| advertisement |
|
|
|
|
|
|
Back to School Chat with Crystal Jackson - September 1, 2009
Moderator (server) Tue Sep 01 08:00:00 PM EDT 2009
Our Back to School chat with Crystal Jackson starts at 9pm Eastern.
I know a lot of people are looking forward to this and are VERY grateful to have the opportunity to get suggestions and advice. It can be emotional sending kids back to school each year.
Very.I almost never cry - start of school I always stress out till I weep
And this is in a supportive school system...
Hi Everyone! Are your kids back at school? Most Virginia students don't return until next week.
What grade is Maddie in this year?
School started here last Wed.
hi!
Sarah, both of my kids are in college (including my kid with diabetes) and I can't stop crying. It's all good though.
Ours are back, and the fun has begun already.
Are there any particular school challenges that anyone wants to discuss?
Connor started August 13th.
Blake started yesterday
Everyone have medical orders or health care plan in place?
Hi Crystal, can we discuss the problems that can be encountered when working with school nurses?
And a 504 Plan or IEP stemming from your child's health care plan? Is everyone familiar with these documents?
504 Plan, DIHP, faxed medical orders etc. - many thanks to ADA
School nurses. Scott, do you have a particular issue you want to discuss?
Article in the local paper today about additional stress school nurses will have this fall with the H1N1 virus, too.
Hi Amy! It is good to finally "meet" you. I've heard so much about you and Connor from Victoria. Glad that all is going well.
H1N1 is front and center for school nurses.
Can we also talk about what if the school is not a public school..
We've gone from the perfect situation to the worst (as far as we are concerned) last year our school nurse was a T1D and it was my son's first year. Now she has been transferred and we have a new nurse who has already started off trying to dictate how we WILL care for him during school.
Has anyone written a provision in your child's 504 plan or IEP that addresses what happens if swine flu epidemic hits your child's school?
Can we also discuss making allowances for extended absences in a 504 during flu outbreaks?
Melissa, is it a private shool or a private religious schooL? Does it receive any federal funding.
I recommend that you incorporate language that enables you to keep your child home - without penalty - if there's an outbreak at school. It's consistent with CDC's recommendation for people with diabetes.
I'm trying to write that up now...meeting tomorrow morning to update 504
Hi sorry - difficult hair shampoo issue
Nice to "meet" you too! We are having a great year so far, which is a very nice change from years past.
Shan, don't you have a statement in the plan that mentions the child will not be penalized for excessive absences?
Melissa, we need to know what kind of private school and whether or not the school receives federal funding.
Maddie's hair, not mine
Hi sarah
I don't have that in place...I am writing it up now to include seasonal and H1N1 flu outbreaks, any suggestions?
It's a small preschool that doesn't get fed funding...
Private schools that are not religious operated schools are considered places of public accommodation and must provide accommodations under the Americans with Disabilities Act. If the private school gets federal funding then it must also meet its legal obligations under Section 504 of the Rehabilitation Act of 1973.
Melissa, is the pre-school operated by a religious entity?
I don't have anything in his 504 Plan about H1N1, but I do know that we received a letter from the State Department of Health that says: The sick person should stay home, unless medical care is needed, for at least 7 calendar days or until fully recovered for at least 24 hours, whichever is longer. No test for influenza or doctor's note is necessary to justify the absence." Is this standard across the country?
no, it's parent run, co-op... in Alex, VA
Shan, et al - include specific language that states your child will not be penalized for absences if kept home due to outbreak and will be given an opportunity to make up missed work and take exams within a reasonable time period without penalty.
ok, adding that in, forgot about the taking of exams
That's a good point - a specific provision for H1N1....
Melissa, pre-school obligated to provide services under ADAct, but not as strong as protections afforded under Section 504. For example, the school does not have to provide services that pose an undue burden upon the school. For example, they don't have to hire a nurse.
