New school requirement: EpiPens to save students
Michigan schools will be a little safer for kids who don’t know they have a life-threatening allergy this coming school year, thanks to new laws requiring every public school to have devices on hand — and staff trained to use them — that could save the life of someone having an allergic reaction.
“This was an important piece of legislation for our state,” said Liz Gellatly, a Macomb Township parent who co-founded FACES (Food Allergic Children Education & Support) in 2004. “It will give us that first line of defense.”
She should know. Her son Cole, 14, has a life-threatening allergy to peanuts and tree nuts.
In March, he had a serious allergic reaction in his classroom and had to be administered epinephrine, a medication used to treat anaphylaxis. Anaphylaxis is a severe reaction that can occur within seconds or minutes of exposure to something one is allergic to, which can include food, bee stings, latex and medication.
The new rules — part of bipartisan legislation sponsored primarily by Rep. Lisa Lyons, R-Alto — require schools to have two auto-injectable epinephrine devices, usually known as EpiPens. Each school also must have one or two staff members trained to administer the devices for students or adults having an anaphylactic reaction.
The law was designed to address those who don’t know they have a life-threatening allergy. The Centers for Disease Control and Prevention, in guidelines issued last year for schools and early childhood centers in managing food allergies, cited statistics showing 25% of the severe and potentially life-threatening reactions reported at schools happened in children who have never been diagnosed with a food allergy.
“Say the child gets stung by a bee for the first time and they have a reaction. Prior to this going into effect, they would have to sit and wait for an ambulance to arrive,” said Cheri Morris of West Bloomfield, whose son is allergic to peanuts and tree nuts and whose daughter is allergic to peanuts, tree nuts, milk and sunflowers.
“We can give them an EpiPen and possibly save their lives,” said Mary Lebioda, a registered nurse and consultant for school health and related services at the Macomb Intermediate School District.
And while kids who have a known allergy are expected to continue bringing their own epinephrine devices to school, the new rules provide protection for them if they forget them.
The training is key to the new rules.
The Macomb ISD is holding sessions throughout August, ensuring as many as 400 school employees across the county learn how to use the EpiPens. Similar training sessions are being held for hundreds of employees by Oakland Schools, the ISD for Oakland County.
“It saves the districts a lot of time and expense for us to do the regional training,” said Michael Yocum, director of learning services at Oakland Schools.
Some districts, though, are conducting their own training. In Detroit Public Schools, for instance, school nurses conducted the trainings in May and June, said Jennifer Mrozowski, a spokeswoman for the district.
“The more folks that know how to handle these situations the better it will be and the safer it will be for the kids,” Lebioda said. “We have to know what to look for and how to handle those situations that we weren’t prepared for.”
During a training session she held Aug. 13 for about 20 school employees, she explained what kind of symptoms to look for.
She told a number of anecdotes, including a story about the time she had to use an EpiPen to help a student who was having a reaction.
“I’m a nurse and I was nervous,” she told the group. She also answered questions and had the attendees demonstrate how to use the the devices.
Training school employees is crucial, advocates say.
“We do not have enough school nurses in this state,” said Dr. Harvey Leo, a pediatric allergist who was among those who pushed for the legislation.
The training only takes districts so far. They also have to get the EpiPens in hand, and that’s where Leo comes in.
Leo practices at Allergy and Immunology Associates of Ann Arbor and is an associate research scientist with the Center for Managing Chronic Disease at the University of Michigan School of Public Health.
The epinephrine devices require a doctor’s prescription, and Leo has volunteered to provide those prescriptions to school districts statewide. So far, he’s written 460 prescriptions for nearly 4,800 EpiPens.
In many cases — as was the case for DPS — a single prescription covers every school in the district.
The need is there, Leo said. “We’re seeing more and more food-allergic children across the board,” Leo said.
He said some physicians have been worried about the legalities of writing the prescriptions. But the new rules spell out that the doctor writing the prescription cannot be held liable for the incorrect administration of the drug. Leo said he’s happy to fill the need, even if it’s a bit painful. Every prescription must be signed by hand.
The new rules come with a cost.
The language in the law says school districts must seek funding from private sources and if that’s not available, they can apply to the Michigan Department of Education for reimbursement.
The Michigan House Fiscal Agency estimated last year the cost could range from $500,000 to $600,000 per year, assuming no private funds were available and schools paid $140 for each two-pack of the epinenephrine injectors.
This year, Mylan Specialty, which makes an epinephrine auto-injector, is giving them away free, part of a nationwide program to provide them to schools. The devices must be replaced annually, and every device has a single dose, so if it’s used the school would have to replace it right away.
“I think there’s always concerns when the Legislature mandates programs or things that districts need to add which are going to increase their costs,” Yocum said. “Obviously there’s staffing costs. You kind of balance that off with the idea that it may really in the end serve the needs of students.”
Lisa Rutter of Rochester, who started the No Nuts Moms Group in 2011 after her son was diagnosed with a peanut and tree nut allergy, said the the new rules “definitely bring awareness.” Her group has since grown to include more than 60 chapters worldwide.
“It makes the schools want to learn more and want to educate people more,” Rutter said.
Contact Lori Higgins: 313-222-6651 or email@example.com