N.C. schools now required to have EpiPens

There've been plenty of stories about pieces of the state budget that educators and the public aren't thrilled with. Here's one that seems to make people happier.

The legislation requires all North Carolina schools to keep a supply of emergency epinephrine auto-injectors on hand at all times. You probably know these better as EpiPens, used when a severe allergy causes anaphylactic shock. Students at risk for this have already been able to keep an EpiPen at school with a doctor's permission.

The budget (page 38, if you're interested) also requires schools to have a staff member trained in how to administer the shot.

The North Carolina Pediatric Society came out strongly in favor of the new requirement. "Children spend half their day in school, where they can encounter life-threatening allergens, such as bee stings, for the first time," said Dr. John Rusher, president of the society, in a statement. "All students need access to epinephrine, which slows the effects of an allergic reaction in the critical minutes following exposure."

At CMS, it's unclear whether these new EpiPens are going to be ready to go for the start of school. A spokeswoman said the district is waiting for more information from the state Department of Public Instruction and health officials to figure out how this was going to be implemented. The spokeswoman also referenced a free distribution program, so there may be no impact to the CMS budget.

Virginia passed a similar law two years ago. South Carolina passed one in 2013. The N.C. Pediatric Society says 45 states now allow or require emergency epinephrine on campuses.

Student's seizure highlights role of nurses and family

When a 9-year-old had a seizure on the playground Wednesday,  University Park Creative Arts School got an illustration of the importance of school nurses and parent communication.

When the child collapsed,  school staff rushed into action,  calling 911,  clearing the area of other children and summoning the teachers trained as "first responders."  The west Charlotte school,  which has about 400 students,  has a nurse only two days a week,  so trained faculty must fill the gap.

Davidson

After getting a dispatcher who provided medical guidance by phone,  Principal Janice Davidson says her staff called nearby schools in hopes of finding a nurse.  West Charlotte High's nurse rushed straight over,  arriving just after medics and firefighters,  Davidson said.

"I feel all schools need a full-time nurse  --  all day,  every day,"  Davidson said after the child had been taken to the hospital.

Teri Saurer and a group of Charlotte-Mecklenburg Schools parents have been lobbying for two years to get just that.  As my colleague David Perlmutt recently reported,  their persistence is making an impression on county officials,  who are thinking seriously about spending the $2.5 million it would take to meet that goal next year.

In this case,  the child's parent had recently informed the school about the medical problem and brought seizure medication.  It couldn't be administered,  however  --  not because a nurse wasn't present but because the paperwork from the child's doctor wasn't complete.

That's the second important lesson,  Davidson said.  Parents whose children have medical issues need to make sure schools are fully informed and authorized to provide assistance.  In this case,  she said,  once the authorization was complete the nurse would have trained the designated teachers.

Bolyn McClung,  who was doing volunteer work at University Park when the incident occurred,  says he was impressed by how well the school responded.  "If nothing else,  the staff knows how to handle an emergency,"  he said.

Success in sight for school-nurse advocates

A year ago, Teri Saurer went to a county budget hearing and made an impassioned pitch for more school nurses in Charlotte-Mecklenburg Schools. It went nowhere.

She's learned a lot since then.  After a year of lobbying, she was overjoyed to see that Interim County Manager Bobbie Shields is recommending that commissioners spend $1 million to add 11 school nurses  (see his budget proposal here).  Now she's trying to rally for a final push for approval at next week's budget hearing.

"Getting to the point we're at now to me is amazing,"  Saurer said this week.

Teri Saurer and her family

Saurer has two daughters at Ballantyne Elementary.  As I reported last fall,  she never thought about the presence or absence of a nurse until the younger girl,  who has severe food allergies,  started school.  That's when she found out Ballantyne,  like many other CMS schools,  has a nurse for only half the week.

Last May,  Saurer went to the county's 2012 budget hearing to talk about how a nurse's presence could be a matter of life and death.  She now realizes it was naive to think commissioners would hear her speech and make a last-minute addition.  The county manager had already winnowed the highest priorities into his proposal,  and commissioners were looking at cuts to some of those items.

So she geared up for 2013.  She worked with other parents of children with medical issues,  in Mecklenburg and Union counties,  to create N.C. Parents Advocating for School Health.  They connected with the School Nurses Association of North Carolina. They gathered statistics and personal stories to make their case,  developed contact lists of elected officials and got active in the 2012 county commissioners' campaign.

"It's become like a part-time job,"  said Saurer,  a working mom.  She also learned that it's tough to build a grassroots movement that spans 159 schools in CMS alone.  She feels sure that even after a year,  there are parents with similar concerns that she never connected with.

Shields'  recommendation won't get Saurer to her goal of a full-time nurse in every school.  She estimates that would take $2.4 million.  But it's a big step for one tight budget year.

Approval isn't guaranteed.  Shields' plan includes a tax hike,  which may not sit well with commissioners.  That's why Saurer is now urging anyone who wants more nurses to show up for the budget hearing at 6 p.m. May 30 at the Government Center,  600 E. Fourth St.  She already has speakers lined up;  she just wants a crowd wearing red and carrying signs,  which she'll have on hand.

 
"You can make a difference,"  Saurer said.  "You just have to be persistent. The minute you're not,  your issue's gone."

CMS's Band-Aid solution -- literally

Kimberly Helms, a Northwest School of the Arts parent, posted an interesting comment on yesterday's story about budget cuts in Charlotte-Mecklenburg Schools. She noted that the school nurse had recently passed along a list of items she'd like parents to donate for the school health room: Kleenex, ginger ale, crackers, bottled water, cough drops, sanitary napkins, and hard candy for diabetic students.

"I nearly cried when I read it," Helms wrote. "It's a shame a school nurse can't even give a kid a tissue or a drink to comfort them."

School nurses have long turned to parents and other partners to stock the health rooms, says Maria Bonaiuto, school health director with the Mecklenburg Counth Health Department. Except for the sanitary napkins -- CMS recently stopped supplying those -- the wish list isn't related to budget cuts, she says.

In fact, Bonaiuto gives credit to CMS school health specialist Nancy Langenfeld and recently-retired Assistant Superintendent Barb Pellin for finding "a couple thousand dollars" in shrinking budgets to make sure the neediest schools have basic health supplies.

At some high-poverty schools that don't have PTAs raising money, "there were times when literally there was not a Band-Aid in the house," Bonaiuto said. Now there's a central supply of bandages, thermometers and other essentials. But yes, she says, nurses continue to ask for help supplying such things as soft drinks to settle stomachs and snacks to help a hungry student get through the day. (Bonaiuto isn't sure cough drops should be on the wish list -- if students can go to the nurse for a cough drop, "they'll come get it like candy.")

Bonaiuto notes that plenty of people are pitching in to make sure needy schools aren't shortchanged. Some strong PTAs team up to support a high-poverty school. Other schools have faith, business or community partners who help with extras for health rooms. And several parish nurses -- nurses hired by houses of worship to serve a community -- work with school nurses to make sure kids get what they need.

"Lots of people in this community reach out," Bonaiuto says. "It's nice."

I caught up with Helms (not related to me) by cell phone and filled her in on the various efforts to stock school health rooms. She was glad to hear there are no new cuts and glad to hear CMS is doing something to fill gaps. Her next stop? Going to the store for some ginger ale to send in with her daughter.
--ADH