The Commercial-News, Danville, IL

April 12, 2010

District’s nurses oppose ‘Care Act’

Proposed law up for Senate vote


DANVILLE — A group of Danville District 118 nurses became phone-wielding advocates last week in an effort to shoot down a proposed state law allowing non-medical school staff to monitor and assist in the treatment of students with diabetes.

SB 3822, the Care of Students with Diabetes Act, is set for an Illinois Senate vote Tuesday after receiving nearly unanimous support in the House last month.

If passed, the law would:

-- Require parents to submit care plans if students with diabetes needed in-school assistance, and allow students who don’t need assistance to self-administer treatment.

-- Allow students to choose a “delegated care aide” to assist in carrying out their care plan, including the administration of insulin medication.

-- Prohibits districts assigning students with diabetes to an attendance center based upon whether it has a school nurse.

-- Requires anyone transporting those students to be given an “information sheet” outlining specific difficulties and allows the volunteer aide to “stand in” at inclusive school events.

-- Calls for the training of all school personnel in how to recognize a diabetes emergency and indemnifies them from liability if they assist.

District 118’s nursing staff, supporting state nursing associations’ rally against the measure, made phone calls last week to state senators they had identified as possible swing voters.

“With this bill, they can just assign a school secretary to be responsible for a student with Type 1 diabetes,” said Sherri Smoot, a certified school nurse who serves three buildings within District 118.

The nurses argue, not only are non-medical staff not qualified to monitor a student facing serious diabetic issues, they are already being overwhelmed with requests to take on added duties.

Right now seven certified nurses monitor and administer insulin to 15 District 118 students, in addition to duties for other medically challenged students. Due to cuts, that number will be trimmed to five next school year.

“Asking others to do more, especially when you’re talking about a life-threatening condition, is a risky thing,” said Judy Pendleton, DHS certified nurse and nurse manager for the district. “We’re advocating for these kids.”

But sponsors of SB 3822 say the bill’s intention has been mischaracterized by the nurses’ associations, and pointedly say they have allowed politics and the protection of their profession to be put ahead of the students’ well-being in keeping it from becoming law for the past six years.

“We started out with tons of opposition,” said Suzanne Elder, director of advocacy for a coalition of groups behind the proposed law. “The nurses are now the only dissenting voice here.”

Elder, who started the self-proclaimed “grassroots” organization after her diabetic daughter was not allowed to attend school because of her condition, said the Diabetes Care Act has a long list of supporters, including the American Diabetes Association, and that 28 other states had adopted similar measures.

She said the law would not affect districts “doing it right,” which she said includes well-trained nurses implementing required in-school treatment plans.

“We have no desire to upset the apple cart where it’s working,” she said.

The problem is, she explained, some schools haven’t done so well and students have suffered. She shared several stories where students became sick or died because of untrained school medical staff or none at all.

Elder said, under the new law nurses would continue to administer treatment in districts that have the resources to do so. But school staff would voluntarily team up with students who may need help if medical staff isn’t around. All school staff would undergo In-Service training to recognize diabetic symptoms and how to react in an emergency if the law passes.

“I have teachers who are dying to help their kids and they are prohibited by law,” she said.

“It’s a very straight-forward bill,” said state Sen. Heather Steans, D-Chicago, its sponsor.

She said the law would lead to better overall school knowledge of how to help a diabetic student and is not designed to replace school nurses.

“It would be great to have a full-time nurse in every school, but it’s not a realistic circumstance at this point because of the funding situation,” she said. “If a nurse is there, a nurse is going to do it (treatment plan). We’re building in as many protections as we can.”

She said the law would not require teachers or staff to treat diabetic students.

“You can only do it if they want to do it,” she said.

Corey Pullin, an official for the Danville Education Association, said the union backs the district’s nurses. He said he’s not sure how many staff volunteers, even if there were indemnity protections, would be willing to step forward with the time needed to effectively monitor a diabetic student out of consideration for their health.

“We think it’s a major safety issue for the students,” he said. “I don’t think the teachers or the administration want any more responsibility on anything they don’t feel qualified for.”

He said the job should be performed by those with medical training and the teachers should concentrate on teaching.

“This could set a precedent of other things being done by laypeople,” he said.

Suzanne Voss, government relations chairman of the Illinois Association of School Nurses, bristled at the supposition the opposition to the Diabetes Care Act is politically driven.

“What we are concerned about is children’s safety,” she said. “That is our utmost belief and why we’re fighting this. Nurses are trained to assess if a child is reacting poorly, teachers and school staff are not.”

She said language in the proposed law is plagued with unwritten consequences, such as the amount of class time teachers will spend monitoring and reacting to diabetic students, and the fact the most-affected students are likely younger or special needs status.

“We want our teachers to teach,” she said. “If they want to be a nurse, then they should have been a nurse. This will only fragment health care.”

On top of that, she said not even Illinois paramedics are allowed to administer insulin “because it’s dangerous.” She said that’s why the state’s Fire Chief’s Association is opposed to the bill.

“It’s a dangerous bill for a lot of reasons,” she said. “There’s a lot of open holes.”

“The thing they need to do is follow current Illinois School Code,” said District 118’s Pendleton. “The nurses are trained to do these things.”

District 118 Superintendent Mark Denman said Friday the issue was new to him and that he was researching the bill. He said he also had asked for guidance from the regional superintendent’s office, who was also trying to find more details.

“He’s looking into it, but until this morning I hadn’t heard about it,” he said.

State Sen. Mike Frerichs, D-Gifford, whose district includes Vermilion County, did not return telephone calls Friday requesting an interview.

An office worker in Frerich’s Champaign office said she had been fielding calls about the legislation all last week, with callers expressing support of and opposition to it.