House Education Committee
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Started. First, I just want to remind those of you that are here, we've got a slim committee this morning, but some people are running bills and other committees are getting that time of year. We've had several requests for bills to be run, but they're out for physical impact. You need to remember that if you have a bill that's been amended, we will not take that bill up until three days after the fiscal impact
comes back so just keep that in mind we've had several requests for people to run bills and really their fiscal impact is not back so we're not going to run those bills that is in the statute we can't
bend the rules even though we like to sometimes but just remember that the other thing we've been asked to have a special order on Tuesday no Thursday special order on Thursday 2109 by Mr. English all those in favor say aye
opposed I believe the ayes have it so we'll have a special order on 2109 on Thursday I'll get it straight in a minute anything else the committee needs to bring up at this time
if not we're first on order of business and special order Representative Hutchinson House Bill 1447. House Bill 1447.
Representative Donna Hutchinson
Unverified
1:28
Thank you, Mr. Chairman and committee members. For years, and I mean long years, we've been discussing how
schools should care for students with diabetes.
All involved had the best intentions, but this was no comfort to the parents or the students. A consensus was never reached. First, school nurses wanted the administration of glucocons to be done by only them or professional medical personnel. But school nurses weren't always on campus, not on field trips, band trips, or sports events. Also, if a school had one nurse but two students with diabetes, and the nurse went on band competition with one student, the other student would be left unprotected.
Finally, in frustration, one family filed a lawsuit in federal court against the Springdale School District. The district lost the lawsuit and agreed to a settlement which the members are now receiving a copy of this settlement. This agreement is our model on what schools must do to comply with federal law. Ladies and gentlemen, our many long years of discussion is over. Our state's laws and rules and regs which have governed school nurses and others
now have to change to match federal guidelines there is already a list of exception in arkansas code 1787-103 we've merely added these students who need glucagon shots to this list it's a very simple procedure we're just adding one more to the list of exceptions i've asked three people to speak to you about this issue uh... the first one is jim swearing jen He is the father who filed a federal lawsuit.
The next one is Steve LaFrance, the licensed pharmacist who also has diabetes. And third is Renee Dean, who's with the Juvenile Diabetes Association. I'd like for Jim to come, wherever he is there, and tell you the story that he and his family have gone through. Sir, have a seat and just identify yourself for the record,
please. Yes sir, my name is Jim Swearengen. You may proceed.
Jim Swearengen
Unverified
3:39
Thank you sir. In March of 2007, my daughter Alicia Swearengen was diagnosed with type 1 diabetes. This diagnosis was not anything that was easily detected. She had started losing weight, was extremely tired. taken her to the doctor twice and had blood tests done, everything that we could think of. They kept saying there was nothing wrong with her. Finally, we used, we borrowed a
meter from a person we knew that had diabetes, and at that time her blood glucose level was extremely high. We took her to the emergency room. She was admitted to the hospital. She at that time diagnosed with type 1 diabetes and put on insulin immediately. As a result of that, we were sent to Dr. Jelly's office, who's an endocrinologist in Tulsa, Oklahoma. And during our visit there, we spent two days in training on what to do and how to handle
my daughter's type 1 diabetes. After we concluded our training in Tulsa, we came back to school, went to the school nurse, and because Dr. Jolly and his office provided us information for the 504 plan that was going to be needed for Alicia's diabetes, we met with the school nurse and attempted to come up with a 504 plan. In that 504 plan, glucagon is one of the very necessary things in case a type 1 diabetic goes into a severe low and goes into a coma.
on our meeting with school nurse, Alicia was playing volleyball. She just started. Her volleyball coach said, hey, I can give her the glucagon. If the nurse isn't here, I can give her the glucagon, no problem. And the nurse also said, well, there's also an EMT that's a teacher here, and so maybe that teacher can also administer glucagon, which was fine with us. We had no problem with this, always asking for someone to be present to administer glucagon in case Alicia was to pass out from a severe low.
August of that year, the volleyball coach, Coach Neal, approached the school nurse and said, I would like to receive training, additional training, for administering glucagon to Alicia if needed. She in turn went to Ms. Ludwick, who is the supervisor of the school district's nurses, And she checked with Mr. Harwell, who is the school district's attorney, and it was their opinion that no one except the school nurse could administer glucagon to Alicia.
Our question was, okay, what happens when you're not here? You're here at this school half of a day. So who's going to administer glucagon to Alicia if you're not here? And they said, well, what we'll do is we'll call 911, and we'll get an ambulance, and we're going, okay, so what happens if the ambulance is out on a call? You know, or what happens if the ambulance is involved in a wreck or something on their way to school? Who's going to administer glucagon to Alicia? And they just said, we'll just call 911, and we can't do anything else for you.
We asked the school district, what are we going to do when Alicia has practice for volleyball? What are we going to do when Alicia goes away to a camp for volleyball? What happens when she's on the bus going to an out-of-town game on volleyball? And the school basically told us if you're that concerned, you need to take her to the games. You need to be at the practices so you can administer glucagon if you're that concerned because we can't do it. This went on for quite a while.
I called Representative Hutchison and told her the problem I'm having. I said, you know, I think that we're within our rights to the school should have someone there to administer glucagon to my daughter. And I also told her, I said, you know, I find it very difficult to believe that any one person that has a compassionate bone in their body could see a little girl lying on the floor unconscious, it would not give her a shot to save her life.
I just found that really hard to believe. And at that time, my wife and I was discussing it and I'm going, you know, what about all the other kids? What about all the kids in Arkansas that are type 1 diabetic? And with the school district and their legal opinions that no, no one can give that, what What cost do we put on this child's life? So anyway, just to shorten my story, we contacted Mr. Harwell, the school district attorney,
several times. We contacted Mr. Rollins, the school district superintendent. We even offered to sign waivers of liability if they would just get somebody that would be there to give her the glucagon. Luckily to this day, no one's ever had to do that. We sent letters to the school district's attorney and to the superintendent and said, look, if we don't try to do something, come up with some resolution of this, I'm going to file a complaint with the U.S. Department of Education,
the Office of Civil Rights, because I believe that our civil rights are being violated here. on I think it was on March 24th we took all the papers and everything we had to Mr. Harwell again also we took everything to on April the 14th took all of our papers to Dr. Rollins the superintendent on April the 16th Mr. Harwell called us and said we're still looking into it but we're standing
by our position we're not going to to be able to do anything to help you. On May the 20th, we still hadn't had any contact by the school district on basically anything. I had sent them letters, or my brother-in-law, who's an attorney, had sent them letters and said, look, if you don't try to come up with some type of resolution to this matter, we are going to file a civil rights lawsuit. And so on May the 20th, we still hadn't had any contact, so that's when my wife and I wrote up our complaint.
and filed it with the U.S. Department of – initially it was Health and Human Services. We got a letter back in a few days and said, we don't have proper jurisdiction here. We believe this needs to go to the U.S. Department of Education in the Dallas office. And they forwarded that complaint to Dallas. I received a call shortly after them receiving the complaint. I got a call from the investigator. Her name was Susan Manson, or Madison, I believe it was, Manson, Manson, I believe it was.
Anyway, she told me she was in receipt of our complaint. It looked like it was a valid complaint, and they would move forward with it. About a week or two later, she called me back and said, Mr. Swearingen, I contacted Springdale School District, and Mr. Rollins, Mr. Hartwell did not answer their phones. and she said ten minutes after I left the message they called me back and they said my god what can we do to help this poor family we've been fighting this battle for 14 months and all of a sudden in 10 minutes they've changed their
opinion and now they want to help a few weeks later Miss Mads called me and says Mr. Swearingen they want to go into mediation my question to her was ma'am who's gonna represent us and she said I will I said that's fine with me I said all I want is for someone to be able to give my daughter a shot if she's lying unconscious on the floor that's it so anyway they went into mediation and she called me after the mediation and advised me that that Springdale School
District had agreed to the copy that you all have in your possessions right now. And I told her, I said, it's fine. I understand that having a school nurse present at all times with my daughter would be very costly. I wasn't looking for that. All I was looking for is someone to be present, to give her a shot, to save her life if she She happens to have a severe low.
