Why I'm a Mother

Interesting Insight (0.00 / 0)

I think you have one line in here that is worth highlighting:

Parents can appeal to principals or local school boards but if these entities authored the misguided policies in the first place, parents are unlikely to prevail.

What people need to understand is that schools in this nation are under local control. This means the community elects its own School Board. The School Board - and no one else in the system - sets policy. The Superintended works for the board, and implements the Board's policy decisions. All other administrators directly or indirectly report to the Superintendent. Teachers - the ones actually in the classroom - routinely have absolutely no say in policy decisions, and report to school Administrators. No one sets policy but the School Board.

So why is this fact important? This Tuesday, April 7th is the Consolidated Election for local offices - including school board positions.

One of the downsides of local control is that any community member with absolutely no experience in education can walk right off the street, and with as few as a couple thousand votes, be in charge of a multi-million dollar enterprise.  So to use your example, a community member with an axe to grind about needles could get themselves elected, and push through a policy like "no blood, no needles" that affects all students in the community. Imagine if this approach applied to corporate boards!

This is why it is critical that everyone learn about your candidates running for school board and vote on Tuesday.

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by: michael in chicago @ Sat Apr 04, 2009 at 10:51:21 AM CDT

Sadly there was no one runnng (0.00 / 0)

I went to vote the other day and there was a spot on my local school board with no candidate.

You are so right these are very important positions that affect our children yet are often overlooked by the community at large.

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by: data @ Sat Apr 04, 2009 at 12:40:30 PM CDT

we have a situation like that here in flossmoor... (0.00 / 0)

we are running one of our "team obama" members as a write-in...

"We have a lot of kids on the ground acting like adults and we have a lot of adults in this room acting like kids," President Obama told his advisors about all the infighting

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by: bored now @ Sat Apr 04, 2009 at 12:49:56 PM CDT

[ Parent ]

Fair and Resonable (0.00 / 0)

I think this statement is very appropriate:

...ask them to engage negotiations on this bill with a commitment to reach a fair and reasonable compromise.

But this statement also requires understanding of why opposition has been raised in the past. The following is from IEA and details the opposition to the 2008 version (HB 5960) of The Care of Students with Diabetes Act.

First, the opposition to this act previously had not just come from IFT and IEA, but also the Certified School Nurses Association, the Chicago Teachers Union, Illinois Statewide School Management, LEND and SCOPE.

The focus of the opposition appears to center on the requirement that the district designate an "diabetes care aide" - an unlicensed, non-healthcare employee charged with implementation of a student's diabetes medical management plan -which could include the injection of insulin and glucagons.

"Routine care" as noted in your post is a broad definition, and could reasonably be interpreted to include the testing of blood and injection of insulin and glucagons.

To quote IEA:

It is unrealistic to expect a non-medically trained, unlicensed volunteer to properly treat an individual in need of care. Medical care of a student should be conducted  by a licensed, certified healthcare professional such as a school nurse.

This is why I believe your statement is appropriate, as a fair and reasonable set of supports should be the goal here. But the broader impacts on the classroom learning environment, legal liability to the school districts and their staff, and district tax payers should be a part of this discussion.

To portray this issue as being opposed randomly by the "influential unions" such as IEA and AFT does not accurately represent the debate.

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by: michael in chicago @ Sat Apr 04, 2009 at 13:38:14 PM CDT

Regrettably, it is accurate (0.00 / 0)

More than fifteen organizations originally opposed this bill. We worked very hard to understand and accommodate opposition concerns and have whittled away all influential opposition except the teachers' unions. There's nothing random about that.

A few points of clarification:

The Care Act (HB146/93rd) does not require appropriations. Zero.

The nursing association's counter proposal to this no-cost, volunteer-based proposal, however, was a full staffing mandate---a nurse in every school. Normatively appealing, perhaps, but problematic for several reasons.

One, a nurse in every school does not solve the problem; nurses simply cannot be everywhere at all times. Two, there are not enough nurses to fill a mandate. Three, most school nurses are woefully out of date on the current standards of care. Why? School nursing is often a second career and since continuing education requirements are fulfilled in terms of hours, not competency, school nurses don't necessarily have any relevant training in pediatric care, much less diabetes.

Still, here's the real rub: Applying an acute care model of health care to a chronic illness like diabetes is unimaginably expensive and no expert in diabetes care endorses the idea. For schools in Illinois it would cost more than $200 million annually, assuming you could hire a nurse, inclusive of benefits, for $35,000 a year. Applied statewide, the cost of mandating nursing care for chronic illness quickly escalates to a billion dollars. Just think about how many teachers we could hire with that. Now, compare that to the number of students with type 1 diabetes (apprx. 1:600).

