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B7- Crystal Jackson.ppt

B7- Crystal Jackson.ppt






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  • The second part of which explains are legal advocacy program and work to insure that students with diabetes are safe at school which underlies our overall legal advocacy program that also addresses issues in employment, police contact and corrections and access to places of public accommodation. The first part focuses on obtaining more money for research and programs and improving access to health care of people with diabetes.
  • The second part of which explains are legal advocacy program and work to insure that students with diabetes are safe at school which underlies our overall legal advocacy program that also addresses issues in employment, police contact and corrections and access to places of public accommodation. The first part focuses on obtaining more money for research and programs and improving access to health care of people with diabetes.
  • Failure to have trained staff to assist students with diabetes. Reality is that most schools do not have a full-time school nurse so there is a need for trained back-up personnel. Trained back-up personnel are also essential in those schools fortunate enough to have a full-time nurse because the nurse usually will not go on field trips or stay for after-school activities. Also, the school nurse may be busy helping another student or may be absent. No one to administer insulin or glucagon. We’ve heard of same instances where even the school nurse has refused to administer insulin. Lack of coverage for field trips and extracurriculars – nurse usually is not available to accompany student during these activities. Even the most experienced and mature student will need help from a trained adult in the event of an emergency. Classroom bgm – is becoming a more frequently accepted practice. However, there is still an unwarranted fear of bloodborne pathogen transmission and fear that lancet will be used to cause injury. Also, some school nurses feel the need to maintain direct control over process. Some school districts have attempted to send away from their neighborhood schools and to schools where there is a full-time school nurse. Many times, this requires a long bus ride and the concern arises about the lack of trained personnel on the bus to help a student with diabetes. We have heard instances where schools have refused to enroll students with diabetes and have recommended to parents that they homeschool child.
  • The SAS campaign was developed to…. It is based on the same principles that have guided the ADA effort for several years…
  • Legislate Legislate after attempts to educate, negotiate, and litigate have failed and current policies and state laws do not provide needed protection to students with diabetes. Alert ADA if you find legal barriers (i.e. nurses refusal to delegate due to state law) to appropriate diabetes care in your school district. ADA maintains a database of discrimination it receives that helps to identify areas of the country where there may be difficulty in the provision of care. Work with ADA to assess need for legislation. Coordinate grassroots efforts with ADA. Realize that systems change slowly and the success of legislative efforts requires patience and perseverance. Many states have laws that limit what non-medically licensed personnel may do to help a student with diabetes. It may be part of the state’s Nurse Practice Act. Often there is no statewide policy. Rather, policy is determined district by district. Some states give regulatory authority to the state Board of Nursing. Some states have school diabetes care specific laws. USE AS TALKING POINTS
  • Dan
  • Litigate Fortunately, most problems in securing appropriate diabetes care will be resolved through education and negotiation. If after education and negotiation, child’s needs are still not being met, parent may want to consider filing an administrative complaint or lawsuit in court. Procedures will vary depending on whether it’s a claim filed under 504, ADA, or IDEA. If 504, parent may want to file an administrative complaint with OCR, initiate due process within school district, or file a lawsuit. If IDEA (IEP), parent may want to initiate a due process appeal through the appropriate state education agency. If ADA – which is applicable to many day care situations – parent may want to file complaint with U.S. Department of Justice or file a lawsuit.
  • Knowledge + perseverance + support = SUCCESS!!!!