So anyway, to this date, at Alicia's school, she's now a senior in high school. She's doing very well. No one has had to administer her a glucagon shot since she was in the eighth grade. No one has had to have that responsibility. But there's always been someone there present since this resolution. Currently at her school, both of her high school volleyball coach, the assistant coach, The principal, three assistant principals, and four teachers have all been trained in
administering Alicia Glukagong. CHAIRMAN BRYANT- Thank you, sir. Committee,
Representative Ann V. Clemmer
Unverified
13:21
have any questions? Ms. Clemmer. MS. So, Representative Hutchinson, it is your desire then that, even though this situation resolved that other persons around the state would not have to go through this rather lengthy ordeal that I would say requires what some sophistication to pursue to have to have this
dealt with I mean it just this is just so
Speaker 24
13:45
that other schools well I think we can do it
Representative Donna Hutchinson
Unverified
13:48
the easy way which is to pass this bill or we can do it the hard way and let I mean And parents know now that they can sue their school in federal court and win. This is considered a civil rights by the federal government. And so I think it would be easier to pass the bill rather than going through one lawsuit after another. And all they're asking is for someone to be trained to give their child a shot if it is
needed. And we have – I know many parents that had children with diabetes would like to speak. I hope you've signed in to speak. But we have a whole state of parents waiting for this bill to pass. And we need to make sure that we follow the anti-discrimination laws of the federal government. And this is the easiest way, is to use this settlement as sort of a model on how other
schools can meet the federal law requirements. So that's basically what we're doing. And this, I appreciate the Swearing Gems for taking this upon themselves, for filing the lawsuit, because it really has parted the waters on this whole situation, and we know what to do. MS. Thank you. Thank
Representative Les "Skip" Carnine
Unverified
15:08
you, Mr. Chair. Ms. Hutchison, and, of course, obviously, Ms. Swearingen, you might want to answer the question, but I'm wondering, as far as the complaint process, did we ever contact the
Arkansas Department of Education and Special Services to get their take on this? Ms.
Representative Donna Hutchinson
Unverified
15:32
Yes, I've been for years working with many of these families, and I've talked to the Department of Ed, and basically it boiled down to the school nurses had rules and bylaws and regulations that would not allow other people to be trained to do this. So it was, that was the problem.
They didn't want to violate the regulations by the school nurses. So we've talked to everyone, and this is the best that we've come up with, that our state laws need to bend to the federal law. And I certainly
Representative Les "Skip" Carnine
Unverified
16:11
don't disagree. I was just curious whether, in fact, we had a member, the Department of Education, could talk about this, because obviously this also has implications for a number of other issues.
Most often school districts are required to ensure parents know the areas in which they can file a grievance. They can file so that these types of things can be resolved relatively quickly. And I'm concerned that not only with this bill, but there may be other issues that don't we have a fairly clear policy that there should have been a review of this very quickly. And, like I said, and, again, I have certainly understand, I think, the issue that you've provided.
But I would certainly like to hear from our department of why this didn't
Speaker 35
17:05
get, you know, looked at earlier. So, anyway, that's fine. I will give them a
chance in a minute, Mr. Carnine, to respond if they want to. Committee, any other questions? Seeing none, sir, you may be
excused. Ms. Hutchinson, do you have a question? I have two more witnesses. Are they
signed up to speak on the bill, for the bill?
Representative Donna Hutchinson
Unverified
17:31
They were invited to lend more expertise on the
situation. Okay. You may bring them
Representative Donna Hutchinson
Unverified
17:42
forward then. And second, I would like to invite Steve LaFrance to come. He's a pharmacist, and he also has diabetes. so he can tell us firsthand, is this shot dangerous to give? What are the negative ramifications if it's given improperly?
Steve Lafrance
Unverified
18:04
Would you identify yourself with the record, please, and then you may proceed? Thank you, sir. My name is Steve LaFrance. I'm a registered pharmacist. I'm the chairman of the board and the founder of USA Drug, and more importantly, I'm a type 1 insulin-dependent diabetic. But my wife, who is an untrained housewife who has no experience whatsoever as a technician or a nurse, she administers glucagon to me very, very often when I have low blood sugars.
There's absolutely no danger of overdose or hurting yourself with glucagon. You can't do it. But the result is that when I'm comatose, I can't help myself. And she can administer glucagon to me within three to four minutes. I can teach anyone in this room how to give glucagon in two to three minutes. It's nothing to it. So simple. And I believe it saved my life, possibly saved me brain damage. And I'm healthy, but I know that I can depend on my wife to give me glucagon whenever it's necessary.
And it's been necessary because I'm very well controlled. I keep, you know, really watch what I do with having diabetes. I've had it for 30 years. And without Linda, again, an untrained housewife, I'd probably be dead. And to deny a child the right to have glucagon administered to them is just absolutely unacceptable. They can't help themselves, and it doesn't take a professional to give glucagon.
It is absolutely nothing to it. So I don't know what else to say except I plead with you to listen to this bill. This bill is a good bill, and it needs to be passed. And that's really all I have
to say, and I'd be happy to answer
Speaker 48
20:03
any questions. Thanks, sir. Representative Pierce, you have a question? Thank you, Mr. Chair. Didn't we pass a law last session that said the doctors could train their clerks to give shots?
Did we not pass that? We did pass that out, didn't we? So, basically, you're asking kind of the same thing. We trained them. They had to give them so many hours of training, I think is what they said in there. Was that not right? So that's what you're asking us for? Well, I would say this. You don't take very many hours to learn how to use glucocon. I can show you in two minutes. I've got one of those kind you have to. I'm allergic to stings, so I have one of those you have to slap yourself in the leg. Well, if you're comatose, you won't be allergic to it. I have been before because I didn't get it fast enough. Okay, well, I'll just ask.
I thought we did that, but thank you. Thank you, Mr. Chair. Committee, any
other questions of this gentleman? Seeing none, you have one other witness, Representative Hutchinson. You may call that person forward.
Thank you very much. Thank you. Next, I'd like to call Renee Dean. She's
Representative Donna Hutchinson
Unverified
20:58
with a juvenile diabetes. She's also been in this discussion for a number of years. Could you identify yourself with the record, please? I'm Renee Dean. You may proceed, Renee. Thank you.
Speaker 60
21:14
Thank you so much for allowing me to speak today. For the past five years, I've worked as the Executive Director of the Greater Arkansas Chapter of the Juvenile Diabetes Research Foundation. We raise money to fund research to find a cure for diabetes. We also provide many outreach services for our children and adults with type 1 diabetes and their families. We are very much involved with advocacy concerning federal funding of diabetes research. My work is not clinical. I am not a health professional. Because my presence here today does not fall under our mission statement, I'm here on my own behalf.
JDRF is aware of my presence today and strongly supports my efforts. Over the past five years, I've had the pleasure of working with doctors, nurses, diabetes educators, school nurses, faculty and staff of Arkansas schools, the corporate community, and many passionate volunteers. But my biggest joy is working with our wonderful families. There are two kinds of diabetes. Most people are aware of type 2 diabetes, which is a metabolic disorder. It can sometimes be controlled by making changes in lifestyle choices.
Type 1 diabetes is an autoimmune disease. It strikes suddenly, making the person insulin-dependent for life. The pancreas no longer works, and the person must constantly check blood sugar levels and administer insulin to live. A person with type 1 diabetes can experience extreme high blood sugars and extreme low blood sugars. The most serious of these situations is an extreme low. Currently in Arkansas, the only person who can give a glucagon shot is a school nurse. We don't have enough school nurses.
The ratio in Arkansas school districts is one nurse to 750 students. This number is established by school districts, not schools. That means that very often school nurses are responsible for more than one school and most often are not on a given property more than a portion of any given day. They are the ones on the front lines treating not only children with type 1 diabetes, but children with many other diseases and conditions. They are spread very thin and cannot be everywhere all the time.