To be absolutely clear: Routine diabetes care IS blood glucose testing and insulin injection (most children with diabetes have type 1 though the incidence of type 2 is rising). Despite the lancets and needles, specialists in diabetes care, as a matter of practice train unlicensed volunteers to provide routine diabetes care and expect their trainees to train others. Parents train babysitters, health care aides train bus drivers, teachers train soccer coaches.

We expect unlicensed people to restart hearts at school. We inject children in anaphylactic shock with epinephrine. I'm confident we can figure out insulin and sugar. Because federal law requires we accommodate children with disabilities, because we reduce liability by providing this simple to learn care, and because by failing to comply, we impose crushing, unconscionable costs on families and deny students with diabetes their right to an education, we are obligated, the teachers' unions are obligated, to respond.  

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by: Suzanne @ Sat Apr 04, 2009 at 22:01:35 PM CDT

[ Parent ]

"right to an education" (0.00 / 0)

No one denies the right to a free and appropriate public education. But what this concept means has been the root of much debate. Regarding this, I looked to the Individuals with Disabilities Education Act. From the ADA on IDEA:

Usually there are two overall goals for a child with diabetes under IDEA.
-To provide the child with any needed assistance to keep up with schoolwork that the child either missed because he or she was involved with diabetes care, or had difficulty understanding because he or she was experiencing high or low blood sugar levels; and
-To keep the child safe and maintain optimal learning ability by providing the means to keep his or her blood sugar levels in the best control possible.

That second bullet seems rather vague, and the heart of your argument. However, the rest of that link discusses the educational impacts of diabetes as it relates to IDEA via Special Education services (IEPs, 504's, etc.). Again from ADA:

To receive services under IDEA, a child with diabetes must show that he or she needs special education and related services in order to benefit from an education. An evaluation of the child must show that, because of the child's diabetes (or other qualifying disability) the child has limited strength, vitality, or alertness that adversely affects the child's educational performance. Simply put, the diabetes must make it more difficult for the child to learn.

Your argument seems much more broad than this definition.

A few questions based on your comment:
- You seem positional: train a volunteer. What volunteer? Do we recruit volunteers or is it your position that this be assigned to the classroom teacher?
- How would this person and by extension the school district be protected from liability should a mistake occur to either the child or the person administering the medicine?
- Where and when would routine maintenance occur?

Regarding your examples, Defibrillators (AEDs) or EpiPens are emergency use items, require little or no training, nor would their emergency use create a routine opportunity for injury to the student or harm to the operator.

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by: michael in chicago @ Sat Apr 04, 2009 at 23:27:27 PM CDT

[ Parent ]

Other Laws More Relevant (0.00 / 0)

IDEA can apply to a student with diabetes but it is unlikely that diabetes alone warrants an IDEA evaluation. The more readily applicable federal laws are the Americans with Disabilities Act and the Rehabilitation Act of 1973 which provide the Section 504 plans you mentioned.

As for volunteers, many teachers and school staff want to help students and serve as a back-up person when a nurse is not available but are often prohibited by school policy. The Care Act simply says that someone must be available. A nurse with recent, relevant training is ideal but there has to be a back up. The Care Act does not, cannot, force a teacher or any other staff member from serving as a trained volunteer if they don't want to.

As for liability, the risks of NOT aiding a student outweigh the chances of getting something dangerously wrong. This idea that well-intended action is privileged over a refusal to act is well-developed in a lot of state and federal law including the ADA. Still, the Care Act includes specific language to protect volunteers.

Routine training would happen annually as part of an in-service. At least that's how the Act is drafted now. There are numerous organizations like the American Diabetes Association and children's hospitals, and pediatric endocrinologists and certified diabetes educators that are eager to provide this training. For free.

It's true, the examples I cited are emergency responses but they are nonetheless events that staff are trained for which begs the question: Wouldn't it be better to learn how to assist with routine care and thus avoid a diabetic emergency?

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by: Suzanne @ Sun Apr 05, 2009 at 01:25:06 AM CDT

[ Parent ]

Appreciate the answers (0.00 / 0)

A question on this part:

The Care Act simply says that someone must be available. A nurse with recent, relevant training is ideal but there has to be a back up. The Care Act does not, cannot, force a teacher or any other staff member from serving as a trained volunteer if they don't want to.

How do you reconcile the first and the last sentence of this? Someone must be available and no one can be made to do this? What is to stop a first or second year teacher in a small school from being volunteered to do this by their administrator, especially should the parent be aggressive and prone to litigation? It would never be stated as job-threatening or required, but the implication would be abundantly clear.

