. Stat. Ann. § 156.502(2)(c) (2002); La. Admin. Code tit. 28, § I.929 (1996); 05-071-40 Me. Code R. § 2(C)(i) (2008); Md. Code Regs. 10.27.11.05 (2008); Md. Code Ann., Health Occ. § 8-6A-02 (2008); 105 Mass. Code Regs. 210.004(B)(1)(b) (2008); Mich. Comp. Laws Ann. § 380.1178 (2008); Minn. Stat. Ann. § 121A.22 (2008); Mont. Code Ann. § 20-5-412 (2007); Neb. Rev. Stat. Ann. § 71-6723 (2008); Neb. Rev. Stat. Ann. § 71-6739 (2008); Nevada State Board of Nursing, “School Nurse Regulation and Advisory Opinion,” (March 14, 2007) available at http://www.nursingboard.state.nv.us/pinfo/school%20nurse%20regulation%20advisory%20opinion.htm, last visited June 11, 2008; New York State Education Department, “Training of Unlicensed Individuals in the Injection of Glucagon in Emergency Situations,” (March, 2004), available at http://www.emsc.nysed.gov/sss/HealthServices/fieldmemo-glucagon-JAK-JDP.htm, last visited June 13, 2008; N.C. Gen. Stat. Ann. § 115C-375.1 (2006); N.C. Gen. Stat. Ann. § 115C-375.3 (2005); N.C. Gen. Stat. Ann. 115C-12(31) (2007); N.D. Admin. Code § 54-07-05-01 (2008); N.D. Admin. Code § 54-07-05-09 (2008); Okla. Stat. Ann. tit. 70, § 1210.196.5(C)(5); Or. Admin. R. 85-047-0030 (2008); Or. Rev. Stat. Ann. § 433.825 (1997); Or. Rev. Stat. Ann. § 433.815 (1997); R.I. Gen. Laws § 16-21-28.2 (2008); 1977 Op. S.C. Att’y Gen. No. 153 (Oct. 26, 1977) at *9; Tenn. Code Ann. §49-5-415(d)(4) (2006); Tenn. Code Ann. § 49-5-415(b) (2006); Tex. Health & Safety Code Ann. § 168.005(d)(5) (2007); Utah Code Ann. § 53A-11-603 (2006); Va. Code Ann. § 8.01-225(9) (2006); Va. Code Ann. § 54.1-3001(9) (2002); Va. Code Ann. § 54.1-2901(26) (2006); W. Va. Code R. § 126-25A-14(E) (2008); Wis. Stat. Ann. § 118.29(2)(a)(2r) (2001); 024-054-7 Wyo. Code R. §§ 6-8 (2008).