Our school nurses are professionals who are bound by mandates set forth by the Arkansas State Board of Nursing, school nurse roles and responsibilities practice guidelines. Type 1 diabetes can turn deadly in minutes. The problem exists that at any given time, a child with type 1 diabetes in an Arkansas school could go so low as to go into a seizure or become unconscious. Treatment must be given within minutes. We have a mother whose teenage daughter has been diagnosed for many years
and has never had exceptional problems with her diabetes. She's here today to tell you her story about what happened when her daughter went into a full seizure. As a state, it is critical that we be proactive and prepare for such an emergency in our school districts now before such an emergency occurs. School district administrators are concerned about liability connected to someone other than a health professional administering the glucagon shot. The glucagon shot is one milligram.
The fact sheet contained in the glucagon shot states there is no danger of overdose. Additionally, it states the intravenous median lethal dose for glucagon in mice and rats is approximately 300 milligrams per kilogram and 38.6 milligrams per kilogram. If the child is actually high and has been misdiagnosed, giving the glucagon will probably make the child sick, nauseated, but will not cause permanent damage or death. Not giving the glucagon shot in time or at all can cause brain damage or death.
One of our other mothers is here today. She was an RN in another state, and she's going to share her story where on two separate occasions she had to inform parents of the organ donation program because their child did not receive the shot. Many school district administrators are concerned about the liability connected to someone other than a health professional giving the glucagon shot. A much more serious concern might be the liability connected to a child who becomes brain damaged or dies because he or she was not given the shot in time or at all.
Section 504 of the Rehabilitation Act of 1973, the 504 plan, is a federal discrimination law protecting those with disabilities from being discriminated against because of said disability. This federal law defines a person with type 1 diabetes as disabled. According to this federal law, having someone available in a school setting at all times to give the glucagon shot in an emergency is the right of a child with type 1 diabetes. Currently, many of our schools in Arkansas are not following this federal law.
It is a matter of time before we have a child who suffers brain damage or even death because the glucagon shot was not administered in time or at all. In conclusion, type 1 diabetes is a disease which can turn deadly in minutes. The state of Arkansas does not have enough school nurses to adequately respond to an extreme low diabetic emergency on a certain day, at a certain time, in a certain place. If left untreated, an emergency such as this could result in brain damage or death.
There is no danger of overdose by the glucagon shot. Not giving the glucagon shot can cause brain damage or death. Most Arkansas school districts are not in compliance with the federal discrimination law concerning disabilities contained in Section 504 of the Rehabilitation Act of 1973. A child in Arkansas has not yet suffered brain damage or died because of failure to receive a glucagon shot in a life-or-death situation. This critical issue should be addressed before a child is lost unnecessarily.
This situation is a ticking time bomb, and we, the people of Arkansas, need to take action now to defuse this threat and bring peace to the many children with type 1 diabetes in our school districts and their families. I'm happy to answer any questions that I am able. Thank
you, committee. Any questions of this witness? Seeing
none, thank you for your testimony. Committee, any other questions before we go to the audience?
At this time, we'll go to the audience. We have someone signed up to speak against the bill, Sue Tedford. Do you still wish to speak against this bill? Okay. Would you come to the table, please? Committee, we've
got several signed up to speak for and against this bill, So we'll follow this procedure for a few minutes. Would you
each identify yourself for the record, please?
Speaker 65
28:10
And then you may proceed. I'm Sue Tedford. I'm the Executive Director of the Board of Nursing. And with me today is Fred Knight, our legal counsel. Thank you, Mr. Chairman. I appreciate the opportunity to speak to this committee about House Bill 1447. I do not want to come across as an opposition of non-nurses administering glucagon in the school setting. but I do want the Board of Nursing to be a part of making our schools in compliance with federal statutes. I think we can all agree that the children with diabetes and their parents need to know
that they will receive adequate and safe care when they're away from home. Glucagon administration is an emergency measure used when blood sugar drops so low that an individual becomes unconscious. Thank goodness that doesn't happen very often, but for the safety of children with diabetes, we must be sure that the individuals trained to administer the glucagon are competent. The administration of glucagon is really not a simple procedure as Mr. LaFrance led you to believe. It's different from administration by an EpiPen.
When you administer glucagon, you have a solution in one thing, powder in another. You have to put the solution in the powder, mix it up until it's clear, and then draw it up in a syringe. The dosage is also variant depending on the size of the individual that is receiving the glucagon. So it does take extra skill and thought to do it. It doesn't take long to develop the procedures of how we can make this happen, but the skill to administer is quite lengthy of a teaching process. I taught in a nursing program for 18 years, and I can tell you from that experience,
it takes time and repeated practice for an individual to be competent at mixing and administering medications. I'd also like to point out that it is not within the scope of practice of an EMT to administer glucagon either. Other states have passed laws, promulgated rules, created position statements to make glucagon administration in the schools possible and safe for the children. However, this issue is much larger than adding an exception to the Nurse Practice Act.
ACA 6-18-1005 states that invasive medical procedures shall be performed by trained, licensed personnel, and it also specifically prohibits the classroom teachers from performing these procedures. That leaves other personnel in the school to administer the glucagon, whether it's the janitor, the bus driver, the person that works in the cafeteria. those are the individuals that are left to administer it based on that law. The Board of Nursing has submitted suggested amendments to this bill.
We believe these amendments do not change the intent of the bill, but adds legal protection to the individual conducting the training as well as the individual trained to administer glucagon. As Representative Hutchins said, we don't have any choice but to make this happen. By making the administration of glucagon an exception to the Nurse Practice Act, we have acknowledged this is a nursing function and should be only administered by a nurse. However, if non-nurses administer glucagon, it is important that the Board of Nursing, as well as those other individuals that are involved in this process, come to the table
and make an agreement of how to make this a safe practice. As we attempt to abide by federal statutes, we must also ensure the safety of the children by this decision. The ideal solution would be to put a nurse in every school, but that's not what reality he is today, so that can't happen at this time. Mr. Chairman, I'll be happy
to answer any questions. Thank you, ma'am. I've got a couple, and then I think my vice chair has a couple also, and I'm very, of course, my committee will tell you I'm not real smart about anything, but especially
medicine, you actually mix this together? Are the doses already made out for
each person? No. You have to take the solution and the
Speaker 65
32:02
powder, mix them together, and then depending on the size of the individual give all or part of it it's based on what just carried
with the person normally or the person is supposed to give it okay the other thing you mentioned about coming to the table the nursing group has had it been any conversation
about that before has that offer been made or the Board of
Speaker 65
32:26
Nursing has approached Representative Hutchinson and gave her our suggestions last week and we have not heard anything back
Speaker 58
32:33
okay thank you Representative Roebuck. Thank you, Mr. Chair.
Representative Johnnie J. Roebuck
Unverified
32:39
That goes to my question. I'm just interested to know, if we're looking at the bill, what were your suggestions? We have
Speaker 74
32:50
someone in the audience who has a glucagon kit
Representative Donna Hutchinson
Unverified
32:54
with them, if they're willing to show it to us.
Speaker 77
32:59
We'll look at that in a minute. If they're signed up, we will look at that in a
Speaker 69
33:08
minute. They haven't signed up. Okay. Okay. Well, thank you. Okay. Okay. To answer your question, we put in there that whoever is designated
Representative Johnnie J. Roebuck
Unverified
33:16
to give the . Could you give us the page and the line of where you suggested that there be an amendment to Representative Hutchinson? The page and
Speaker 65
33:28
the line? I'm not sure. On the bill. On the bill. Oh. Well, we kind of pretty well redid it.
