Leading the Way
ADA and N.C. Schools Work Together to Keep Kids Safe
The first night Jenna Bowman, 12, and her parents spent at home after she was diagnosed with diabetes was a scary one. That Thursday in February, they came back from the doctor's office nervous about managing Jenna's disease at home—and weren't sure what to expect when Jenna returned to her middle school in Raleigh, N.C. But with a school nurse who was well versed in providing diabetes care, other school personnel who had been trained to perform tasks like giving insulin shots, and help from the pediatric diabetes clinic at nearby Wake Medical Center, Jenna was back in school the next day.
Trained staff at Jenna's school "know how to handle an emergency for low blood sugar," says Jenna's mother, Joy Bowman. "They've been given good information [and hands-on training] by the nurse. We have a glucagon kit at school, and they can administer that, too. Jenna gives herself insulin shots, and if she has a low, she knows what to do." Just as important, she knows that her teachers can help her if she isn't able to help herself.
Since North Carolina's Care for School Children With Diabetes Act was signed into law in 2002, schools, health policy officials, health care providers, and the American Diabetes Association have worked together in the state to implement ADA's Safe at School recommendations for kids like Jenna. The law requires that written care plans be established for all North Carolina schoolchildren with diabetes and that the plans meet or exceed ADA guidelines. Although not specifically required to do so by law, most school districts have trained at least two individuals in each school to handle routine and emergency diabetes care, says Jenny Hutto, ADA executive director in North Carolina.
With funding from a grant by Blue Cross Blue Shield of North Carolina, ADA has worked with the state department of education and with health care providers like WakeMed Children's Diabetes and Endocrinology Clinic in Raleigh to give schools the tools to meet the law's requirements. A subsequent grant made last year will enable ADA to coordinate follow-up training sessions. Educators who attend take what they learn back to school nurses and other school personnel involved in diabetes care plans.
Kim Warlick, RN, BSN, CDE, CWOCN, a diabetes nurse clinician with the WakeMed Pediatric Diabetes Program, works with children like Jenna Bowman and their parents to teach them all about managing diabetes. But Warlick, the recipient of Merck's Advocate of the Year award presented in March by ADA, doesn't stop there. She sets up additional training for families on specialized topics like insulin pumps, and on the first visit, she makes sure to ask for parental permission to consult with the child's school nurse if the parents haven't made arrangements already.
"Most of the time I hear relief in parents' voices when one of our first questions is, 'May I contact the school nurse?' " Warlick says. "They want to make sure their child is safe to go to school. By the time I call the parents again, a school care plan is in place. [It provides] that security in knowing someone is managing their child's care at school."
Debbe Langdon, manager of WakeMed's Pediatric Diabetes Program, knows what it's like for the parent of a child who has been diagnosed with diabetes. Her daughter, then 10 years old, was diagnosed with type 1 in 1997. "We were pretty much on our own. I experienced what it was like to leave your child with people you felt were [not well informed] about what was going on," says Langdon. "I think we provide a much better safety net for parents in that regard now."
North Carolina is one state that sets a standard for schools elsewhere that don't have protocols for training school personnel like principals, teachers, and secretaries to provide diabetes care. That often affects how a child's diabetes can be managed, Langdon says, noting that kids in some schools in other states either aren't allowed to give themselves insulin injections or don't have trained staff always on hand to help them. Paula Collins, the State Board of Education's health policy advisor, says the attention to students' health pays off in the classroom: "We really see the link between healthier students and academic achievement."
ADA has worked with school boards, public-health officials, and school disability coordinators to make sure students with diabetes have the accommodations that they need. "Our law says if students want to leave class and have a private place to check blood glucose, they can, or if they want to stay in class, they have that option as well," Collins says. That's just one example of the ways North Carolina makes sure that kids with diabetes have the same opportunities as others to attend field trips and take part in extracurricular activities.
In addition to carrying out the 2002 law, North Carolina schools run a program called Healthy Active Children, which requires that all students have at least 30 minutes of exercise a day at school. Each school district must have a health advisory council.
"With the laws that are in effect now, I only have positive things to say about schools in North Carolina," says Joy Bowman, Jenna's mom. "I feel much better equipped to be a parent of a child with type 1 diabetes."
You can learn more about your child's rights and how you can work with your child's school by visiting diabetes.org/safeatschool. You can also call 1-800-DIABETES (1-800-342-2383) to request a packet on school discrimination or to speak with an ADA legal advocate about a specific issue. More resources for you and your child are available at: