Legal Protections in Childcare, Camps, and Recreational Programs

Federal and some state laws protect children with diabetes and their families against discrimination and set out the legal responsibilities of "public accommodations," such as childcare, camps, and recreational programs. Children with diabetes have the right to the same opportunities to attend childcare, go to camp, and participate in community activities as any other child.


Can a childcare, camp or recreational program refuse to admit my child because of his/her diabetes?

The Americans with Disabilities Act requires public accommodations, including camps and childcare centers, to avoid discriminating against people with disabilities. This includes small childcare centers operated out of a person's home. The Americans with Disabilities Act does not cover programs operated by religious organizations, for example, a childcare operated by a church. Section 504 of the Rehabilitation Act of 1973 (Section 504) requires any entity receiving federal funds—including religious organizations—to provide equal access to people with disabilities.

Childcare centers, camps, and other recreational programs covered by the Americans with Disabilities Act and/or Section 504 cannot refuse to admit a child because they have diabetes and may be required to provide services, called accommodations, to a child with diabetes to enable the child to participate in the program.

The U.S. Department of Justice has entered into several settlement agreements that require childcare centers to enroll children with diabetes, administer blood glucose (blood sugar) tests and insulin, recognize hypoglycemia (low blood glucose) and hyperglycemia (high blood glucose), and respond to emergencies. The Department of Justice has also entered into agreements with various camps regarding the rights of children with diabetes. Read more about these settlement agreements. Both the Americans with Disabilities Act and Section 504 require programs to provide disability-related accommodations if they are necessary and reasonable.

My child cannot self-administer insulin, and they need someone to administer glucagon if they have a severe low blood glucose emergency. Are they entitled to these services?

It depends. Under the Americans with Disabilities Act and Section 504, entities may refuse to provide certain services if, in light of the total resources and budget of the organization, the cost or difficulty of providing the accommodation would be an undue burden or if it would fundamentally alter the nature of the service. If an organization does not have a nurse on staff and it can show that the cost of hiring a nurse would be an undue burden, the reasonableness of providing insulin and glucagon injections will depend upon whether state law allows trained, unlicensed staff to administer medications such as insulin and/or glucagon.

Generally, where organizations provide first aid and medication to other children in their care (EpiPens, asthma inhalers, oral medication) and state law allows trained, unlicensed staff to administer insulin and/or glucagon, it will be difficult for the organization to show that providing these services is a fundamental alteration or an undue burden.

My child's childcare provider is unsure whether state law allows childcare staff to administer diabetes care. Where can I find my state's laws on this topic?

This page provides information about states that have passed laws regarding diabetes care in childcare and other programs, or have laws that allow lay people to administer injectable medications, such as insulin or glucagon.