Representative Donna Hutchinson
Unverified
33:45
let me look at yours, yours
Speaker 65
33:51
she has the licensed nurse through the training. We added other health care professionals, because just because you're a licensed nurse
doesn't mean you're the expert at teaching glucagon administration. We thought that possibly there might be an interested physician in the school district. A diabetic educator could teach it. So just because you're a nurse doesn't mean you're the expert at it. So we wanted to add that other individuals could do the teaching besides the school nurse so that they got the best training possible. We also added protection of liability to the person that did the training and the person that administered the injection
Representative Johnnie J. Roebuck
Unverified
34:39
May I interject here? Were those the only two changes that you are
Speaker 89
34:48
saying that you would? We also put in here that it would be on a
Speaker 65
34:53
volunteer basis of who would administer it Because if you don't want to do this, it's a pretty big task to say you have to do it. It needs to be somebody that was willing to do it because it is an awesome responsibility to agree to administer the glucagon.
Representative Johnnie J. Roebuck
Unverified
35:11
So just to clarify, so it is the position of the Board of Nursing that you're not opposing the bill if it were amended to meet your specifications on those three issues? Yes, sir. Yes, ma'am. Thank you. Thank you, Mr. Chair. May
Representative Donna Hutchinson
Unverified
35:31
I respond? Yes, ma'am. If you look
at your resolution agreement, number one, it says action times. It says under number one at the end, the training will be consistent with the recommendations in helping the student with diabetes succeed,
a guide for school personnel published by the National Diabetes Education Program. We weren't sure every doctor or medical personnel would have that and would be able to follow the guidelines. The parents really have no problem someone else doing this, but they weren't sure every medical profession would have these guidelines with them. So that's the only reason we limited the training to the school nurse.
And we did set up, you see on the next page of the bill, that they're going to have a plan and the nurse will make sure. And then we left it up to the board and the Department of Education to work with the nurses to set up more rules and regs. our problem is what do you do in a school if you don't have enough volunteers
do you just say well we can't meet this law do we encourage those to step up other teachers and the if you look at the resolution agreement Springdale had to ensure that
two of Alicia's coaches would be trained they didn't ask for volunteers
they said you will train two coaches to do this so that they'll be ready if she does start having problems so we have
worked with the nurses much already and we'd be willing to work with them more but I really would appreciate if this bill could get passed as is we have some other questions the messenger
Representative Randy Stewart
Unverified
37:37
yes thank you mr. chair I'm gonna question And it may be to the ADE, because I want to
know if a coach is considered a teacher. I think they are. And if we have a state law right now that says teachers can't administer that, then this is in direct contradiction to that.
So if I could get someone from the ADE to answer a question, is a coach considered a teacher? They're nodding their head yes. Okay, so that clarifies that, that part of it. And also on, Representative Hutchison, on page two, line seven, I guess, it talks about the board in collaboration. Which board is that? That is
Speaker 96
38:21
the Board of Education. State Board of Education?
Representative Randy Stewart
Unverified
38:27
Not the local Board of Education,
Representative Donna Hutchinson
Unverified
38:30
but the State Board. And also, this bill, if passed, will contradict some laws we already have, but the federal law overrules state law, and we'll have to change a few laws to make sure that these children are treated correctly under our civil rights bills that the federal government has established. Right. And you
Representative Randy Stewart
Unverified
38:57
– I think I heard earlier an amendment maybe for liability purposes might be useful.
Representative Donna Hutchinson
Unverified
39:03
Did you mention that? Well, I think the schools already are under an exemption for liability already.
I'm not sure the individual – I'm not
Representative Randy Stewart
Unverified
39:13
sure about that. So that's what I'd like to find out, if they are already under the liability clause, if they are administering medications. So it's a little bit different than their standard liability. We might get that answer from ADE maybe. When someone from ADE comes to the table,
we've got a couple of questions that we would like to have you on record.
We can't see you. The camera doesn't pick you up and nod your head over there, so come
down and have a seat, identify yourself. Ma'am, you keep your seat. He can come around on the other side. I
think Mr. Stewart had asked two different questions that we would like the responses to. The
Representative Randy Stewart
Unverified
39:53
first one is, to clarification, is a coach considered a teacher, and they would fall under the current law that says teachers may not administer medications? Mr. Chairman, I'm Mark White, Staff Attorney for the Department of Education.
Representative Homer Lenderman
Unverified
40:07
Representative Stewart, yes, coaches are considered teachers. Now, I have not looked at
Speaker 108
40:11
that particular law, so I can't tell you for sure, But I would
Representative Randy Stewart
Unverified
40:17
say if it says teachers, then that would include coaches. All right. Thank you. And the second question is, if you could expound on the question of liability, if a teacher or a school person does administer this medication, how would the umbrella of liability work in that case?
Representative Homer Lenderman
Unverified
40:37
Under state law, schools are protected from tort liability
except to the extent they have insurance. So if they have an insurance policy, they could be sued up to
Representative Randy Stewart
Unverified
40:48
the amount of that insurance policy. And that would
be the school insurance? Yes, sir. All right. Thank you. Okay. Ms.
Representative Ann V. Clemmer
Unverified
40:58
Clemmer, I believe you have a question. Yes, sir, Mr. Chairman. And I'm not sure who this question should go to, someone who can answer it. I don't care particularly who. Are schools currently then in violation of ADA if they're not providing a nurse or nearby to help a student?
Speaker 113
41:20
Mr. White, do you like to respond to that? I would, because that's
Speaker 108
41:26
been the subject of some litigation, I don't know I can give you a definite answer on that. There would be
Representative Ann V. Clemmer
Unverified
41:34
then at least a possibility they're in violation of? Yes, ma'am. I would say there's a possibility. I guess that leads to a follow-up question. It shows the way my mind's working. Then it seems to me, would it be true then the choice is either for a school to find willing volunteers or hire more nurses?
Speaker 108
41:55
Yes, ma'am. Under ADA, they must provide reasonable accommodation. And so it's a question of what is reasonable for that
Representative Ann V. Clemmer
Unverified
42:02
school to provide. What currently is the status of the number of nurses per school building in our schools? I mean, isn't it true that some schools just sort of have a rotating nurse and maybe even every campus doesn't have a nurse every day? Isn't that true? There's a percentage in our
Speaker 108
42:19
standards, and I apologize. I don't remember offhand what that percentage is,
Speaker 120
42:22
but there has to be a certain number of nurses per number of students in the district.
Representative Ann V. Clemmer
Unverified
42:28
I'm about to form a question, but it seems rather shocking then that we have students with a known disability and we might have campuses with no nurse even on the premises to
Speaker 123
42:44
help that student. That's all. Would you
agree? Okay. Next we have, excuse me, Representative Roebuck has a question for
Representative Johnnie J. Roebuck
Unverified
42:56
ADE. What is the ratio of school nurses to students?
What's the requirement? One to 750. Okay, so if you have a school with less than 750, then you've got a part-time nurse? Must be
at least one, I believe. And so are we saying that every school district in the state has a nurse available? Every district should
Speaker 105
43:26
have at least one nurse available. Should. They should have?
Speaker 128
43:32
Yes, ma'am. But they may not have. Is that what your testimony
Speaker 108
43:36
is? Well, I mean, from day to day, you may have a nurse that may take the day off or sick leave or something like that. So I can't tell you that there will be a nurse on
Representative Johnnie J. Roebuck
Unverified
43:48
that campus every hour of every day. Okay,
Speaker 120
43:51
so the requirement is one per district. Well, it's one nurse for every 750 students, but at
Representative Johnnie J. Roebuck
Unverified
43:56
least one nurse per district. Okay, but what you're saying is that if the nurse is on leave or sick or whatever,
then there is no nurse available, if that's good. Yes,
Representative Donna Hutchinson
Unverified
44:10
ma'am. Thank you, sir. Mr. Chairman? Yes, ma'am. If I could interject, we have schools that have five or six students with this type of diabetes, and even one nurse that's there all day could not be in all the places that the students go. And it's just the more students you have, the more this nurse has to decide, which student will I go with today?