Amy, CDC is recommending that kids who are at high risk be kept home if there is H1N1 outbreak at school so it is a reasonable accommodation.
Scott, did you have a specific concern about school nurses?
thanks this is good info... so if I don't need a 504... what kind of forms should i get filled out at the endo... the school left it up to me!?! They told they will do what ever i need them to do...
I"m looking for a diagram - a venn diagram that shows the relative authority of IHP and 504 - anyone know this doc- and a link?
Good point. I'll bring it up with the school. Thanks!
Is it acceptable to require that a nurse receive "formal" training on pump operations and diabetes care?
But, I thought I'd read that many kids with the "flu" were not getting tested for the specific H1N1 virus (cost issue) so how does a school know if they have an outbreak of the H1N1 virus or not?
my sister is coming down with a cold, and my mom said to ya know, wash hands, don't share food, all that? and she got angry but you know, with diabetics, a small cold can put you in the hospital. 2 weeks after I was diagnosed I got a small stomach bug and I was sooo close to going into the hospital.
Sarah, do you mean IEP vs. 504? What is your specific question?
Yes, sorry
Scott, the school nurse and other trained personnel should have formal training on pump operation. Recommend that you help coordinate a training with your child's pump company. My experience is that all of the pump companies are happy to do training.
Scott:see http://www.diabetes.org/advocacy-and-legalresources/discrimination/school/schooltraining.jsp You might want to look at the pump information and print it for the nurse (I admit that I have not looked at it).
I am putting in my 504 (as I'm typing it right now) provisions for BOTH seasonal and H1N1 flu outbreaks.
Second confession: I don't know anything about documents that are in PowerPoint.
IEP (Individualized Education Program) is developed for kids eligible for services under the Individuals with Disabilities Education Act (some kids with diabetes will qualify). All kids with diabetes are protected by Section 504 and these protections have been greatly strengthened and clarified by the recent passage of the Americans with Disabilities Amendments Act.
Thanks Brenda.
My wife's concern is that this new nurse "strong willed" will try to take care of things on her own and mess it up. Then we have to deal with it at home after school.
Yes, ADA has a pump training module that is very basic and intended for the lay audience. I would engage a pump company to train the school nurse. ADA's modules are intended for use by the school nurse or a CDE to train school personnel.
Got that - this was a very clear graphic that I wanted to have on file - It was a long shot that you'd know it off hand - just thought it might have come out of your office
Hello - I need help getting logged on.
CGMS is alarming low...gotta run
Very anxious about transitioning to middle school
Thanks for your help and your time Crystal, goodnight everyone!
9 classes, lockers, no time between classes
Scott, the school nurse needs to be trained. You might check www.nasn.org to see if the H.A.N.D.S. school nurse diabetes training is being offered in your area and then work with PTA to fund sending your school nurse. It's a very comprehensive all day training.
It's going to be a real test of her self care
I have a Venn diagram from our county's 504 manual with Studen Population as the heading. But - I hesitate to share since much of it is misinformation. The county's is wrong, but the state's manual is correct.
Sarah, does your child provide her own care? If so she should be able to do it anywhere, anytime which is a huge help in middle and high school. She can check bg and bolus wherever she happens to be.
Sorry, for the typo. Student Population as heading.
Yes, she has for the past 3 years
but one classroom rather than a hallway
That works well, considering my wife is the secretary of the PTA!
she'll have to be far more assertive
and anticipate her own needs far more
Sarah, kids adapt. I promise. She will get down a routine of where and when to test and bolus. Important to write into her 504 plan that she be allowed to test and treat anywhere at anytime.
Yes, I know that it will be ok
Is there a question about IEP vs. 504?
but still I fret
And communication hasn't been as good as with the last school
Also extra bathroom privileges (at least in our schools they are notorious for trying to control that)
No, it's a 504
Oh - situation here
sorry but must go
Kids with diabetes may be eligible for an IEP if their diabetes or another disability adversely impacts academic progression - a need for "special education" must be demonstrated Not the case with Section 504. All that need be shown under 504 is that diabetes substantially limits a major life activity or bodily function such as the endocrine system. Pretty straight forward with the passage of ADAct last fall.
yes, crystal... can you explain 504 v IEP?
We don't hear of many folks have problems with bathroom access. Most problems revolve around the little ones getting their insulin when a school nurse isn't around. Anyone encountering this problem?
504 Plan and IEP both should contain diabetes provisions.Don't need both. If you have an IEP there is no need for a 504 plan.
How about a child with an existing IEP for gifted program. Parent wants to add 504 accommodations to IEP. How does that work?
Along the same lines diabetes care in the classroom during a lockdown situation has been a concern also.
All kids with diabetes should be eligible under 504 and a subset of kids eligible for services under IDEA. IDEA is a higher threshold, but provides greater protections and remedies, but my experience is that most kids with diabetes do not qualify.
Amy, just incorporate diabetes provisions into the IEP.
Scott, lockdowns, evacuations need to be addressed in 504 and emergency care plans. This is why it is important for other school personnel to receive training. If there's a lockdown situation your child is not going to be able to access the school nurse (that is, if your child's school even has a school nurse).
That's what I thought too. Thanks.
Any school districts trying to qualify kids incorrectly for IDEA/IEPs to get funding for things that should be covered by 504 Plan?
Who provides care at your child's school? Do you have a school nurse? Have others been trained to provide care?
hello?
anyone there?
Amy, most school districts will first see if the child qualifies for services under IDEA, but that's a harder standard to reach. IDEA actually provides stronger protections so if your child qualifies it is a good thing.
anyone there hello?
hi erin
Other concerns? Questions?
hi
can i chat in this room no one else is on in any of the rooms please?
This chat is about issues at school.
I'm good Crystal. Thanks for the links.
:(
ADA has a wealth of resources that you can read at www.diabetes.org/schooldiscrimination. You can also call 1-800-DIABETES and ask for ADA's free school packet and ask to speak to one of our expert legal advocates to discuss a particular concern. Just want to make sure everyone is aware of this resource.
plz?
plz?
Sorry, Erin, just aren't many people chatting in the other rooms tonight. Do you have any problems with your diabetes at school? Do you test in the class or at the clinic, office?
anyone ther plz hello?
no this is my first year why?
How often is 504 Plan supposed to be reviewed? Does the whole team have to be there if I just want to add the H1NI coverage?
howdy folks
Some kids with diabetes have issues not being allowed to test their blood sugar in their classroom, not being allowed to use the water fountain when they are high, not allowed to use the bathroom, and such.
What plans do you have in place for field trips and extracurricular activities?
Erin, did your parents meet with your school nurse and/or teachers to teach them how to take care of your diabetes?
Cystal, I have one last question for you since you know the NOVA system pretty well...
our 504 plan says that if a parent doesn't accompany Paige on a field trip then one of the school nurses has to
can i plz talk to someone plz i am cry really!
Amy, recommendation is that 504 plan be updated when needed and usually on an annual basis. I recommend that you talk with your school nurse or 504 coordinator to have the H1N1 provision written in. I don't think there will any objections.
I'm having a hard time following the conversation.
In VA you can go to public preschool for low income or have other issues like spesch delay... do you know if I could get my DD into a public preschool program bc for her D
I'll try that first. Thanks.
Great if a school nurse can accompany on field trips, but not what happens in most school districts. Usually a teacher or other staff member is trained to provide care on a field trip.
me crying plz someone talk for a while plz?
Melissa, I see no reason why your child wouldn't be eligible for the pre-school program - just like other kids.
Erin, is there something you want to share about school? This is a chat about school issues.
well we do have exceptional nurses in our school and I know that our school is a lot better with our 504 plan than the norm, I have helped quite a few people with their fight for a 504 plan and have actually directed a few to you for assistance Crystal
um yeah i have a question?
