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[IP] Re: California Assembly Bill 481

    Sorry to say it did NOT get passed....
 Hopes dashed for greater role by schools in diabetes care

By Laurel Rosen -- Bee Staff Writer
Published 2:15 a.m. PDT Saturday, September 28, 2002
Two weeks before she went off to kindergarten, Helaina Lindsey was diagnosed 
with type 1 diabetes. She was just 5 years old when her parents taught her 
how to prick a finger and test her blood sugar level."We knew no one at 
school would be able to do that," said Helaina's mother, Judy Cherney.As is 
the case in many California schools, there was no full-time nurse at 
Schweitzer Elementary School in Carmichael. So a few times each day, Helaina 
would leave class and go to the office where she would check her blood 
sugar.When it was very high, Helaina called her mother. Cherney would leave 
work, go to the school and give her daughter an insulin injection. She would 
wait with Helaina until it was safe to leave.Cherney said she thinks parents 
going through what she has should be able to count on the schools to care for 
California's estimated 15,000 children with type 1 diabetes. Often referred 
to as juvenile diabetes, type 1 diabetes is associated with immune system 
dysfunction.She hoped a greater role for schools would have been accomplished 
by AB 481, which would have required that in schools without nurses, an 
administrator or teacher be trained in monitoring blood sugar levels and in 
giving insulin and glucagon shots.Today, Cherney is left disappointed.Gov. 
Gray Davis vetoed the bill Friday, citing the potential for liability suits 
and the cost of training non-nurses in diabetes care."This bill, while 
well-intentioned, would create a costly new state reimbursable mandate 
estimated by the Department of Finance to be potentially tens of millions of 
dollars," Davis said in his veto message.The bill, by Assemblyman Marco 
Firebaugh, D-Los Angeles, also would have allowed diabetic children who can 
treat themselves to do so in classrooms -- or anywhere else on school grounds 
-- instead of in a school office, as is now the practice in many 
schools."Parents who have to leave work and attend school to provide the care 
are being forced to choose between taking care of their children's health 
needs and taking care of their family's economic needs," Firebaugh said in a 
statement.Cherney still has to train her daughter's teachers each year to 
respond to a diabetes emergency, even though Helaina, now in the fourth grade 
at Deterding Elementary in Carmichael, is able for the most part to care for 
her diabetes on her own."Yes, teachers have a lot of responsibilities," 
Cherney said, "but the fact is that my daughter is sitting in that classroom. 
If the schools are not going to provide nurses, somebody has got to take care 
of her."With the veto of AB 481, who that somebody is remains up for 
debate."We feel the people who should be responsible for administering 
insulin are school nurses," said Vicki Bermudez, a policy specialist with the 
California Nurses Association, which represents 45,000 registered nurses in 
the state and which opposed the bill."If there is no school nurse, the school 
should take advantage of collaborating with clinics or other agencies to 
provide the care," she said.Bermudez also said that in hospitals insulin is 
considered a high-alert medication and requires two licensed nurses to check 
the dose before it is administered.The presence of school nurses varies 
greatly from one district to another. Roseville Joint Union High School 
District has four nurses for four schools. Sacramento City Unified School 
District has 45.8 nursing positions for its 79 schools.Statewide, there are 
2,469 school nurses, according to the California School Nurses Organization, 
serving more than 6 million students. The average nurse-to-student ratio is 1 
per 2,450.With the complex demands placed on a short supply of school nurses, 
the school nurses organization supported the bill."It's great to say it's the 
job of school nurses, but then put your money where your mouth is and hire 
them," said Executive Director Nancy Spradling. "Those students have the 
right to appropriate diabetes care, so either hire a nurse or pass some kind 
of bill that will provide the care."The bill also was opposed by the 
Association of California School Administrators, which said in a statement 
that AB 481 had "serious ramifications for principals and vice principals" in 
terms of liability and costs.Since 1999, legislation requiring school 
personnel to be trained in diabetes care has passed in Virginia, Washington 
and North Carolina.AB 481 was a revised version of a similar piece of 
legislation Davis vetoed in 2000, said Lisa Murdock of the American Diabetes 
Association. The new legislation involved fewer costs, she said."We feel the 
bill addressed concerns of his from the previous legislation," Murdock said. 
"The governor's veto has placed the health and education of children with 
diabetes in jeopardy." 

About the Writer
---------------------------The Bee's Laurel Rosen can be reached at (916) 
773-7631 or email @ redacted 

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