Will I go on the field trip with this student and leave the other five without a nurse? So it does become more complicated than just counting nurses and students. Next we have
Representative Karen S. Hopper
Unverified
44:49
Representative Hopper. Thank you, Mr. Chair. And Representative Hutchinson kind of
touched on this after I raised for the question, and that is in reviewing the resolution agreement, I was looking for references to the involvement of the Board of Nursing,
and I know you've touched on that, but can you expand on that a bit to the extent was this agreement reached sitting around the table or was it something drafted and put before the board?
Representative Donna Hutchinson
Unverified
45:17
You know, just elaborate if you would, please. The testimony that you've heard today is the
testimony that was given. They rehashed everything and came to the conclusion that our state needs at least the Springdale School District, in order to get out of this lawsuit needs to follow the guidelines set down in this resolution.
And we want to work with the nurses. We think they're great. They're hardworking. They sacrifice. They put in long hours. But, you know, you saw that movie, what is it called, Multiplicity, where they could, they can't do that. And the federal government has said you must be able to provide a full school experience for even children with diabetes. So that means these children should be allowed to go to band concerts, field trips.
They should be allowed to go and enjoy all of that, which means you need to have someone with them who can administer this shot. But we have no problem with the nurses, and we would like them to train the personnel to do this and to sort of be the supervisor over this situation. So we have no problem with the nurses. It's just they can't be every place at the same time. Thank you, Representative. And thank
Representative Karen S. Hopper
Unverified
46:36
you, Mr. Chair. Okay, next we have Mr. McLean.
Speaker 139
46:41
Thank you, Mr. Chairman. My question, Representative Hutchison, is kind of in line with Representative
Representative James McLean
Unverified
46:48
Hopper. Just how involved, in terms of hammering out this bill, were you and the folks that are concerned about it, along with the nurses? I mean, was this something you all kind of worked on until you came to an impasse? Were you all ‑‑ I'm trying to get an idea of the level of involvement between yourself
Representative Donna Hutchinson
Unverified
47:12
and the nurses. I think when you listen to the parents that are going to be speaking for the bill, you'll find out what they've gone through, and this has been going on for years, and they just finally
Representative James McLean
Unverified
47:25
got so frustrated, one of them filed a lawsuit. But in terms of process of putting the bill together, were you communicating with the
Representative Donna Hutchinson
Unverified
47:33
nurses? We added an amendment because they suggested it. We added the amendment that they would train the personnel. We added the amendment that they would oversee it, and we added the amendment that they would
Representative James McLean
Unverified
47:44
help promulgate rules necessary to administer. So this is something you all are working in concert. You were
Representative Donna Hutchinson
Unverified
47:54
working in concert with the nurses. Yes, until we came to
the point the parents said, no, we can't change anymore, and this This is where we had to then
Representative James McLean
Unverified
48:03
just go with the bill as it is. And as of now, and this is just for my clarification, I'm a little slow on the uptake, you're not prepared to entertain the amendments that they've offered?
Representative Donna Hutchinson
Unverified
48:15
Unless they can show that the school would have some jeopardy, I think that's the only one that we are, they might be unclear about. We think they do not have legal jeopardy, but I can understand why they would want that. But I think the parents want someone there all the time to give the shots. That's what the parents are concerned about. They aren't concerned about little rules and regulations and have you dotted the I's.
They want someone there to prepare the shot. If you pass this bill and we need something else, I'll file an amendment. But the parents want to know before they leave that Arkansas is going to stand behind their students. I understand that. And we'll have someone there for the shots. The other things, they're not as concerned. But we need to leave with these parents knowing there's going to be someone there to give these children
Representative James McLean
Unverified
49:13
a shot. I think that's proper and appropriate and proper. I just kind of just want to know that
if we do move forward on this, it will be without the support of the nurses.
Is that kind of where we're at? If we pass this thing out unamended, we're going to have the nurses who are not on board. Is that kind of where I'm at here? I
Representative Donna Hutchinson
Unverified
49:35
guess that's up to the nurses. But as I said, federal law overrules state law and rules and regulations. Could the
Speaker 148
49:43
nursing folks speak to that? I would like to address that. I'm Fred Knight. I'm general counsel for the Arkansas State Board of Nursing. And to be quite honest, no, we have not sat down at the table and hammered this out. although we do not oppose what Representative Hutchison is attempting to do.
We understand the Springdale school situation and what was going on up there, and it is our understanding under the ADA these children are entitled to have this type of health care. Now, I'll tell you right off the bat, if you look at ADA, ADA makes it clear that they are to have the same standard of care that other children are to have. There's two different acts that rule here. There is the Federal Rehabilitation Act, Section 504, and then there is Title II of the Americans with Disabilities Act that have covered this.
They don't set out, though, in detail who is to perform all these procedures. That appears to be left somewhat to the states to determine. That being said, there is no question, as Representative Hutchison has said, there are parents out there who may sue the schools if they don't have these individuals available to administer glucagon And to be honest, there's other procedures that will probably need to be dealt with also. But there is also another type of lawsuit that's out there, and absolutely, schools can be sued if their student is injured.
You see that all the time. If they're injured playing on the fields, if their heads are bashed from the field goals, the kinds of things we've seen, they can be sued. There's limited liability. State employees have limited liability, and they have limited protections. the problem I think with the bill and let me just say this we looked at other states and how they've addressed this it appears that about and when I say we that's Miss Tedford and I and other people it on the staff of the State Board of Nursing it appears to us and I'm no expert on this but it looks like
22 other states have addressed this in a bit more detail than just trying to create a signal exception to nursing as we're doing right now and when you look at those states I'm gonna give you some of the states North Carolina who we called and talked to, state of Georgia, Nevada, Utah. Utah is a very comprehensive bill on this that looked very good. They made it very clear in their bills that the individual who's going to be administering this is a volunteer. You don't want to force somebody to have to do this, and they do it wrong.
And the child, one thing you've not heard here today is when the child has gone into the coma, and you administer the glucagon, it's not like the child may wake up and stretch and get up and start running again or go back to their books and start studying. Children can start vomiting when they come out. They can asphyxiate on the vomiting. I'm not saying it happens every time. I'm not a nurse. I'm just a lawyer here. But I've heard others talk about it, and it's documented. Fortunately, glucagon does not have to be administered often.
But the bottom line, if you're sitting here and you don't think those parents will not sue the state when that child's injured, and then that lawsuit starts and the person administers takes the oath and says, I didn't want to do it. I was forced to do it by the school superintendent. I don't think that's going to help the schools one bit. That is not how to solve this problem. And then on top of that, you've got a nurse by the bill. If you look at the bill, and I think it's on page two, and in all fairness to Representative Hutchison, I think she was trying to fix one of our earlier concerns.
This is not a criticism of her, but where she says the nurse, the school nurse shall do the training. Well, it's the first time in the history of the board that a nurse is being ordered by statute to train an unlicensed person, even if the nurse thinks that particular individual is not competent to do it. I wonder if the individual tells the nurse it's training he or she, I don't want to do this. The superintendent of the school or the school board is making me do this, and I'm not qualified to do it. Well, then again, look at the liability issues down the road.
Everybody knew the person wasn't qualified to do it, didn't want to do it. I just think the reason other states put in the individual willing to do it has to be a volunteer is you're trying to eliminate that kind of liability. You're trying to not force people to do it. And I think when we looked at other states, they gave them very specific legal protections. In fact, the state of Georgia, their language was that they are not liable as long as they are acting in good faith.