To address your final question leads to some other questions. First, preventing a diabetic emergency and routine care are two separate issues, especially from a liability perspective. By asking this question, what you've implied is that if there was a mistake or omission made in the routine maintenance (i.e. blood testing and insulin injection), even if done by pure accident, if a diabetic emergency occurred there could be be legal ramifications for the volunteer and school district, and via proxy the district taxpayers. Correct me if I'm wrong, but your question seems to indicate this to be the course of action most likely.

What age group specifically are we really focusing on here? Once students get into middle school they are often able to manage their routine care. High School students certainly are. According to the CDC, approximately 0.02% of all people under the age of 20 have diabetes; even fewer under the age of 10. Of these, an even smaller percentage would require the routine maintenance this bill is requiring, and even smaller percentage of these unable to perform this themselves. This seems tremendously targeted for a piece of legislation.

I guess I'm confused as to the end-goal of this legislation. It appears to require someone to perform the child's routine maintenance - essentially assume responsibility for monitoring blood testing and injection of insulin - when according to the statistics most students will be of an age to perform this themselves. Does this legislation seek to plug this age gap? What about transition to self directed maintenance? At what age is this routine maintenance to be the responsibility of the student to monitor and perform?

You've noted this should be done for several reasons - to ensure their right to an education, to avoid an emergency, undue cost to parents, etc. I'm not sure I follow what the ultimate goal for this legislation is, and what group of students it targets.  

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by: michael in chicago @ Sun Apr 05, 2009 at 10:37:21 AM CDT

[ Parent ]

Addressing several points (0.00 / 0)

What age group specifically are we really focusing on here? Once students get into middle school they are often able to manage their routine care. High School students certainly are. According to the CDC, approximately 0.02% of all people under the age of 20 have diabetes; even fewer under the age of 10. Of these, an even smaller percentage would require the routine maintenance this bill is requiring, and even smaller percentage of these unable to perform this themselves.

Everybody with type 1 diabetes requires routine maintenance. It is true that high school, and maybe middle school, students should be able to do this for themselves if allowed to do so. As I understand it, one of the goals of this legislation is to deal with schools that in fact prohibit students from doing their own self-maintenance.

This seems tremendously targeted for a piece of legislation.

Although this particular legislation deals only with one particular type of disability, it goes to the general concept of students with disabilities needing reasonable accommodations for their disability.

Someone must be available and no one can be made to do this? What is to stop a first or second year teacher in a small school from being volunteered to do this by their administrator, especially should the parent be aggressive and prone to litigation? It would never be stated as job-threatening or required, but the implication would be abundantly clear.

Why should anyone need to "be volunteered?" The porblem will be choosing which volunteers to accept. If you were a teacher, wouldn't you volunteer if you were allowed to do so? Of course you would! The problem, as you point out in your first post, is school boards that not only are anti-student but, as we see here, anti-teacher in prohibiting teachers from doing what they know is best.

Bill Thomasson

Permission to reprint explicitly granted

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by: wathomasson @ Sun Apr 05, 2009 at 12:10:30 PM CDT

[ Parent ]

Good distinction to raise (0.00 / 0)

Although this particular legislation deals only with one particular type of disability, it goes to the general concept of students with disabilities needing reasonable accommodations for their disability.

So far, I don't see this Act as dealing primarily with accommodation, but mandating the performance of routine maintenance which includes blood testing and injection of insulin - essentially dispensing of medications. Speaking for myself,  this is probably the objection to this type of legislation resides as it would place the liability for care on the school district, whereas providing accommodation would not. I don't believe accommodation would be objected to by anyone, especially where medically necessary such as with diabetes.

Also you mischaracterize my first comment. School boards are not inherently anti-student. They are by nature "big picture" in scope, and hence can appear be opposed to specific student needs in their attempts to balance these with the needs of the overall population.

For example, lets look at how accepting liability for the maintenance of diabetes might be interpreted. Moving beyond emergency measures to routine maintenance for one disability might then be looked as discrimination against students with other conditions that require routine maintenance and administration of other medications.

A next logical step might be for a school district to then be charged with administering other such medications required for routine maintenance of other disabilities thereby assuming the liability for a much wider dispensing of medications. Again, via this act, this would be done by a minimally trained volunteer probably with no formal medical training. This raises a host of questions and legal liability issues.

Whether or not a teacher would volunteer if allowed to do so has many more levels of liability and appropriateness than one might realize. There is not only personal liability, but as an agent of the district there is also considerable liability to the district. There is also the question of time and resources related to teaching and learning that this potentially would impact. What you describe as "best" has applications to a broader perspective than your sweeping conclusion might indicate. This is not a simple issue.

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by: michael in chicago @ Sun Apr 05, 2009 at 12:48:53 PM CDT

[ Parent ]

Clarifications (0.00 / 0)

So far, I don't see this Act as dealing primarily with accommodation, but mandating the performance of routine maintenance which includes blood testing and injection of insulin - essentially dispensing of medications

You seem to be under the impression that the law would require the volunteer in all cases to actually perform the blood testing and inject the insulin as needed. That's not my understanding at all. For students old enough to do these things themselves, the volunteer will simply provide whatever level of supervision the school district deems necessary in order for maintenance to occur.

Incidentally, I notice that on several occasions you speak of classroom teaches. I don't think there is anything the requires the volunteer to be a classroom teacher. In many cases it might be a school secretary or perhaps an assistant principal. Anyone who is a full-time employee normally present at that specific school throughout normal school hours.

I don't believe accommodation would be objected to by anyone, especially where medically necessary such as with diabetes.

What you mean by "accommodation" is unclear. You seem to be referring to a situation where the student is allowed to carry the necessary equipment and use it as needed, without supervision. But many if not most schools refuse to allow that sort of accommodation.

A next logical step might be for a school district to then be charged with administering other such medications required for routine maintenance of other disabilities thereby assuming the liability for a much wider dispensing of medications.

This does indeed set a precedent for dealing with diseases such as asthma. Asthma is less controversial because the medications are inhaled rather than injected. Consequently, many school districts simply allow students to carry their medications and use them as needed. But if they do not, then they have a responsibility to provide a mechanism that will in fact allow the medications to be used. This is already implicit in the Rehabilitation Act and the ADA, but the Care Act will provide a clear example of what they need to do.

Again, via this act, this would be done by a minimally trained volunteer probably with no formal medical training. This raises a host of questions and legal liability issues.

A very important point here is that routine diabetes care is essentially never provided by trained medical professionals. For patients too young to do it themselves, it will be provided by a parent or someone acting in the parent's stead. That is why many laws distinguish insulin from other injected medications.

Which brings up an important point regarding liability. I am no lawyer, and welcome input from anyone with appropriate legal training, but it is my understanding that schools are deemed to be in loco parentis. That means they have, simply under common law, the obligation to provide the care that a parent would under similar circumstances. Which includes providing (or supervising) routine diabetes care.

Bill Thomasson

Permission to reprint explicitly granted

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by: wathomasson @ Mon Apr 06, 2009 at 10:27:20 AM CDT

[ Parent ]

Precisely right, Bill. Thanks. n/t (0.00 / 0)

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by: Suzanne @ Mon Apr 06, 2009 at 16:56:50 PM CDT

[ Parent ]

This is not the economic climate (0.00 / 0)

in which increased staffing is likely to be implemented.  Rather the contrary.  School nurses are being eliminated in cost-saving drives.

I am convinced that the only thing that will shift the school boards is lawsuits and more lawsuits.  It is fear of lawsuits that motivates most of these inane policies in the first place.

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by: curmudgeon @ Sun Apr 05, 2009 at 09:54:03 AM CDT

[ Parent ]

Lawsuits (0.00 / 0)

Fear of lawsuits is what will drive school boards to pass policies to limit any liability routine maintenance might present and block any compromise that will achieve any type of legislation on this issue. And lawsuits to a local school board create deeper financial issues for the school district that lead to deeper cuts to educational programs that ultimately lead to more rigid policies passed by the board in response.

Both sides of this debate have merit and must be addressed. I'm still not convinced that this legislation is the right fit for the problem however. But I'm certain suing school districts will not arrive at a productive solution either.

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by: michael in chicago @ Sun Apr 05, 2009 at 10:48:59 AM CDT

[ Parent ]

The behavior of school districts (0.00 / 0)

is what brings on the lawsuits, when they leave no other options open.

It is definitely fear of lawsuits that leads to the restrictions in question, and there is really no other lever that will move them in the other direction.

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by: curmudgeon @ Sun Apr 05, 2009 at 21:00:56 PM CDT

[ Parent ]

Sometimes, but not always (0.00 / 0)

The behavior of parents sometimes necessitates lawsuits. If a parent seems prone to litigation or is an unreasonably aggressive advocate this will garner a certain stonewalling that seems to turn into self fulfilling prophecy driving the process to the courts.

