Bill Expanding School Medication Policy Stalls in Committee

March 25, 2010

Long before the state’s budget crisis led to predictions of dire cuts in education, Wheaton Warrenville School District 200 was spending beyond its means.

The K-12 district, based in the affluent western suburb of Wheaton, consistently ranks among the state’s top performers. But that performance has come at a cost. Like a surging number of districts around the state, it is spending more than it brings in, forcing a reckoning.

District 200 has been spending into a deficit every year since 2002. It has taken out millions of dollars in loans and dipped into reserves to pay the bills. Last year the district cut nearly $7 million out of its budget, and this year it plans to cut up to 73 teachers and reduce spending by another $7 million.

District officials blame the tax cap, which brought only $106,000 more in local property taxes this year. They blame the state for being late on $6.4 million in aid payments. And to some extent, they blame themselves and the educational arms race that pressures districts to keep up with their neighbors.

The district recently had the state’s highest-paid superintendent. Faced with staff predictions in 2006 of a "problematic" financial outlook, the district agreed to a teachers’ contract that raise d average salaries 17 percent from 2006 to 2009, more than double the state average of 8 percent.

"It’s frankly unsustainable" said Mark Stern, a Wheaton resident who took District 200 to court in 2006 after it refused to make that superintendent’s contract public. "The average teacher makes $72,000, which is a pretty good salary even for a full-time job, and (the former superintendent’s) contract had everything and the kitchen sink in it."

The Wheaton district is a snapshot of the troubles facing many school districts today. Shackled by teachers’ contracts, generous administrative salaries and benefits, increasing special education needs and parents’ expectations, many have been overspending. State officials say 41 percent of school districts — 355 out of 869 — were spending into a deficit in 2009. The number is expected to go up to 44 percent in 2010.

As in every budget mismatch, this one is partly about the amount of money coming in — revenue — and partly about the amount of money going out.

On the revenue side, the recession has kept a lid on local tax caps at the same time that the state fell behind on aid payments, said William Phillips, an associate professor of educational leadership at the University of Illinois at Springfield. The governor has proposed big cuts for next year.

A bill that would give school workers clear authority to administer an emergency anti-seizure medication to students stalled in the state Senate’s education committee Wednesday, with lawmakers urging the bill’s backers to try to reach a compromise with the nursing unions that vociferously oppose it.

The state Senate’s education committee declined to vote on the bill following a 45-minute hearing, in stead telling the bill’s proponents – led by the Orange County Department of Education – that the two parties should sit down together and try to hash out a mutually agreeable solution.

"I’m confident that after I work with the unions, we’ll be able to get the votes," said Mike Kilbourn, a Sacramento-based legislative advocate for the Orange County Department of Education. "I have some amendments that will go toward mollifying their concerns. … The issue is so clear, so black and white. These students need to have this drug administered in five minutes, or we have possible brain damage and possible death."

Senate Bill 1051, authored by Sen. Bob Huff, R-Diamond Bar, who sits on the education committee, is an attempt to counter a directive issued last September by the state Board of Registered Nursing that advised school nurses statewide not to train laypeople to administer the anti-convulsion medication Diastat.

Leaders from eight California nursing and teachers unions signed a joint letter in November urging state lawmakers "not to seek to weaken existing safety measures" by allowing school workers to administer Diastat in the absence of a school nurse.

The letter argued that Diastat, the brand name for diazepam rectal gel, is a "dangerous medication" and that there is "always a risk that something will go terribly wrong."

"We urge legislators to avoid placing children in harm’s way under pressure of political expediency," the letter says. "Schools must be properly staffed so that each child will receive a quality education and adequate health care."

Nursing shortage

It is precisely the shortage of school nurses statewide that has necessitated the legislation, advocates say.

Last year, Orange County’s 27 school districts had a combined 249 nurses for nearly 600 schools, according to state data. To help cover the gap, school nurses began training teachers and other laypeople to administer Diastat, which is given by inserting a plastic syringe with a premeasured dose into the child’s rectum.

But after the state nursing board warned nurses in September that they could lose their licenses by training laypeople to administer Diastat, it sparked confusion and a wide range of interim solutions.

Some Orange County school districts, seeking to protect their nurses from disciplinary action, have been inviting local epilepsy advocacy groups to train school employees in the procedure instead.

Meanwhile, a similar bill extending these rights to the injectable drug insulin – used to treat diabetes – has been introduced by state Assemblyman Isadore Hall III, D-Compton.

Assembly Bill 1802 would clarify existing law by allowing, but not requiring, school employees to administer insulin to a diabetic student at the parent’s request.

The insulin bill is in the Assembly’s business and professions committee; a hearing date has not been set.

School workers already are explicitly allowed under state law to administer the injectable drugs epinephrine and glucagon – used to treat severe allergies and diabetes, respectively. The Diastat bill closely mirrors the language of these laws.

Tweaking the bill

The Orange C ounty Department of Education is considering multiple modifications to the Diastat bill to try to gain union support.

Kilbourn said he may tweak the bill’s language to clarify that employees who administer the drug cannot be accused of sexual assault. Diastat is administered rectally with a plastic syringe.

Kilbourn also said he may add language clarifying that school employees cannot be coerced by an administrator to undergo Diastat training. (Employees must volunteer for the training.)

The Senate education committee is likely to consider the Diastat bill again on April 14; it must clear both the education and health committees by April 23 to come before the full Senate this year.