7B Jodi Guarnieri response to Cynthia Rocco

Cynthia, I really enjoyed reading your critical issue paper on the passage of Ohio House Bill 264. It was very informative and showed the impact that this legislation has on the schools in Ohio. This was a much needed piece of legislation to ensure that children with diabetes will be safe at school. There is always the potential of a medical emergency with diabetic students, and schools must be prepared to act in an appropriate manner. The student’s life is dependent on this.

I agree with you in regards to the indicators of why the bill was needed. As you stated, 13 states fall short of the current recommendation of nurse-to-student ratio of one nurse to 750 students. This places more responsibilities onto the school staff and families of the students. I am the only school nurse in our district which is comprised of 3 buildings. We have diabetic trained staff in all three buildings to handle any medical issues that may arise when I am not in the building. I train the staff the week before the students come back to school. The principals and I come up with a list of staff that we would like to be trained. A few of our trained staff either have diabetes, or have family members with the disease which really helps, because these staff are comfortable with the complexity of the disease. Any staff member who is asked to be trained, is allowed to refuse if they do not feel comfortable. However, I find that most staff are willing to be trained because they want to be more knowledgeable concerning this disease. The district has had trained diabetes staff in each building even before House Bill 264. This has always been necessary since there is not a health care worker in each building at all times.

I very much agree with you that all students having diabetes have very individual needs. There are many factors that determine what each student’s needs will be with a diagnosis of diabetes. Their emotional maturity and their intellectual ability must be considered. How long they have been diagnosed is also important. Grade level of the student is not always an indicator whether they will be self-sufficient. I have a newly diagnosed 10^th grade student who was very apprehensive on counting carbs (even though he had a doctor’s order stating he could self-manage his disease. While checking on him the first week of school, I found he didn’t even bring any of his diabetes supplies to school with him including his insulin. I had to intervene and insist on having a set of supplies kept locked in the clinic. I also made a binder for him which he recorded his blood glucose before lunch and also a menu with the correct carb counts for the daily school lunches. Because he is newly diagnosed, this is providing him comfort and helps keep him safe while at school. It especially provides the mother comfort during the school day.

This Bill also states that a 504 plan must be offered within 14 days of a doctor’s order of diabetes. I also agree with you that most families don’t understand what a 504 plan means. Once the accommodations are explained and how it provides a means of keeping them safe while at school, they understand why it is needed.

Thank you for sharing all of this pertinent information with all of us.