And sometimes that's where this belongs

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by: michael in chicago @ Sun Apr 05, 2009 at 22:08:00 PM CDT

[ Parent ]

Another symptom of our broken health care system (0.00 / 0)

One, a nurse in every school does not solve the problem; nurses simply cannot be everywhere at all times. Two, there are not enough nurses to fill a mandate. Three, most school nurses are woefully out of date on the current standards of care. Why? School nursing is often a second career and since continuing education requirements are fulfilled in terms of hours, not competency, school nurses don't necessarily have any relevant training in pediatric care, much less diabetes.

I can see both sides of this particular issue -- a better scheme is certainly needed yet teachers are understandably reluctant to have to deal with medical care -- however the sad statement above strikes me as a symptom of our busted health-care system. There should be enough nurses; they should be as well-trained.

If a school nurse can't be everywhere, well, neither could a lone volunteer. And a nurse could certainly be trained as well as a random volunteer might be.

The only reason against mandating nurses for this purpose is funding them. There's the rub. But it might be addressed as part of overall health-care reform. If we had universal health-care, one way of bringing down costs overall would be to make sure that schoolchildren get preventative care at school.

An interim solution, perhaps, for this particular issue might be mandated annual education for school personnel/school boards that teaches about pediatric diabetes (perhaps along with other health issues such as allergies). That might at least help some of the problems about insulin pumps, needles in school, etc. It would garner less opposition than one that turns teachers into health aides.  

Ill and Uninsured in Illinois

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by: Ill and Uninsured in Illinois @ Sun Apr 05, 2009 at 13:06:02 PM CDT

[ Parent ]

The specter of liability (0.00 / 0)

is often and mistakenly brought forward as a reason not to comply with federal law and accommodate a student with diabetes. Yet federal law has already settled this question and, more, the evidence from those states that have implemented a statewide policy like The Care Act Unequivocally support the federal view. We are, as a state, the outlier here, not kids with diabetes or other disabilities.

Adverse events (diabetic emergencies) decrease, student health measures, attendance and participation rates increase. Are there medication errors? Yes, but more than in populations served exclusively by licensed personnel. In fact, the incidence is actually LESS. Most interesting, I think, is that this: medication errors are, in the case of diabetes, recoverable. In other words, when mistakes have happened, they have been corrected with no adverse consequence.

The fundamental issue really is simple: Are we, as a state, going to comply with federal law or not? If the answer is yes, what remains is how we're going to do it. Michael sees this not primarily an issue of accommodation, but mandating the performance of routine care. The problem is they are one in the same. If a young student needing assistance with diabetes care does not receive it, he or she is not accommodated.

You're right, this is an extremely targeted piece of legislation and it's an embarrassing statement, I think, on how we've allowed fear and self-interest to trump one of the few rights a child possesses. It's also a reflection of the extreme and debilitating costs this failure imposes on families already crushed, both emotionally and financially.

The Care Act does not turn teachers into health aides. It allows teachers and other staff members who wish to help, the ability to do so. More, it provides them the opportunity to become educated about a disease that will occupy more and more space in their classrooms as diagnoses increase. Whether a teacher chooses to learn how to test glucose or help with a lunchtime insulin injection is their choice but I can't imagine any teacher not wanting--at a minimum--to know what to do in the event of an emergency. I can't imagine any teacher not wanting to learn.  

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by: Suzanne @ Sun Apr 05, 2009 at 13:52:51 PM CDT

Whoops (0.00 / 0)

When summarizing the state research, I should have written "Yes, but no more than in populations served exclusively by licensed personnel. Typing too fast . . .  

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by: Suzanne @ Sun Apr 05, 2009 at 14:08:36 PM CDT

[ Parent ]

More questions (0.00 / 0)

The fundamental issue really is simple: Are we, as a state, going to comply with federal law or not? If the answer is yes, what remains is how we're going to do it. Michael sees this not primarily an issue of accommodation, but mandating the performance of routine care. The problem is they are one in the same. If a young student needing assistance with diabetes care does not receive it, he or she is not accommodated.

In this comment, you've now narrowed the spectrum to "young" students. As mentioned in my previous comments, I believe most students with diabetes are at an age where they can monitor and administer their own routine care if provided the accommodation of time/location/storage to do so. In this I think we have consensus.

I think we also agree that "young" students can not do this on their own, and therefore the accommodation would necessitate  the inclusion of routine maintenance support as well. I think this is a reasonable assumption as well, but needs better definition related to age and length of transition period.

