Previously, I have blogged that with respect to title II, the critical question is whether a person has meaningful access to the services, programs, activities of the public entity. This week’s case, Medina v. City of Cape Coral (an unpublished decision), , 2014 U.S. Dist. LEXIS 168680 (M.D. Fla. December 5, 2014), stands for the proposition that meaningful access does not mean total access nor does it mean that plaintiff’s preferences determines meaningful access. As is my usual practice, I have divided this blog entry into categories: facts, court’s reasoning, and takeaways. The reader is free to focus on any or all of the categories.


A child who had participated in defendant’s school programs and summer camp since the age of five was diagnosed with type I diabetes. As a result, the child requires various treatments, including daily monitoring of her blood glucose levels and weekly maintenance of her insulin pump. The child is able to monitor her glucose levels independently but is unable to self administer insulin injections if needed. In anticipation of having the child participate in the defendant’s 2012 summer camp, plaintiff contacted the defendant’s risk manager informing him of her child’s diagnosis and requesting that they provide a staff member at the summer camp whom would be able to administer insulin injections if needed. While the defendant refused that request, the defendant did have a comprehensive diabetes accommodation policy, which they also amended during the course of litigation. In particular, the policy provided that: the defendant would assist in monitoring the child’s glucose levels; if the child’s glucose level fell outside the target range, the defendant agreed to take action such as providing fast acting carbohydrates and contacting the plaintiff so that she could take her to a physician; in the case of more serious symptoms, calling paramedics to the scene; and providing glucagon injections in the event of an emergency. Other important facts included: 1) it was rare that the child needed the requested insulin injections. In fact, plaintiff stated that the child only needed three insulin injections since her diagnosis in 2012, and in those situations, it was absolutely not an emergency because the child’s insulin pump kept the child regulated; 2) plaintiff could not remember a time in the last year when the child’s school nurse was required to give the child an insulin injection; and 3) plaintiff admitted that assuming glucagon injection could be given, her child would be able to attend camp with just an insulin pump.

Court’s Reasoning for Granting Defendant’s Motion for Summary Judgment

1. With respect to title II of the ADA, when it comes to deciding whether a modification/accommodation to a public entity’s service, program, or activities is reasonable, the question is whether the modification/accommodation results in meaningful access.

2. When an individual already has meaningful access to a benefit to which he or she is entitled, then no additional accommodation, regardless of whether it is reasonable or not, need be provided by the governmental entity.

3. The defendant’s diabetes accommodation policy, mentioned above, was quite extensive. That the policy did not provide access to trained individuals capable of administering insulin injections, did not prevent the child from enjoying meaningful access to the defendant’s program.

4. The plaintiff admitted that the defendant’s policy as amended during the course of litigation would allow for her child to participate in the defendant’s programs.

5. Even without staff available to administer injections, the child was able to participate in and enjoy the defendant’s program to the same extent as any other participant except for rare occasions when the child might miss a single meal.

6. The ADA entitles persons with disabilities to reasonable accommodations not to optimal ones finely tuned to their preferences.

7. Since the defendant already has a system so that the child can meaningfully access their programs, insulin injections are not a necessary accommodation.


1. A defendant can go a long way towards becoming victorious in an ADA lawsuit by having a comprehensive policy based upon the best available scientific or medical evidence. That policy should lay out detailed steps that the defendant will take. Doing so, can go a long way in showing the court that the defendant’s policy ensures that meaningful access is granted to the person with a disability.

2. Meaningful access does not mean total access nor does it mean that a plaintiff’s preference has to drive the outcome (be careful here because if you are dealing with effective communications, it doesn’t work that way as seen in this blog entry).

3. It doesn’t say in the case that the plaintiff’s admissions were from a deposition, but one has to assume that such was the case. If so, one wonders just what the deposition preparation involved.

4. It is also curious as to why once the defendant amended their policy during the course of the litigation, that the case did not settle. For example, why not settle the case, insist on a consent decree to ensure that the amended policy is implemented, and then go for attorneys fees on the grounds that the plaintiff prevailed because the defendant changed their policy as a result of the litigation?

Lest I forget, you still have the chance to vote for my blog to be the best of the category(niche) here, and please do so, if you are so inclined. I am fortunate that there are so many great blog entries in the category. Also, I am even more fortunate that none of these blog entries in the niche category overlap with each other. That way, regardless of who wins in this category, I can’t get an inferiority complex:-)