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Health Care

  • Enough is Enough!


    You’d think that after announcing profits of over $1.5 billion for just the first half of this year, Kaiser Permanente wouldn’t have the nerve to ask for millions of dollars in rate hikes from school employees, especially as thousands of us suffer from layoffs. But that’s exactly what Kaiser is doing.

    At some point we have to tell Kaiser enough is enough! Your voice will make a difference for students, school employees, patients, healthcare workers and the public.

    Please join us in sending the letter below to Kaiser CEO George Halvorson today.

    "Subject: Enough is Enough!

    Dear Mr. George Halvorson,

    Kaiser has made over $1.5 billion in profits in just the first half of this year, and yet you are asking for double digit rate hikes from school districts where school employees have suffered layoffs?

    And while Kaiser executives enjoy multi-million dollar salaries, Kaiser is asking the union healthcare workers who provide care for cuts in their retirement and health benefits.

    Now we’ve learned that Kaiser lobbyists are opposing AB 52, modest legislation that would protect healthcare consumers from unreasonable rate hikes.

    We think Kaiser has the wrong priorities.

    As school employees and union members, we are asking Kaiser to put students, school employees, healthcare workers and consumers before Kaiser’s outrageous profits and excessive executive compensation.

    Sincerely,"



    SB 161

    We are disappointed that the governor signed SB 161, legislation that will charge non-medical professional "volunteers" with the invasive administration of a potentially risky seizure drug in a school setting. SB 161 was not the answer to the medical needs of California students. These short-term fixes do not solve the problem. The long-term solution is to restore budget cuts and hire more school nurses to meet the medical needs of our students.

    Read CTA's letter to the Governor

    Coalition's letter of opposition

    Diastat article from Sacramento Bee

    Educators are concerned about the danger to students by having unlicensed school personnel -- including teachers, other certificated personnel, and education support professionals -- administer Diastat. Educators believe it is unrealistic to assume unlicensed school employees will receive sufficient training to distinguish between different types of seizures and recognize whether the seizure can be safely treated with Diastat. Inappropriate administration is not harmless; it can result in serious consequences, such as respiratory depression.

    The manufacturer’s instructions call for the medication to be administered through a student's rectal cavity while she/he is in the middle of an epileptic seizure. Unlicensed educational personnel would be required to administer the drug to students wherever the seizure occurs – the playground, the school bus, a field trip, or a classroom.

    Nothing in SB 161 protects school employees against being disciplined or fired if they fail to volunteer or if something goes wrong during the administration of Diastat. The current “liability” language does not go far enough to protect school employee “volunteers” from a myriad of civil and criminal liabilities.

    Educators are concerned about the health and safety of all school children. SB 161 is the wrong answer to get students the health services they need. Under current law, parents can already use the 504 process to get their child specialized medical services.

    Background:
    CTA opposed SB 161, which authorizes non-medical school personnel to administer the prescription drug Diastat to students with epilepsy. CTA believes strongly that all students, not only those with disabilities, should have access to licensed and appropriately trained medical staff to ensure proper dignified care. The passing of SB 161 reduces the standard of care deserved for all students, and poses serious potential risks to students with disabilities if the medication is not properly administered. The administration of Diastat requires assessment of the type of seizure the student is having, proper administration during the seizure, accurate dosage amounts and rectal injection. If not properly given proper dosage during the seizure, the student could face death by respiratory failure.

    This burden is compounded by the facts that SB 161 does not provide funding for training of non-medical personnel, and current liability language does not go far enough to protect school employee ‘volunteers’ from a myriad of civil and criminal liability. In addition, educators are facing further struggles in our education system, which has faced $18 million in budget cuts over the past two budget cycles and thousands of school staff layoffs. This bill is just the tip of the iceberg; recently, the Obama administration stepped into a current California Supreme Court case involving diabetic students, urging the court to let non-medical school employees give insulin shots if no trained medical personnel are available. Again, these short-term fixes do not solve the problem. The long-term solution is to restore budget cuts and hire more school nurses to meet the medical needs of our students.

    Key Points:
    Diastat (valium) is administered rectally to control “cluster” or “breakthrough” seizures only. There are many types of seizures so it is important to assess what type of episode the student is exhibiting. Diastat must be administered when a child is seizing. The rectal syringe is made of hard plastic which could result in the possibility of piercing the rectal cavity during administration. If the appropriate dosage is not given (if an adult syringe is administered instead of the child syringe) death due to respiratory failure can occur.

    • Lawsuit regarding Administration of Insulin. The December 2008 ruling in American Nurses Assoc. v. Jack O'Connell by the Sacramento Superior Court overturned a portion of the settlement of K.C. v. Jack O'Connell (the settlement allowed non-medical school personnel to administer insulin to pupils). This decision was appealed; the 3rd Court of Appeal ruled in June 2010 that the Superior Court ruling correctly determined the portion of CDE's legal advisory is inconsistent with California law and is therefore, invalid. An appeal of this latest ruling was filed with the California Supreme Court in July 2010.
    • 504 plans. Section 504 of the federal Rehabilitation Act of 1973 requires school districts to provide a free appropriate public education to each qualified pupil, regardless of the nature or severity of the disability, which includes reasonable accommodations required for the management of chronic medical conditions. A "504 plan" differs from an individualized education program (IEP) in that an IEP provides for specialized instruction while a 504 plan provides for accommodation due to a physical or mental impairment that does not require specialized instruction. Currently, a pupil with a prescription for Diastat could have a 504 plan that requires a licensed health practitioner be on site to administer Diastat if necessary. If this bill were to become law, a 504 plan that calls for a non-medical school employee to administer Diastat would be authorized and would supersede the Nursing Practices Act.
    • Parental Designation. In accordance with current law (Education Code 49423) parents are authorized to designate a school volunteer to assist their child with a variety of medical services including insulin injections, etc.
    • Employee Coercion. Concerns have been raised that school employees will feel pressured to volunteer by their supervisors. This bill specifies that the district may only solicit volunteers through an electronic communication and cannot approach employees directly. SB 161 opponents believe there are not sufficient protections to prevent employees, particularly probationary and classified employees from being compelled to volunteer to protect their employment status.
    • Who will do the training. Concerns have been raised about who will provide training to volunteers. According the California Nurses Association, nurses are prohibited from providing training to non-medical personnel. If nurses provide such training, they could be in jeopardy of losing their license.
    • Liability. Concern has been raised over the possibility that school employees who volunteer to administer Diastat could be held liable if any errors are made and/or the pupil incurs any injuries. In addition to liability based on making an error during the administration of Diastat, concerns have also been raised regarding whether employees who volunteer to administer Diastat could also be held liable for failure to act in an emergency.

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