Where we appear to disagree is in how this accommodation for this narrow demographic should be facilitated. I have yet to formulate a position on this, but am raising the questions that would apply to a blanket "mandate" of providing routine maintenance to students with disabilities, as like it or not, in reality this does raise broader issues, including that of liability.

My comment about it being "targeted" is to raise the issue that this practice has overlap with other disabilities that require routine maintenance in the form of administering medications. You have not addressed how this Act might impact this larger dynamic.

Is it your contention that this Act is needed because school districts are as a general practice not providing any accommodations for students with diabetes? Or is it that they are not providing the type of accommodation you are requesting (a dedicated "volunteer" aide to assume the responsibility for routine maintenance).

Additionally, what specific federal law are you alleging the state is not following? ADA? I've raised IDEA in another comment, but you noted that the 504 process was a better fit. I'd ask you to be more specific with this charge.

Your comment regarding teachers not wanting to learn about emergency procedures I feel is misleading. This type of training is pretty standard and also part of the student's health care plan that is shared with teachers. But again, you are conflating an emergency training with administration of routine maintenance that includes the dispensing of medication.

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by: michael in chicago @ Sun Apr 05, 2009 at 15:17:50 PM CDT

[ Parent ]

What you provide (0.00 / 0)

is dependent on what a child needs. A younger child needs hands-on assistance from trained, caring adults. An older child needs the same trained and caring adults not to prevent them from caring for themselves. A 504 plan should ensure these needs are met but some schools quibble.

The Care Act itself is not blanket mandate. The blanket "mandate," if you will, was created by the Americans with Disabilities Act (ADA) and the Rehabilitation Act (Section 504). These are the two federal laws that schools oftentimes run afoul of when it comes to diabetes (see the original post for examples).

If you read The Care Act, you will see that it provides a baseline, a set of specifics that apply depending on a student's level of self-sufficiency. Why do we need the specifics? Two reasons. One, most people don't have good, up to date information on diabetes care. Two, currently there's a patchwork of policies across the state and that variation serves some kids and really hurts others.  

So yes, it is absolutely, without equivocation, my contention that this Act is needed because some school districts do not properly accommodate students with diabetes. Some are also not responding to reasonable requests made by parents who seek accommodations for their children, (i.e. requesting a 504 plan, as provided by the Rehabilitation Act).  It's not an either / or state of affairs. We're getting it wrong in all sorts of ways.

By the way, I did not say teachers don't want to learn about emergency procedures. I said I couldn't imagine a teacher not wanting to learn. Also, training in emergency procedures is not "pretty standard." That's why a little girl can be sent to the nurse's office, not make it, and fall unconscious in a hallway for want of a glucose tab. The Care Act creates the minimum standard, the one you might think exists (but doesn't).

We disagree on how "this narrow demographic should be facilitated"? Which narrow demographic? Children? Children with disabilities? Or children with diabetes? Sorry for the push there, Michael, but given federal law, the current standard of diabetes care, and 10 years worth of evidence from other states, what's there to disagree with?

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by: Suzanne @ Sun Apr 05, 2009 at 21:06:47 PM CDT

[ Parent ]

Thanks for the answers (0.00 / 0)

What's to disagree on? What a child needs and how best to provide accomodation for this is a wide open question.  This is a difficult question even in the most "normal" of children, let alone a child with a disability. No one disagrees that these students should have a free and appropriate public education, but how to facilitate their accommodation in a way that addresses broader impact to the classroom and wider school community is a difficult question. That's what this discussion has been about. I remain unconvinced of your complete point, but appreciate your thoughtful comments.

"This narrow demographic" relates to where we agree - younger students who are unable to perform routine maintenance on their own. In this case, I still find it hard to accept that the examples you point to are the rule rather than the exception. But perhaps I've been fortunate to have my reality skewed to the opposite of your reality.

Again however you resort to hyperbole in your last paragraph. This is not a black and white, with us or against us issue as you portray it. "Children with disabilities" is a very broad description, and you still have not addressed my point about how this Act may impact other disabilities that require the dispensing of medication as part of their routine maintenance. Nor have you acknowledged the legitimate liability concerns of dispensing medications. Nor have you touched on the other concerns raised related to how this would affect teaching and learning by adding additional health care responsibilities potentially to the classroom teacher - in addition to the many other responsibilities that have been added in recent years. Perhaps this is addressed in the text of the Act?

You mention reading the Act. Could you provide a link to the most current version?

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by: michael in chicago @ Sun Apr 05, 2009 at 22:17:49 PM CDT

[ Parent ]

What Can I Say? (0.00 / 0)

You've drawn distinctions that do not exist, asserted liabilities that are nowhere in evidence, and argued about legislation you haven't read. The last full draft is available on the ILGA website. Look it up (HB146/95th).