And I think the reason Georgia and some of these other states put those kinds of protections in there was to encourage volunteerism. I think people will want to volunteer. I think people will want to help. But I don't think they want to take on that liability. We know folks will see somebody in a car wreck and drive past it. Because why? They don't want to get involved. And so I think all we're trying to do is to come up with a better way to make this work. And that was what our suggestions were. They were three or four. They were fairly simple. And that was our goal. But if anyone here is thinking that once this is happened or has happened and a student is injured,
whether it was the person doing its fault or not, there will be lawsuits. We all know that. That when children are injured in schools or anywhere, they see the
Representative Donna Hutchinson
Unverified
55:08
Chairman, may I respond? Yes. I did amend this bill, and we went over the amendments, and this is what the attorneys of the nurses wanted. Took almost a week to get that amendment on. Then as soon as I got it on, other attorneys from the nurses started calling and said,
we want that off. So there came a point when we wondered if this was just to drag it out. We're coming to the end of the session. We can't keep putting amendments off and on. Every time we try to put one on, there's another suggestion comes up. Many of you know about my other bill, about the soccer goals. This law in the state says if they have money, they can sue. school system did not have any money for that tragic situation that happened with the soccer
goals. The family didn't get any money for burial, they didn't get any money for medication, nothing, because that school had no funds. The schools decide if they want to have funds for a lawsuit. If they don't have funds, then sorry, the accident happened on the wrong school for your child. So I think we probably need to change the state law when it comes to schools being sued. But these parents aren't concerned about that. They want their child
to get a shot when that child goes into a coma, and that's the overriding. I will talk to the parents but um we want this bill passed so these children will be safe and the bill says the nurses and the board can work on other rules and regs they can take care of the problems as they work on the other rules and regs but we need a bill that protects these children so they'll have someone who can give
Speaker 148
57:01
them the shot mr chairman may i respond yes just for clarification
I am the only attorney for the State Board of Nursing, and I don't know. I've had no, other than one day meeting Representative Hutchison outside the door, we had no direct contact as far as communicating about this particular bill. We did send over early on some of our concerns. If she took those to be amendments, then they were never meant to be amendments. We just sent over concerns, and we sent those unsolicited. We did, however, later send over what our amendments were, and we never heard anything back, and those are not a part of that.
I don't think Representative Hutchison and the State Board of Nursing are that far apart, but I do think there is a lot to be done on this. I mean, I'll be real honest with you today. If you look at that section on page two that talks about the board, one of the members asked, which board is that? And it was the Board of Education. I'm going to have to be honest with you, until just that was said, we thought it was us. Because it doesn't tell us which board it is, and we assumed it was the Board of Nursing that was going to be doing that. So this bill needs to be clarified and cleaned up, if anything, so we can get something done.
And it probably should involve both boards, and it should address them specifically. And I would strongly encourage this committee, at a minimum, not to restrict the training to just nurses hired in the school. I mean, I'm from Yale County. I'm from a very rural county where there are, I can tell you, they may not want to say it here, but there's not a full-time nurse in the schools up there. I can tell you right now, I've already been told, at best, maybe two or three hours a day in some of the schools, and that may be a week.
I don't know that that's the best person to be training. If you've got a physician living in that county who has a child that's a diabetic, that physician may be willing to take that task on and go in, and I think they would need the legal protections. That's all we were saying. We were trying to protect people from lawsuits. The physician's not a part of the school. The physician won't want to take it on if there's no legal training or say there's another nurse in the area. But they may not be an employee of the school, but as the bill is currently written, they can't even train them, and if they do, there's no legal protections.
And trust me, I don't think Representative Hutchison and the board are that far apart. All right.
Thank you. We're going to kind of let things go down here back and forth, but
we're going to stop that right now. Thank you. Another thing, Mr. White, if you would like to remove yourself, I know you enjoy sitting there, but if you'd like to back up, we'll let you do that also. Glad to do so, Mr. White. Committee, I'm sorry, but we're going to Mr. I'm not sorry we're going to this young lady, but Ms. Clemmer is next. Yep. I think my question has been answered. Okay.
Representative Karen S. Hopper
Unverified
59:51
Representative Hopper. I hope I don't muddy the water here, but as we've talked about liability, legal protection, volunteers, et cetera, my thoughts went to how did we resolve two years
ago putting defibrillators in all the schools? Is
that? Mr. Steele just left, and he's
the one that supported that. But Mr. Kimbrell, would you like to come to the table and answer that question for us, please?
Speaker 162
1:00:29
Mr. Chair, from my information working with Tom Kimbrell, Commissioner of Education, from my understanding, every
Speaker 165
1:00:35
school now has a defibrillator. Every school through some grant funds, training is required now. Who does the training? It is in conjunction with the Heart Association. So the training is there, and each school now, because there were funds that were made available for schools that did not have them,
they were able to apply, and from my understanding, they were able to provide every school district now. Either they bought it themselves, already had it, or those that didn't got grants and got
Representative Karen S. Hopper
Unverified
1:01:13
the defibrillators. That part I understood, but again, are we still not
dealing with the liability issues? Do folks sign off? I
Speaker 169
1:01:23
mean, employees? Sign off? Well, they do sign off that they've had the
Representative Karen S. Hopper
Unverified
1:01:29
required training. And so from that, that addresses liability?
Speaker 165
1:01:32
Well, I can't answer whether that addresses liability or not. Not every staff member is required to have that. Representative Steele, we're telling you
about one of your great bills you passed. You may want to jump in on this. Most of the training
Speaker 165
1:01:49
is being done at a lot of the educational service cooperatives and by a lot of the school nurses who have also got the training. In conjunction with the defibrillator training was also the CPR training. That was on top of that, and that was a part of the 60 hours required.
Speaker 175
1:02:09
Mr. Steele, would you like to just make a comment? Yes, sir, Mr. Chairman, and thank you for acknowledging that. I think Dr. Kimbrough has done a good job in that. I would just like to say we did deal with some of these issues of liability and so forth. But, again, the overarching issue for us was to get the help to the person who needed help as soon as possible, even if it meant dealing with some of these issues afterwards, Because if a child is sick and needs help right away, I don't think waiting on clarification of language or any of these other issues are as important.
And that's the kind of what, that's the way
we proceeded with the defibrillator bill. All right. Thank you. Ms. Hopper, you. Thank you. Representative Carnot has a
Representative Les "Skip" Carnine
Unverified
1:03:02
question. Thank you, Mr. Chairman. Again, I would like to go back to my initial thought, and obviously it's a little bit off the bill, but if I could take a minute, if Dr. Kimbrell could kind of help me on this one. This is the particular facts we have here about the resolution of the civil rights complaint.
And I know, Dr. Kimbrell, you weren't actually there at the time, but is there a process of which the state becomes knowledgeable about these types of rulings? And as we've heard testimony, there are probably between 20 or 25 other states that have either laws or regulations that deal with issues on 504 and Title II. As you know, I guess my question is, do we have a process that if a person has a concern that they could go to the state
and obviously propagate rules or request laws? I mean, this is back when we could have dealt with this a session ago, had been necessary. You're correct. In
Speaker 165
1:04:19
fact, I wasn't here apparently when this happened with Springdale and the issue was there. We don't have a clearinghouse for these kinds of issues. In other words, that was a local issue that was dealt with at the local level. I do have Mr. Tom Hicks with me with the Special Education Department,
and under ADA issues, if we need to ask him further questions, we can do that. But we don't have a clearinghouse when these types of things. this was something that I was made aware of when this bill was filed, and then Representative Hutchinson provided us with a copy of that agreement that the Springdale School District made in order to satisfy in their arbitration, or the mediation. We do have the processes in the special education department. When ADA issues are not being dealt with, there is a process in which that department
has mediators, there's investigation, and we resolve these issues. I can't answer whether that particular issue that brought this forth today was actually brought over there or not. Mr. Hicks is shaking his head no, he's not aware of that, and he's been there a long time, 40 years, so this particular issue wasn't brought to that, but we do. I mean, I sign orders to discuss, or I guess their investigations pretty regularly lead When we have a complaint by a parent or an individual and their ADA needs are not being met,
we have investigators who go in, investigate that allegation, work with the school district, and then there are additional steps that can be taken to even go further
Speaker 179
1:06:01
than just with our mediation team. And thank you
Representative Les "Skip" Carnine
Unverified
1:06:04
for your answer. I think that was what I was trying to get at, There is already a process that could have been followed and had it, we potentially could have been really dealing with this a couple of years ago, and my only concern I have is with this particular, and I certainly understand Representative Hutchison's bill, and I'm
also very concerned that we get help where it's necessary, but I guess what I'm trying to express here is that in some way, shape, or form, we've got to come up with a way in which these issues get dealt with in an appropriate way and people understand that there is a process available to them but I'll stop at that mr. chair because I know there's
other things thank you miss Hopper may not miss Hobbs I'm sorry I apologize miss Hopper you
Representative Debra M. Hobbs
Unverified
1:06:56
apologize to her and not me thank you
Ms. Chair. Earlier, when the pharmacist testified, I'm sorry, I forgot his name, but he talked about the
necessity of getting that glucagon administered very quickly. Do you agree with that? Absolutely. Time is of essence with glucagon. Okay. And then, so in my mind, I guess I think that if there's someone that can administer that shot, then that gives a little bit of time to get the nurse there or someone there to deal with once the person comes in.
