New York City public school students with diabetes could receive better care under a tentative agreement announced this week between a group of parents and education officials.

The preliminary settlement is the result of a class-action lawsuit brought by three mothers in 2018 on behalf of their young children with Type 1 diabetes. They said schools did not have trained staff to provide essential care for their kids, ages 4 to 7, including monitoring their blood sugar, and providing glucose, insulin or glucagon as necessary.

“This is a huge overhaul of the way the [New York City] Department of Education treats students with diabetes,” said Torie Atkinson, a senior staff attorney at Disability Rights Advocates who represented the plaintiffs.

Atkinson said there are nearly 2,000 students with diabetes in the city’s public schools.

“This situation was beyond unnerving and stressful and [my child] was always a moment away from a severe health episode,” said Yelena Ferrer in a sworn statement.

Fearful for their children's safety, the mothers accompanied their kids to school every day for weeks or months while educators scrambled to put protections in place.

One of the mothers said she worried she would lose her job because she had to be in school with her daughter. Another said her son was absent many days because she could not always accompany him.

The mothers and the American Diabetes Association sued the city on behalf of all New York City public school students with diabetes.

Diabetes comes in three forms. Type 1 diabetes typically develops during childhood, and federal data shows it's becoming more common among children and teens. Type 2 causes most cases of diabetes overall but is more common later in adulthood. The third version of diabetes only happens during pregnancy.

Atkinson said the public school system has never had a centralized process for supporting students with diabetes, with major gaps in training.

The lawsuit argues students could not attend school safely or access the same extracurricular activities and field trips as their peers – a violation of the Americans with Disabilities Act and the New York City Human Rights Law.

To address those problems, the settlement requires schools to move swiftly to enact “504 plans” for all students who require them before classes begin in the fall or within the first few weeks. The plans outline care for students with a range of disabilities, including asthma, severe allergies, attention deficit hyperactivity disorder, mobility issues and depression.

Atkinson said she hopes the timeline requirements will improve care for all students with 504 plans, as well as those with diabetes.

“For the first time the DOE has agreed to actual timelines to create the plan, and to implement it,” she said.

The settlement also mandates training so that all school staff are able to monitor students with diabetes and respond to symptoms of dangerously high or low blood sugar. Nurses and paraprofessionals will receive additional training based on students’ individual needs, and bus drivers will be trained to provide glucagon in emergencies.

While the settlement is not final yet, city officials said the education department has already begun making changes.

“We are pleased to have worked constructively with advocates to improve services to these students and have begun implementing the reforms set forth in our settlement agreement,” said Art Nevins, an education department spokesperson.

“DOE to its credit took [the lawsuit] very seriously and went almost immediately into settlement negotiations,” Atkinson said. “We’re thrilled that the reforms in the settlement agreement will ensure that students with diabetes receive the care they need to fully participate in school."

Brooklyn Federal Judge Nina Gershon granted preliminary approval to the proposed settlement last week, with a hearing scheduled for April. The court must still grant final approval before the settlement goes into full effect.