Need help with preschool

[brownkkeb]

Hi everyone,

I'm fairly new here, but have learned a lot by reading all of the posts. My 3 year old son Russell was diagnosed on 8/14/07. He began on NPH/Humalog, but we recently switched him to Lantus/Humalog because his numbers were all over the place.

My issue is this - he is currently in a preschool two days a week, and the school does not have a school nurse. His teacher is the parent of a type 1 son, which was a huge relief for him starting preschool so soon after diagnosis. She is comfortable with the idea of giving him an injection to cover snacks, but we need to cover the school by providing state required training. In investigating this, for the state of CT, I discovered the following in the CT Public Health Code: "Injectable medications shall only be given in emergency situations, by a premeasured commercially prepared syringe, unless a petition for special medication is granted by the Department." Huh?

I spoke with a woman who was going to provide Injection training and medication training to the school staff, and she said first we would to get this in place. The other kicker was that if he was on a pump, the school staff would be allowed to administer the insulin.

I am so floored by all this, I don't know where to turn. Anyone ever encounter anything like this?

Thanks in advance,
Kathy

[Kirsten]

For this reason Griffin stayed on NPH until he started pumping.

Kirsten

[Kaylee's Mommy]

HI and Welcome.. that line to me would suggest things like glucagon and epi pens.. the fact is that a T1 person can not live without injectable meds, wether it be via syringe or a pump,its still being injected.. does the preschool accept any federal funds? if so then they you should get a 504 plan, I also know that for the state of CT that every school is required to have a registerd nurse on site at all times.. I just don't know if this includes preschools.. I know a friend of mine has public preschool and they are required to have a school nurse there all day every day, no exceptions..

any nurse doing the training should know the laws and regulations in your state:)

[Abby-Dabby-Doo]

CT Public Health Code: "Injectable medications shall only be given in emergency situations, by a premeasured commercially prepared syringe, unless a petition for special medication is granted by the Department." Huh?
Kathy

Kathy~
First and foremost welcome to the forum!
I'm defiantly not a pro when it comes to school laws and such. But it sounds like the school needs to be notified (obviously) of his medical condition of D. I don't know what they mean by petition?! You're very fortunate to have a mother of a type 1 for a teacher, that's fabulous.

[Christopher]

Hello,
Is the school balking at giving the injections? If not then move forward with things, get a plan in place that outlines what everyone is supposed to do and use it. There are a lot of "laws" out there that are ridiculous and if the school is OK with the teacher giving the shot then I say go for it.

[brownkkeb]

Just to clarify - that line is not from the school, it's from the CT Department of Public Health policy.

The school is more than willing to get whatever training they need, but to hear we first have to be "granted" permission seems ridiculous to me! Unfortunately, the school is a private, non-profit cooperative preschool, so no requirements for a school nurse.

And the school is balking at giving injections until after they have been trained by an appropriate state-approved source. So I've been going in every school day to give him his shot at snack time.

Kathy

[Val]

Hi & welcome to the forum!

This is a very frustrating experience. :mad: I too had problems with preschool. Simon was on Lantus/Humalog when first diagnosed & could have a 15g uncovered morning snack, so originally it wasn't a problem. When he switched to the pump all of a sudden they wanted nothing to do with touching the pump (even though they said they would do it at first) So of course he needed to cover his morning snack now. They flat out refused to do it & I had no recourse b/c it was a private preschool as well. We ended up programming the pump to deliver extra insulin for the snack. Without a pump, the only other thing I can think of (besides doing it yourself of course) is having a non-carb snack. I know it is hard if they are having something different, but sometimes I don't think Simon even minds. Maybe that will work until you can figure out the state law thingy. I just wanted to say that I am sorry - I know it would keep me up at night just thinking about it.

[Charmed7]

Just something to keep in mind, I don't know how much will be needed to cover the meal, but the school may be more comfortable with the insulin pen. I would mention that option to your endo and get a feel for what they say. I wonder if that would be considered a "Pre-measured syringe"?

Send me PM if you want, I'm in CT too. Always looking for fellow mom's for support, and love helping out any way I can.


Good luck,

Charmed

[Christopher]

Just to clarify - that line is not from the school, it's from the CT Department of Public Health policy.

The school is more than willing to get whatever training they need, but to hear we first have to be "granted" permission seems ridiculous to me! Unfortunately, the school is a private, non-profit cooperative preschool, so no requirements for a school nurse.

And the school is balking at giving injections until after they have been trained by an appropriate state-approved source. So I've been going in every school day to give him his shot at snack time.

Kathy

Thanks for the clarification. Danielle goes to public school so I am probably not the best person to be speaking here, and this may be an ignorant question, but if they are a private school why does the training have to come from a "state approved" source? And what does that mean exactly? Could it be a nurse from your local hospital?

[Sari]

my son is in a daycare setting as well, guess it is considered private because we pay for it, KinderCare corporation. Years ago there was a lawsuit over this. Turns out, BY LAW, they are REQUIRED to do a finger stick and that is it.

Now, Ross happens to be on a pump and we managed to work with the corporate office and they are now accepting children on pumps (we are the test program) - because they do not need to "inject" him. Also holds true for Glucagon - if he needs it, they need to call 911 or me.

As of now, KinderCare has about 8 kids worldwide on pumps!

[taximom]

Just a thought, but if he's only there for snack time and not lunch, could you just send him with a very low-carb or no carb snack that you do not have to cover with insulin?

[momof2D]

We too had a MAJOR problem with preschool. Our youngest son Jake was diagnosed at 13 months. By 2.5 I started looking for preschools and found that no one would take him. He was already on the pump at that point and one of the schools said they couldn't allow him in the program because they don't allow medication in the classroom. I called all ADA, JDRF, the agencies in the state we live in, and even paid for a child advocate. No luck. After teaching ourselves everything we could about law, we finally used the personal touch and contacted the head of child study in our town. We live in a town that offers a pre-school program for those who qualify and matches qualifying students with "mainstream" children to balance the classroom. After a lot of paperwork, months of testing, and realizing a major gap in the interpretation of the law, our school made an amazing decision to accept Jake into their public preschool program under medical necessity as "other health." He is in his second year of preschool and it has been the most incredible experience for all us. Luckily our school has 2 full time nurses who will be with him through the fourth grade. Be persistant!! Our school chose to step up and see the legal definitions in a different light.

[brownkkeb]

Thanks for the input everyone - keep the ideas coming! His preschool teacher and I had already considered carb-free snacks, and we will do that on occasion. Part of the reason for pursuing this is so that he can be just like everyone else, trying new foods, etc. And how do I tell him that he can't have the birthday cupcake - here's some string cheese instead....

Also, just yesterday for snack, they made English muffin pizzas, and topped them with mozzarella cheese slices cut into their favorite shapes (circle, triangle, etc) to go along with the rest of the theme for the day. It would be a shame to have to forego things like that.

I find it ludicrous that my son's preschool is unable to follow his doctor's orders to administer insulin until they apply for and get a petition from the state department of health (never mind the state required training and recordkeeping).....

Kathy

[Tamara Gamble]

Call 1-800-diabetes and ask for the school discrimination package. Also when you call them tell them that you would like to be connected with a parent advocate for your state. Go to www.diabetes.org you can look at state laws etc.

Tami