The one thing I notice is that a lot of the accommodations are based on Liam being allowed to test his BG and act on that number, but my concern is that if you want the data from the CGM to be considered important and actionable, then you need to have some bullet points related to how to interact with and respond to low alarms, high alarms and numbers. For instance, our care plan at daycare dictates treating lows and highs based on CGM data. Even if you require a confirmatory BG stick, you should probably dictate that, for instance, a caregiver needs to check a BG number if the CGM reads below 80 or above 200 or whatever.
The other thing I would imagine is a sticking point, that I’ve read in different forums, is when, say, a kid is more or less insulin sensitive or resistant, their settings are changed and the school district balks at giving a correction at, say, ISF of 200 instead of 250. So you need to specify that the parents are allowed to change pump settings and or insulin dosing regimens without a corresponding doctor’s note.
At Liam’s age I would also specify something like: At any given time, a person who is tasked with monitoring Liam’s CGM and has been trained to respond to low blood sugar is close enough in proximity to treat within 5 minutes. We’ve found that otherwise during extra events (say, a dance class), Samson will be going up to a different classroom and no one there is being told to monitor his numbers.
Also do you need to specify what to do in the event that a site comes out or a pod fails, or if the sensor falls off? We have these things happen frequently at school and we have contingency plans for how to respond when there is no data. I’m not sure if school nurses have to be trained to insert a new sensor or replace an infusion site, or whether it’s considered fair game for a parent to come do that.