B7- Crystal Jackson.ppt B7- Crystal Jackson.ppt Presentation Transcript

  • SAFE AT SCHOOL: HOW POLICY CHANGE ENHANCES THE MEDICAL SAFETY AND ACCESS TO EQUAL OPPORTUNITY IN EDUCATION Crystal C. Jackson, Associate Director Legal Advocacy, ADA CDC Diabetes Translation Conference 2008 Orlando, FL
  • School & Diabetes
    • Diabetes care is 24/7
    • Child with diabetes cannot take a break
    • Smooth transition from home to school
    • Access to equipment, medication, and assistance is essential
    • Development of written care plans
  • Why is care at school important?
    • To prevent short-term complications such as hypoglycemia
    • To prevent or delay long-term complications such as heart and kidney disease and blindness
    • To ensure that child has the best possible opportunity achieve academic success and safely participate and benefit from all school activities
  • Goals of School Diabetes Care
    • A medically safe environment for students with diabetes.
    • Equal access to educational opportunities and school-related activities.
    • Enable academic achievement and enhance quality of life.
  • Legal Protections
    • Section 504 of the Rehabilitation Act of 1973 (Section 504)
    • Americans with Disabilities Act (ADA)
    • Individuals with Disabilities Education Act (IDEA)
    • State law and regulations
  • Common Barriers to Care Despite Legal Protections
    • Failure to have trained staff to assist students
    • School’s lack of knowledge about diabetes
    • Refusal to administer insulin and glucagon
    • Lack of coverage during field trips and extracurricular activities
    • Refusal to allow self-management where the student is
    • Refusing to enroll child or sending child to “diabetes school”
  • School Concerns
    • Blood glucose testing
      • In the clinic
      • In the classroom
    • Insulin administration
      • Supervision: nurse vs. student vs. school personnel
      • Location
        • In the clinic
        • In the classroom
        • Other
  • Reality Check
    • School nurse not available at all places at all times.
    • Reality is that most schools do not have a full-time school nurse.
    • Even a full-time school nurse does not solve the whole problem.
    • ADA supports a safe model that utilizes trained school personnel in the absence of a school nurse.
    • All school staff members need to have a basic knowledge of diabetes and know who to contact for help.
    SAFE AT SCHOOL CAMPAIGN PRINCIPLES Students should be permitted to provide self-care wherever they are at school or school-related activities. What Is Diabetes School nurse is primary provider of diabetes care, but other school personnel must be trained to perform diabetes care tasks when the school nurse is not present.
    • American Academy of Pediatrics American Association of Clinical Endocrinologists American Association of Diabetes Educators American Diabetes Association American Dietetic Association Children with Diabetes Disability Rights Education and Defense Fund Juvenile Diabetes Research Foundation Lawson Wilkins Pediatric Endocrine Society Pediatric Endocrinology Nursing Society
    • Educate school personnel about diabetes and legal obligations.
    • Negotiate using resources such as NDEP guide, Florida guidelines.
    • Litigate if necessary – OCR, due process, courts
    • Legislate if all else fails and clear legal barriers exist.
    • School diabetes care legislation passed in 17 states.
    • U.S. Department of Justice settlement with two major day care providers.
    • U.S. Department of Education agreements resulting in improved standards of care for students with diabetes.
    • Lawsuit settlement with California Department of Education (federal law vs. state law)
    • School diabetes care laws enacted in 18 states
    • School diabetes care law legislation active in 5 states
    LEGISLATE Consider changing state law or policies if current laws and policies do not provide students with diabetes the protection they need
    • Arizona
    • Connecticut
    • North Carolina
    • Kentucky
    • West Virginia
    • Virginia
    Board of Nursing Action: Nevada Colorado SCHOOL DIABETES CARE LAWS Hawaii Montana Washington Oregon California Oklahoma South Carolina Tennessee Texas Nebraska Utah Indiana
  • School Diabetes Legislation Pending in: Massachusetts New Jersey Rhode Island “ Advocate for children with diabetes at local, state and national levels.” Sign up at the ADA Action Center: www.diabetes.org/advocacy Pennsylvania Illinois
  • Litigate
    • File complaint with U.S. Department of Education, Office of Civil Rights.
    • School district or state due process/grievance procedure/hearing.
    • File complaint in state court.
    • File complaint in federal court.
  • CDE Lawsuit Settlement
    • California Department of Education Legal Advisory
    • Permits non-medical school employees to administer insulin when a nurse is not available
    • California school districts must meet requirements of federal law – even if nurse is not available
    • Prohibits sending students to a particular school as a condition of receiving medication and care
  • But not all policy change involves a fight…..
  • Examples of Collaboration Resulting in Policy Change
    • Colorado School Diabetes Resource Nurse Model
    • Colorado Board of Nursing Rule Change
    • Utah Glucagon Legislation
    • Proposed Utah Board of Nursing Rule Change
  • Safety + Access = Success!!!