As for what constitutes a disability, it is defined in black and white terms in the Americans with Disabilities Act. The state-based research provides the evidence on practice concerns and the experts in diabetes care define the care standards. There's nothing hyperbolic about any of this. These are the variables and their breadth, depth and applicability are all pretty straightforward.

How might complying with federal law affect other children's medication needs? I suppose it would reinforce the idea that the protections of federal law apply to them, too. As for how accommodating a child with diabetes might affect teaching and learning? Like anything, it's what you make of it. Good teachers search for and use these opportunities to teach.

Bill made a comment earlier that reflects the reality of most teachers I've had the opportunity to work with:

"If you were a teacher, wouldn't you volunteer if you were allowed to do so? Of course you would!

In the past three years, I've worked with hundreds of teachers, schools and districts. The legal team at Chicago-Kent and American Diabetes Association has worked with thousands more all across the country. I can report quite confidently that the most teachers want to help their kids, including kids with diabetes and other disabilities. Teachers aren't typically scared or burdened by these manageable health issues and they don't expect children to be free of complications or challenges. Most teachers I've worked with describe their classrooms as diverse communities, where each child needs and contributes a different life experience.

A lot of teachers tell me their students with diabetes often become the go-to students for math computation tricks, nutrition and exercise information, and, often, examples for how to face a discriminating world with dignity and grace.  

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by: Suzanne @ Sun Apr 05, 2009 at 23:44:04 PM CDT

[ Parent ]

You sure you want compromise? (0.00 / 0)

Final comments for me:

You still haven't addressed my question regarding how this Act may impact other disabilities that require the dispensing of medication as part of their routine maintenance, and how this practice may impact the classroom and school districts. You also continue to dismiss the liability issues of assuming responsibility for administering medications and assuming responsibility for routine medical care by a minimally trained volunteer.

Finally, if every teacher you've heard of is open to doing this, why is every teacher's association in the state - IEA, AFT and Chicago - representing hundreds of thousands of teachers, not supporting it?

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by: michael in chicago @ Mon Apr 06, 2009 at 06:50:16 AM CDT

[ Parent ]

Why are you wanting to throw the 'baby' out with the bathwater? (3.00 / 1)

Propose solutions you think might work, don't just restate the problem.

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by: BobB @ Mon Apr 06, 2009 at 08:58:45 AM CDT

[ Parent ]

Every teacher? (0.00 / 0)

Michael, it would be much more sporting of you if wouldn't put words in my mouth. If you haven't noticed, I'm quite good at filling up on my own ;-)

I don't dismiss liability issues; I just don't embrace what's not there. This question has been researched, carefully, and for more than a decade and the hazards you seem to think are inevitable when administering medication just aren't there.

And yes, I did answer answer your question about other children requiring medication and how it might impact the classroom. I think maybe the problem is you're just looking for an answer that you like better.

The Care Act has been redrafted nearly a dozen times. Each time, it's been because someone, usually someone who initially opposes it, brings forward an important element we did not think of. Please contact me after you've read the bill. I'd be interested in hearing what you think we might do better.

Off now to go get that baby out of the bathwater! ;-)))

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by: Suzanne @ Mon Apr 06, 2009 at 16:53:04 PM CDT

[ Parent ]

What you can do better (0.00 / 0)

First, provide links.  That's not difficult and provides direct reference for those short on time, as well as transparency in one's position. Let me know if this is not the correct version. It is from ILGA, cited as the "Care of Students with Diabetes Act" filed 3/25/09.

Liability:
I don't know why you insisted on continuing this discussion when you could have just quoted this:

Section 25. Civil immunity. A physician, nurse, school employee, public charter school or public school district, or governing body of a private school is not liable for civil or other damages as a result of conduct, other than willful or wanton misconduct, related to the care of a student with diabetes under this Act.

If the "hazards" I've raised where "not there", then this section would not be necessary. But they are, and this is. But, this does address this issue IMO.

Volunteer?
You've repeatedly portrayed this as voluntary. I did a search of the Act, and that word is not in it. The word "requires" however is:

Section 15. School policies; diabetes medical management plan; self-care; training.

[...]

(6) Requires, at least once every 2 years, the in-service training of school employees by a health care provider with expertise in diabetes regarding the care of students with diabetes.

(7) Requires school employees who have completed the in-service training regarding the care of students with diabetes to assist students who are unable to provide self-care.