In fact I have a friend that I have been texting trying to get her here tonight so that she can ask you questions about a 504, doesn't look like she's gonna make it
crystal i have a question?
Great. Any child who has a school nurse is very lucky. But there must always be back-up care because the school nurse cannot be in all places at all times.
um wut do u do if you get a insulin reation or take the wrong one for giving shots?
Yes, we have that at our school. We are very lucky. Connor's teacher is one of the ones who is trained, so he tests in the classroom. :)
I agree, we have one card in the deck that is available to us too that is pretty good, one of Paige's teachers is also a parent of a cwd
hey
Nice!
hi there Stacey
crystal what do u do if you have a insulin reation or take the wrong insulin for giving shots?
Erin, what do you mean "take the wrong one for giving shots?"
How many trained backup TDMP's do you recommend?
Erin, your parents need to work with your school nurse, principal, and teachers to make sure that you are properly cared for at school. If you are feeling "low" there needs to be someone available who knows to get you juice or glucose tab and help you out. You should always carry a fast-acting source of glucose with you.
For an insulin reaction, that is a low blood sugar, you need to consume a gorm of sugar, such as juice, glucose tablets, honey. This is something your diabetes team should have explained to you/your parents.
In addition to the school nurse, I recommend that there be a minimum of 2 trained school personnel to ensure coverage at all times. In my school district, there's a minimum of 3 trained personnel at each school.
crystal- is anything happening in NY - with the glucagon issue?? of teaching non nurses??
like instaead of a pump u give a shot u take a day shot 3 times a day and night once at night wut if i give nph instead of reagular at school?
Hi everybody
erin- when are you supposed to take your NPH?
Stacey, do you mean NYC or NY State?
Crystal how do we get other staff to train if they simply refuse to?
at night why?
NY State has had a glucagon training program in place for years. NYC is very resistant to training lay people, but ADA is working feverishly to change that policy.
i am saying i have 2 insulins ok
Becky, why are they refusing? Are they being told by their union not to be trained? We rarely hear of teachers who refuse unless they are being pressured by their union.
NYC ... I know there was a mandate by the state to train non nurses... but the NYC dept of health - who are in charge of the nurses have told them not to follow it... I personally have trained a few teachers and Jesse's friends... without the nurses knowledge
Erin, you should never have your NPH at school. Most people take Humalog or NovoLog for meals. Is that what you take for lunch?
i think they are scared, of liability perhaps or just dont want to, so far we have the nurse there at all times or a sub
i do not know what there names are ok ? cry cry cry cry cry cry cry
but there have been a couple of instances where a sub could not be found and the staff is being very resistant to being trained
crystal- if you need help- let me know...
The problem in NYC is that the teachers union is telling its members to refuse training.
Erin, we are not trying to upset you.
ADA plans to conduct Safe at School parent workshops in NYC in early December. If more parents demand change, it will happen. Need to turn up the heat on NYC Depts. of Education and Health.
thats not what the teachers have told me, there are many who are willing.. I spoke to the head of nursing last year. She's the one that told the nurses not to train the teachers...
can they do that Crystal? refuse to train on glucagon? why would they? what do they fear?
Is there a Good Samaritan law that would cover glucagon injections? Someone who acted in good faith, to the best of their ability to administer glucagon would not be sued if it was done incorrectly? As a parent, I'd much rather an attempt was made than staff to just stand around and wait for help. I'd be willing to sign a waiver.
Becky, it is the school's legal responsibility to make sure appropriately trained personnel - whether it be the school nurse or a teacher - be available to provide care at all times. Write this into your child's 504 plan.
cry
brenda u guys mad at me?
thats the way i feel Amy and ive expressed that to the school
Most states have Good Samaritan laws. The reality is that anyone can sue anybody over anything, but if a lay person is rendering care in good faith then very unlikely that a lawsuit would be successful.
it is written in Stevens 504 but people are dragging their heels no one wants to volunteer to be trained ive offered to do trainings myself
Right. So what's the issue?
anyone mad at me?
we probably wouldnt have a glucagon problem if it was pre-mixed like an epi pen...
