Laws that Protect People with Type 1 Diabetes

Federal Legislation has forever changed the way that individuals live with type 1 diabetes and other disabilities. The fight to have governmental involvement in advocacy across the globe has been a slow and sometimes frustrating process, however it continues to progress.

The United States: Americans with Disabilities Act

The most far-reaching legislation for those with disabilities is the Americans with Disabilities Act (ADA). Passed in 1990, the ADA prevents discrimination against qualified individuals on the basis of disability.

Under Title I of the ADA, private employers with 15 or more employees, states, and local governments cannot require a medical examination before offering a new employee a job. This means your future employer cannot ask you whether you have diabetes before hiring you. Furthermore, once hired, an employee with diabetes can request reasonable accommodations, such as extra breaks to eat, test blood sugar levels, or take medication. If such accommodations are not an undue hardship to the employer, the employer must fulfill the requests.

Under Title II of the ADA, state and local governments must provide you with services that are not any different from those they provide people without a disability. They must not screen out or exclude you because of your disability and they must modify their policies and provide reasonable accommodations if necessary. For example, a courthouse should permit you to carry your diabetes supplies with you even if it means a modification of a general policy against allowing sharp objects and food.

Under Title III of the ADA, providers of public accommodations, such as daycare centers and recreational programs, must provide you with services that are not any different from those they provide people without a disability. They must not screen out or exclude you because of your disability, and must also modify their policies and provide reasonable accommodations if necessary. For example, a summer camp covered by the ADA cannot refuse to admit a child because she has diabetes, and may be required to have camp counselors help monitor the child’s blood sugar to enable the child to access the program.

The Rehabilitation Act of 1973 (Rehabilitation Act) prohibits recipients of federal funds from discriminating against individuals with disabilities. Under Section 504, private entities, such as private hospitals that receive funding from the Department of Health and Human Services, and public entities, such as public schools that receive funding from the Department of Education, are prohibited from discriminating on the basis of disability. This means that public schools must ensure that staff members are available to administer insulin and glucagon to allow students with diabetes to attend school.

In recent years, the passage of the The Patient Protection and Affordable Care Act (PPACA or ACA) also had a significant impact on the healthcare of those who suffer from diabetes.

The ACA, known by many simply as ObamaCare, was passed in 2010. A provision of the ACA created a National Diabetes Prevention Program (NDPP), which brings evidence-based lifestyle change programs to local communities. Led by the Centers for Disease Control and Prevention (CDC), NDPP initiatives are available across the country and online to help prevent or delay the development of type 2 diabetes.

The ACA also has important benefits for those who suffer from type 1 diabetes. Starting in 2014, the ACA dictates that health insurance companies cannot refuse to cover you or charge you more just because you have type 1 diabetes or any other pre-existing condition. In addition, a health plan can no longer limit the total amount it will spend on benefits for a particular individual.

A rarely discussed aspect of the ACA is the incorporation of a bill from 2009 into the language of the act. “The Catalyst to Better Diabetes Care Act” directs the U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention (CDC) to enhance diabetes surveillance and quality standards across the country. As a result, the CDC published a Diabetes Report Card every two years to provide information about the current status of diabetes in the United States.

Resource: Diabetes Discrimination by the Diabetes Council. 

Australia: National Diabetes Services Scheme (NDSS)

Began as a joint initiative between the Australian Government and Diabetes Australia in 1987. Registration to the NDSS is free and open to all Australians diagnosed with diabetes. Once registered, you can receive free advice on diabetes management and access to NDSS products, such as needles, syringes and blood glucose test strips, through local pharmacies.  From April 1, 2017, the Australian Government will provide free continuous glucose monitoring products to all people under 21 with type 1 diabetes.

Canada: The Canadian Charter of Rights and Freedoms

Amended in 1981, section 15 disallows discrimination based on physical disability by federal, provincial and territorial governments. While this does not apply to the private sector, most workplaces are covered by provincial human rights legislation, which also prohibit discrimination based on disabilities. Employers must do what they can to allow a person with diabetes to perform the job unless the employer would suffer “undue hardship” in terms of health, safety or cost.

United Kingdom (England, Scotland, and Wales): The Equality Act

Passed in 2010, this law requires schools to make reasonable adjustments for children with diabetes. For example, schools must have enough trained staff to enable a child with diabetes to participate in all parts of school. In Northern Ireland, similar requirements are required by the Disability Discrimination Act, passed in 1995.

Know of a law that isn’t included here? Contact Ryanne@beyondtype1.org.