By requiring training of "school employees" this includes everyone in the school by definition, does not limit this training to only those volunteering for it by this definition, thereby making everyone in the school a manditory care giver - not a volunteer. This language is quite contrary to how you have repeatedly portrayed this in multiple comments on this post.

Please correct me if you believe I'm reading this incorrectly. If your intent is to enable those willing to volunteer to do this, this language can be done better.

Guidlines and Procedures:

Section 20. Guidelines and procedures. The Department of Human Services, in consultation with the State Board of Education and other appropriate representatives of without limitation the Illinois Society for Advanced Practice Nursing, the Illinois State Medical Society, the Illinois Chapter of the American Diabetes Association, and the Illinois Association of School Nurses, shall develop all guidelines and procedures necessary for the implementation of this Act.

I see everyone in this paragraph who should be a stakeholder in the process except one set of key stakeholders in the education of every student in this nation: teachers. This is especially lacking given the language in Section 15 noted above. If you would like the support of the "most influential unions in Illinois" including them in development of the guidelines and procedures necessary for the implementation of this Act can certainly be done better.

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by: michael in chicago @ Mon Apr 06, 2009 at 21:18:57 PM CDT

[ Parent ]

My point was, that you seem to be arguing... (0.00 / 0)

the "union's position", while tacitly acknowledging that the overall goal of the ADA is a worthy one.  That's why I asked if you had any solution suggestions, or, were just restating the objections of the opponents.

Do you think there is ANY middle ground?  Do you have any suggestions for improvements that could be made to the bill, or, barring that, what is your solution?  I'm not saying that you're suggesting this, but, separate but equal schools for children with disabilities with busing?  If not, I don't think you're adding much to a discussion on a bill that's been vetted and re-vetted over several years and seeks to mainstream an eminently 'mainstreamable' population.

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by: BobB @ Tue Apr 07, 2009 at 11:55:48 AM CDT

[ Parent ]

fwiw ... (0.00 / 0)

... the amendment was withdrawn

oddly enough, though ... the senate breezed a frame-only (short title section) through a 3rd-reading vote (56-0), and handed it over to the House, with GOP leader Tom Cross taking on sponsorship ... it's off to the Rules Committee, where it'll likely die, while all the senators (Dem & GOP) will be able to claim that they supported students with diabetes

it's watching springpatch crap like this that makes my head spin

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by: wystler @ Tue Apr 07, 2009 at 15:10:15 PM CDT

[ Parent ]

Geesh . . . (0.00 / 0)

Links. To what? A shell? Read my first post. Couldn't have been clearer. The significance of the shell is this: It's the first time in SIX years we've been able to move ANYTHING out of the Senate. As for clicky convenience, come on. You can keystroke like this, you can find the bill. Or maybe not . . .

Language. The amendment you dug up is the School Management Alliance's version of the bill. No one, including the teachers' unions, likes that version so it was scuttled. That's also why I pointed you to HB146(95th).  

Liability. I did tell you. You preferred the statute's language to my narrative.

Volunteers. Yup. The Care Act still calls for volunteers. Those who elect to be volunteers, however, are required to be trained. Those pesky endocrinologists and lawyers added that ;-)  

The House. Death knell? Not necessarily. We've passed this bill (some version of HB146/95th) not once, but twice. It's back in the hands of Rep. Cross who, more than any other legislator, I think, gets this issue and not just as as legislator but as a father. His girl has diabetes, too.

Springpatch &*#@. While I am more confident that the bill will move given Rep. Cross' commitment, I share Wystler's exasperation. Any way you cut it, the State's response to the dilemma faced by students with diabetes and their families is shameful.  

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by: Suzanne @ Tue Apr 07, 2009 at 17:48:52 PM CDT

[ Parent ]

Oh, heck (0.00 / 0)

In the spirit of accommodation, I've taken a few minutes to learn how to embed links. It's not as easy as clicking through the ILGAs website (at least not for me), but Wikipedia proved to be a fine tutor. This is the most recent version passed by the House (May 2007) Have at Michael from Chicago:  HB146: The Care of Students with Diabetes Act

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by: Suzanne @ Tue Apr 07, 2009 at 19:22:52 PM CDT

Thanks (0.00 / 0)

I appreciate the effort. This clears up much confusion and like this language much better.

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by: michael in chicago @ Tue Apr 07, 2009 at 20:15:38 PM CDT

[ Parent ]

This is THE ticket (0.00 / 0)

Michael, what you and I accomplished here is exactly what we're hoping to achieve with the teachers' unions. :-)

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by: Suzanne @ Fri Apr 10, 2009 at 21:16:03 PM CDT

[ Parent ]