No, Erin, not at all. We are just trying to discuss a specific subject in this chat. Why don't you try the chat again tomorrow after school or in the evening? You might have better luck finding kids your age.
Laws vary from state to state. Important to know what state laws impact diabetes care. For example, some states have nurse practice acts that may limit what a lay person can do.
i think thats what worrys people that they have to mix it
erin, this is a special chat tonight for back to school. Please chat in a different room. Thanks for understanding.
I don't understand how teachers could watch a child go into a seizure or become unconscious in their arms without wanting to help. It's unfathonable to me.
Hopefully, glucagon technology will progress so that it's not as much of an issue.
Is it more about schools trying to cover their you know what's by limiting those they want to allow to administer glucagon.
Not just teachers - other staff there too...
I know Amy thats the way i feel
Amy, I agree. I am not aware of any teachers who have refused to step up to the plate. I think it's all in the "ask."
That's important, actually. Anyone can be trained - doesn't have to be a teacher. I'd trust anyone who was willing to be trained.
Ignorance and fear of the unknown are our greatest challenges.
Hi all, just wanted to chime in that there is a company working on a glucagon pen type device that is similar in function to an Epipen....
It definitely is Crystal... When Jesse went to Greece, I trained 3 teachers.. but didnt mention it to the nurse at all....
Once school folks understand glucagon and that it can't hurt a child they embrace it.
If developed it would make administering glucagon easier...
Chris, my husband just told me that same information!
hi all
so, Brends- ask Jeff when??? lol...
See Brenda, husbands are good for somethings...
It doesn't make sense that schools make such a big deal out of glucagon when we parents learn how to do it and most of are NOT medical professionals!
Well, watching a child go limp in your arms with no way to help them would arise more of a panic in me than worrying about how exactly to administer the glucagon (or any lifesaving device).
Hmm, been here over an hour and just realized this thing says Marissa is 21. As of yesterday, she's 22. Geez I feel old.
Glucagon is not nearly as much of an issue as it was a couple years ago. By that I mean, most school districts willingly train folks to do glucagon. Insulin adminstration by lay people is a key burning concern right now in a number of states.
Is the way it's delivered (with a shot) the issue? Or is it that it's a lifesaving device?
Happy Birthday Marissa.
aww happy birthday to Marissa
How many in this chat have actually had to administer glucagon to their child? Knock on wood, but we haven't.
Happy belated birthday Marissa!
need to go get Danielle into bed..bbiab...Crystal, if you are gone before I get back, thank you for all that you do...
I personally think its the mixing thats the issue/fear...
i think cause its different then epipen you dont just poke em with it but have to mix it first
teachers are taught how to use epipens
I've administered glucagon twice. I think there is a certain panic that sets in as it does with any emergency. But the truth is your follow the steps and save a life. It's not difficult.
not that I have this issue... but does anyone have in their 504 that the child can have and use a cell phone?
yes we ahve that in allys 504 plan
Jesse's 504 has it..
"Mixing" as a concern is just an excuse for not wanting to have another tasks added to a teacher's list. Key is training. Doesn't matter if it's a one step process or 10 step process.
ive had to use the mini dose glucagon when STeven was ill thats not quite so bad used a reg syringe
Crystal, are you okay staying around maybe 15 more minutes? We'd appreciate it.
It is common to include cell phone access in 504 plans where the child is able to provide self-care.
I haven't used it (knock on wood), but I've drawn it up thinking I was about to use it on my husband. Luckily, Zofran kicked in and nausea stopped. Practiced with expired kits many times. Gets easier with every practice.