Okay. And then my other question is, does Arkansas have a good Samaritan law that if you're trying to do good, it exempts you from? Can my legal counsel answer that? Yes,
Speaker 148
1:07:42
that would be great. We do have a good Samaritan law, but it is not set up for this situation. It is truly the accident where it would not be expected or anticipated. It's where you're driving down the highway and you come up on a wreck and you deal with it there. It's not, this is anticipated. This is something you know that's going to happen in a certain period of time over long enough time.
If you have diabetics, somebody may go into and need glucagon. But there are a couple, if you remember, two years ago or four years ago, they heavily amended and rewrote our Good Samaritan Bill. And I think we've had one attorney general's opinion come down and talk about it. And it's really set up to be for the unexpected emergency and not to where you can anticipate it within the schools. I think this is directed more by ADA, as Representative Hutchison has pointed out.
I don't think this is what the Good Samaritan Bill was intended to do. I really don't. And I think there's an opinion to
that effect. Thank you. Thank you, Mr. Chair. Okay. Committee,
any other questions? If not, thank you, ma'am, sir. Thank you. For your testimony. Next, we're going to go to the audience for someone
for the bill. And we have Kathy Farrington. Do you still wish to speak for the bill? Okay.
Can you identify yourself for the
Kathy Farrington
Unverified
1:09:15
record, please? Yes, sir. My name is Kathy
Speaker 192
1:09:18
Farrington. Okay. I am a mother of a child with type 1 diabetes. I'm a registered nurse here in the, registered by the State Board of Arkansas, and I have a specialty in pediatrics. have had that for about 26 years and I am here to tell you just a couple of things that I'm definitely for the bill I know that I've myself in another
state practicing as a registered nurse have unfortunately had the scenario of two times where two children did not receive the glucagon shot when they needed it and had since gone into a diabetic coma and had to be taken off a ventilator and had discussions about organ donation. When I was discussing this to some of my contemporaries, I realized having been a registered nurse,
this is not something people experience very often, the average layperson doesn't. As a nurse, you have had that experience usually before if you've worked in a critical care setting at all. And so I realized this is an important thing for me to tell you, that there is a reality here of that happening should we not consider the glucagon. Now, something that they have expressed here earlier is that when children,
it is not often that you need to have the glucagon administered. In fact, my own daughter has never had to have it at this point, and I'm very grateful for that. I have actually the glucagon with me, and I would like to just give personal testimony that I've trained many, many people in this. It isn't all that difficult to train. I'm not trying to do a he-said-she-said situation.
But there are four easy steps. In fact, when my daughter was diagnosed, we brought in other siblings, and the young siblings were trained by the nurses and the doctor in order to give it to my daughter. They told me I needed to train her classmates and her friends, including other adults. And this includes children. We've had people in camp settings that we've needed to train at camping situations.
These would be other children. The point being, I don't necessarily advocate a child giving this glucagon shot, but a child could give it if they needed to. It is not that difficult. And also on the weight issue that was mentioned earlier, these are standardized in an emergent setting. In the hospital setting, you do consider different levels of glucagon amount depending on the weight of the individual.
But these are a standardized shot, and they are easy to give. And I also would like to just speak briefly on the comments about vomiting and asphyxiation secondary to a low blood sugar and things like that. It could happen. But vomiting and asphyxiation can happen in many medding situations. And so I do want to address that comment that concerned me a lot as a mom and as a nurse,
that that was being set before you as a potential for liability. I am very concerned about liabilities for the State Board of Nursing, but I'm more concerned about us taking care of this and doing this well with the children that need to have coverage. It is not that difficult to give. It is rare that they have to have it, and it is very, very, very easy. I could teach probably each one of you in here very quickly.
In fact, I've been asked to go to many different settings and teach this particular thing for people who need to know, and it is easy and it is quick. So that's what I wanted to tell you, and I implore you to use a voice of logic at this point, and maybe let's work out the
liability details later. Thank you. Committee, any questions? Seeing none, thank you, ma'am, for your testimony. Next, we'll go to the
audience. Be against this bill, Margo Bushmeyer.
You still? Okay. Have a seat and recognize
Speaker 195
1:13:57
yourself at the record, please. Thank you. I'm Margo Bushmeyer. I am a school nurse supervisor for a large school district, and I think everybody has said almost everything that I wanted to say today. And I want to thank Ms. Dean for you explaining the situation about school nurses very well. The only thing I have to add is that I teach non-nurses how to give oral meds and EpiPen and have been doing that for 12 years.
And every time I teach it, I have someone that says, I can't do that pen. I can't do that. And yet they're the volunteer that's come forth from the school. But watching it just freaks them out. And I think, well, you know, I'm a pretty good teacher. I taught in nursing school for nine years. But there's always some employee that says that they just can't go to that level. So I'm concerned about what if the school could not find someone. And in our district, we would then have to pay someone. So there may be some financial responsibility to this bill.
but I am all about the kids getting this emergency medicine. So I think we need to make it happen. But as a school district representative, I just have to say I have had difficulty teaching non-nurses how to do emergency medications prior to this. That's really the only other thing I have to add. Thank you very much. The other thing is I do just have to say that staffing for our diabetics is number one priority. First thing I check in the morning is who's out and how we're going to cover the diabetics. So school nurses are all about taking care of these kids.
They are our priority. Questions? Thank you
for your testimony. Next we have, this will be for the bill, Tammy Del Dono. Is that correct?
Well, it's a miracle I got it right. Ms. Donnell, I'm not going to just please don't plow any old
ground. Let's just try to, if you have points you need to cover that haven't been covered.
Tammy Daldano
Unverified
1:15:58
Of course. We appreciate that. My name is Tammy Daldano, and I'm here as a mother of a soon-to-be 16-year-old daughter named Courtney. She's sitting over there. I let her skip school today for a couple of hours anyway. And what I want to share with you is just an experience that happened to us last April 18th. Courtney's had diabetes for almost 10 years, and it's really funny. You never forget those days that they were diagnosed or that you could have lost your child.
It was one morning. We'd all slept late. We'd been to a fundraiser the night before, and I woke up to a loud crash in my kitchen. I recognized that one of my bar stools had fallen over on the ceramic tile, and I thought it was the dog, and I went running in there. It was actually my daughter, and she was having a seizure, and I'd never seen anything like that before. And like I said, she's had diabetes for 10 years.
I screamed for her dad. He came rushing in. I called 911, and I have huge needle phobia, which is really ironic. I was terrified, absolutely hysterical. She's having this major seizure, and I was shaking like a leaf, and I gave her this. When Ricky called 911, we live right behind Lakewood Village in North Little Rock, so EMTs get to us, like, really, really quick.
And by the time that they got there, she was coming around. I mean, it was a matter of minutes. This is not complicated. You guys are welcome to look at it, take the insert. This is what lives in her purse 24-7 and at our home. You know, by the time we got to the hospital, she was absolutely fine. She was bruised and battered and looked really bad for a while because she took a really hard fall also. But this saved her life, and as hysterical as I was, I was able to give her the shot.
