People with diabetes face discrimination at work, at school, and elsewhere in their lives. The American Diabetes Association is committed to ending this discrimination through its legal advocacy program. To do so, we have developed a four-step approach:
The goal being to resolve the problem at the earliest step possible.
Because much of the discrimination that people with diabetes experience is the result of decision-makers’ ignorance of diabetes and current methods of diabetes management, we begin by trying to educate in order to prevent discrimination or stop ongoing discrimination.
For example, in response to the barriers that children with diabetes face at school, the Association proposed developing nation-wide materials on care of students with diabetes that would have the imprimatur of the organizations and agencies respected by school personnel and education officials.
The result is the National Diabetes Education Program’s “Helping the Student with Diabetes Succeed: A Guide for School Personnel,” a comprehensive guide developed by the Association, the National Institutes of Health, the Centers for Disease Control, the Department of Education, and key organizations in the diabetes and education communities.
Similarly, we worked with Cornell University on educational materials for employers and collaborated with the Equal Employment Opportunity Commission on initiatives to educate employers and the legal community about diabetes issues in employment.
The Association receives hundreds of calls and letters each month from people who want to understand their legal rights. The calls involve topics such as employment, education, incarceration, police brutality, places of public accommodation (including public transportation, restaurants, and concerts).
We have developed a system in which general requests for information about discrimination issues are handled by our Center for Information and Community Support, but individuals who feel they are currently experiencing discrimination are routed to the Association’s Legal Advocate who provides case-specific information and resources.
The goal is to empower those who are experiencing discrimination by giving them the means to educate decision-makers and, when that doesn’t work, the tools to negotiate resolutions or to pursue litigation. These tools include:
- understanding one’s rights;
- knowing how to effectively utilize elected officials, media, and grassroots organizing to counter discrimination; and
- having access to lawyers and health care professionals.
The original focus of the Association’s legal advocacy efforts was litigation and it remains a key element of the program. The Association appears as amicus curiae in important diabetes cases, usually at the appellate level.
For example, the Association was actively involved as an amicus in Kapche v. City of San Antonio, a case involving an individual who was turned down for a position as a police officer solely because he has diabetes. The case reached the Fifth Circuit twice (176 F.3d 840; 304 F.3d 493), with the court ultimately overturning prior case law and determining that blanket bans that disqualify a person with diabetes from a given position without an individual assessment are unlawful.
On rare occasions, the Association brings its own litigation. For example, the Association was a plaintiff in Rosen v. City of Philadelphia, Civil Action No. 2000-CV-764 (E.D. Pa), a class action involving the mistreatment of people with diabetes in police custody.
The settlement of this lawsuit included procedures to ensure that people with diabetes have access to food, medication, and health care personnel, and that police officers receive training on the medical needs of people with diabetes. These procedures and training materials serve as a national model.
In addition to direct litigation, the Association assists private and governmental lawyers around the country who are working on individual or class discrimination cases. We advise lawyers, edit briefs, and develop legal arguments, particularly with respect to those issues that require expertise in both discrimination law and the disease of diabetes.
We have developed an on-line materials bank to train lawyers and to provide litigation resources, and a listserv to connect lawyers around the country who are working on diabetes discrimination cases. In order to make sure the larger legal community is aware of the Association's legal resources, we have written for and spoken to disability rights and attorney organizations on topics ranging from establishing coverage under the Americans with Disabilities Act to the process of building a legal advocacy program within a voluntary health association.
We also work closely with a number of federal agencies including:
- Department of Justice
- Equal Employment Opportunity Commission
- Department of Education
- National Institutes of Health
- Centers for Disease Control.
Finally, sometimes the most appropriate tool is changing the laws or policies that lead to discrimination. The Association took a lead role in advocating for the Americans with Disabilities Act Amendments Act, a federal law that will help people with diabetes qualify for protection under the Americans with Disabilities Act and the Rehabilitation Act of 1973.
Working through the legislative and regulatory processes, we were also able to change Department of Transportation regulations that prohibited anyone who uses insulin to treat diabetes from driving a commercial vehicle in interstate commerce.
The Association has also developed state model school legislation to make sure students with diabetes are medically safe at school and have the same access to educational opportunities as do other students. So far, either comprehensive or targeted school legislation has passed in seventeen states.
To meet the needs of people with diabetes, we have developed networks of attorneys and health care providers who are willing to work on educational initiatives, litigation, and legislation. The Association's Advocacy Attorney Network consists of over 600 lawyers who have agreed to work on diabetes discrimination matters, usually pro bono.
Lawyers, however, are not enough. Given the complexity of the medical issues involved, our anti-discrimination efforts simply cannot be successful without help from health care professionals. The Association's Health Care Professionals Legal Advocacy Network is made up of many of the country’s most highly-respected diabetes health care professionals, all of whom have agreed to provide pro bono assistance on diabetes discrimination matters. The Association’s legal advocacy efforts are spearheaded by the Legal Advocacy Subcommittee, a group of lawyers and health care professionals with expertise in the various substantive areas in which the Association focuses its anti-discrimination efforts.
Diabetes Legal Advocacy Comes of Age (PDF)
Michael Greene, former national chair of the American Diabetes Association and the founder of its legal advocacy efforts, describes ADA's approach to fighting discrimination and its many successes during the period from 1999-2006.
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