Brenda, I can stay on until 10:20.
thats true Crystal, i think some of it is not wanting another responsibility they would be the d emergency person then
things ar e going ok for us so far at the high s chool we ahd a rough time with the nurses aid last yr she said im too busy to call even though it wa s in the plan
almost had to use it the other morning.. out of nowhere Jesse was 30?? but he drank juice... BUT- I did have it mixed, ready to go...
only 9:10 here in the midwest Crystal, so you can stay for another hour and change
Is it common to ask for a trained person to accompany kids on field trips? I've heard of cases where schools tell the parent the child must skip the trip.
itsd only 715 here
Jesse is a senior this year, so soon I'll have to worry about glucagon in college?? How does that one work??
There are a number of very good glucagon training curriculums that can be easily accessed. ADA has a module at www.diabetes.org/schooltraining. Some of the state diabetes prevention and control programs (NY and CA in particular) have excellent training materials.
yeah they mad e my d aughter skip a feild trip in junior high cause of ehr diabetes
we are lucky that my husband or i can go on field trips but what if people have to work?
yeah i w ork in a child care center so its hard to get time off
they did Jen? thats cruel! and discriminatory
when Jesse was in middle school, I couldnt make it to one trip, so they sent a nurse.. Jesse was so embarrased by her.. She followed him like glue. I promised himI'd never let that happen again...
Field trips - a parent cannot be required to go on a field trip in order for the child to participate. Absolutely violation of Section 504. School nurse or another trained person needs to accompany. High school kids may only need someone who can do glucagon (suggest training the bus driver). Our little guys will someone who has been trained to perform all care tasks.
by 7th grade, I trained his homeroom teacher to give glucagon... and he went unattended..
he didnt want me either at that point
Having a child with diabetes really makes you more empathetic towards families with children with other chronic diseases. I think that epilepsy emergencies involve a dosage of medication via rectal syringe.
Although I don't know much about it, I know there's GlucoMon that somehow can send your child's BG to you remotely. Assuming this is still around, see www.glucomon.com
In my school district, the bus drivers are all glucagon trained.
What about athletics? Are your coaches and/or trainers glucagon trained? Highly recommend it.
Sorry, I see you've moved on to field trips..
thast good i dont care for the district w e ar e in they bartely efven ahve nurses mostly nurses aides who like to violate 504 plans
Any other concerns or questions this evening before I say good-night?
just a big thanks to you Crystal...
Crystal, on behalf of CWD, thanks so much for sharing your time with us this evening.
the aides ar e horrible and they moved the horrible aide up to the hgih s chool w ith allyson lol
None from me. Thank you!
Brenda- change that 21 already !!
thank you Crystal and to the CWD staff for setting this up
Please call ADA at 1-800-DIABETES if you need information or want to discuss a particular school problem. The best thing you can do for your child is to get his or her 504 plan coordinated and be a resource for your school nurse.
You are very welcome. Hope it helped.
Geez, Stacey, I am tchnologically challenged and tired. I'll figure out tomorrow.
thanks crystal
Crystal- is there any kind of plan for colleges??
See, I can't even type.
Hope to see you in La Jolla next month.
thanks for your time Crystal
Stacey, not to my knowledge.
Fish tacos at George's in La Jolla - yum!
Post-secondary schools are required to accommodate under 504 and ADAct, but have different legal obligations. Also, there's a real shift from parent advocacy to student advocacy. There's no child find requirement. Stay tuned for more ADA resources on this topic.
Really not on topic with that one. Thanks again!
good night everyone....
Good night all!:)
thanks crystal.
Bye all.
bye
night everybody
|
|||
 |
 |
||
Last Updated: Wednesday September 02, 2009 08:33:22
This Internet site provides information of a general nature and is designed for educational purposes only. If you have any concerns about your own health or the health of your child, you should always consult with a physician or other health care professional.
This site is published by Children With Diabetes, Inc, which is responsible for its contents.
By using this site, you agree to our Terms of Use, Legal Notice, Privacy Policy, and Safe Harbor Policy.
© Children with Diabetes, Inc. 1995-2013. Comments and Feedback.