And when seizures happen, the response is just so critical, the time factor. And, you know, she's a really smart girl, and she's got a great future, and it just terrifies me that, you know, if I hadn't been home or if she had not been somewhere where someone could act quickly, that she could be brain damaged or worse. So I really don't care how you guys work out the details, But as a parent, you know, I don't care if an 8-year-old does this, gives this to my daughter.
Seriously, it's so simple. It really is. I had looked at the instructions probably one time because I, honest to God, never thought that I would need this. It was just absolutely for emergencies only. So. Thank
you. Thank you. Committee, Mrs. Hobbs, you're recognized. Thank you,
Speaker 184
1:19:01
Mr. Chair. Is the kit obtained by prescription or? It is. Okay.
Representative Debra M. Hobbs
Unverified
1:19:05
Okay, so then, and I'm assuming, like your daughter, probably people that have that would carry that with them in the school.
She really wouldn't have to worry about the amount
Tammy Daldano
Unverified
1:19:18
and that sort of thing so much. You keep going at school. Courtney goes to Central. There's 2,600 kids there and two and a half nurses. And I have talked to security there because, you know, if she's in the hallway, you know, by herself, Central's a huge school. You know, she could be there for 20 minutes before somebody's sorry if someone
Representative Debra M. Hobbs
Unverified
1:19:37
wasn't with her. Thank you. Thank you,
Ms. Chair. Okay. Thank you. Any other questions, committee? Seeing none, we will go to the audience for the bill.
I'm sorry, against the bill. Kathy Haney.
Kathy Haney
Unverified
1:19:59
My name is Kathy Haney, and I'm the past president of the Arkansas School Nurses Association. You may proceed. I just want to say, just like everyone else, that the School Nurses Association is very concerned about the welfare of these students. We have a large number of diabetics across the state.
Their well-being is very important to us, and we support the practice of all students, not just the diabetics, but getting the emergency medications that they need. The Arkansas School Nurses Association does oppose House Bill 1447, and there are several things that we find that we could sit down, because as the association, we were not contacted to be able to sit down to be a stakeholder. There's approximately between 600 and 700 school nurses in the state of Arkansas.
Yes, we do need more school nurses, and yes, we do not have school nurses in all of the buildings at all the time. But just like Mrs. Bushmeyer said, that if a nursing supervisor knows that she has a diabetic student in that school, she will do everything that she can possibly do to make sure that there's a school nurse in there. I have a population of 900 students, and I'm the only school nurse. I also have diabetics. My diabetics range from very low blood sugars to very high blood sugars.
I'm able to assess them when they come in. Now, one question that has been raised is that we're going to have volunteers to come in to do this. okay, we're going to have volunteers to go on football games, basketball games, soccer games. Most volunteers are going to want to get some kind of compensation, even if they do work at the school. Who's going to fund that? If we've got more than one or two diabetics going to two different or three different activities,
how many volunteers is that school going to have to have? Also, this bill, I believe we need to pull it down and we need to get with all the stakeholders, everyone involved from Representative Hutchinson, the Arkansas State Board of Nursing, the Nurses Association, the Department of Education, and come to some kind of mutual ground. Because, yes, these are very important issues, and today is not the day to make a split decision
when we can investigate and look at what other states, just like the State Board of Nursing's legal counsel said. There's other states that have already done this, have already wrote programs that have training in process. So I do not feel like today is the day to pass this bill. We do need to pull it down, have all the stakeholders come together.
Thank you. Thank you. Committee, questions? Seeing none. Thank you, ma'am. We'll go back to the audience. For the bill, Steve Sparks.
Mr. Sparks, have a seat and identify
Steve Sparks
Unverified
1:23:06
yourself with the record, please. My name is Steve Sparks, and I'm in my second year of pharmacy school and also a recently diagnosed type 1 diabetic in November. And type 1 diabetes is an autoimmune disease in which you don't produce insulin, so you have to take insulin shots. Type 2 is more prevalent because the risk factors include obesity and genetics. But type 2 diabetics also take insulin and sulfonylureas, which are insulin-sensitizing medications, which also can cause hypoglycemia.
The key for people with diabetes is the key through blood sugar in a range of 70 to 140. Anything below 70 is considered hypoglycemic. It is also one of the most feared complications of diabetes treatment. Approximately 90% of all patients who receive insulin have experienced hypoglycemic episodes. An estimated 2% to 4% of deaths of people with type 1 diabetes have been attributed to hypoglycemia. The prevalence of symptomatic hypoglycemia episodes in type 1 patients range from 1 to 10 per week.
And this was all cited in the Clinical Diabetes Volume 24. The problem with hypoglycemia is your brain does not receive enough glucose, which is blood sugar, so it cannot act. And a series of nervous system interactions happen. You shake, you get really hungry, and this can cause sweating, and then it can go into seizures and then into a coma. What you're going to do with the glucagon pen, it is the primary fast-acting hormone against hypogastemia.
It works in three to six minutes. So call 911, and then you act on this. Three to six minutes is fast, even enough time for a nurse to come all over campus. I know I went to BB High School, and our nursing was clear across the other side of the street. The glucagon acts to increase your blood sugar And a shot means This is basically a Krispy Kreme donut in a shot You're just going to inject it And you're going to go to a normal level of blood sugar
This is a packet insert from Lilly My glucagon pen is a Lilly manufacturer There's Novartis and there's Lilly And they're saying the severe complications It says, side effects, although rare, include nausea and vomiting. And it says, if not treated, the patient may progress to severe seizures and death. So it's give or take, nausea, vomiting, seizures, death.
Now, the glucagon pin comes with a packet insert. This vial right here is the glucose. This is your sugar. You get a pin and it has a carp project, which is you can't pull anything further than this. This is saline. What you're going to do, you're just going to pop this open, take the needle off, inject this is all the saline in it. You're going to swirl it up until it's clear, take it back out, and inject a muscle. Thigh, butt, arm, and that's it. And then you're just going to roll them on the side and wait.
If they throw up, they throw up. If they don't, they don't. and then when they come to, you just give them juice or hard candy and wait for the paramedics to get there, and that's it. So not very difficult, and I've had to use it once. And my training considered, given my friends in pharmacy school, said here, here it is, here's the steps, do it, and they did. So
thank you. Thank you, sir. Any questions, committee? Seeing
none, we'll go back to the audience,
Speaker 209
1:26:51
And we have against the bill, Rich Nagel. Thank you, Mr. Chairman. I'm Rich Nagel with the Arkansas Education Association. And I think it's clear to everybody we've got a serious and rather immediate problem that we need to deal with. The only thing I would suggest is let's let the parties get together. I disagree that the logical thing to do is to pass the bill and then worry about the details later.
I think we need to worry about the details right away, get the bill back here, and let's get it going.
Thank you. Thanks, sir. Okay, we'll go back to the audience. We will follow the bill. Allie Hastings, are
you still here? Have you disappeared? No, you're still here.
I'm okay. Have a seat, please, in the table. Ms. Hutchison will help you. Hi, I'm Allie
Speaker 213
1:27:53
Hastings and I'm a type 1 diabetic and I
Speaker 215
1:27:55
go to Mount St. Mary's and I'm kind
of concerned about my life because if I pass out I don't have a nurse in school and I don't want to die because of one accident and not having anyone to take care of me and it scares me every day that I might go low, and I don't have a nurse there, and I just need one person that can do that for me. I'm a cheerleader, and I can't. There's not a nurse that can give me my pen because she's not
out there. Allie, do you carry medication with you?
Yes, sir. Do you have friends that carry it also with them, or they know you have it? They
Speaker 215
1:28:41
know I have it, sir. Okay, all right. Anything else you want to say? I'm just that I'm not the only person that has this, and there's only two in my school, and I don't have a
nurse, and we really need this. Okay. All right.
Speaker 207
1:28:57
Thank you for your testimony. Thank you. Thank you. I think last we have against the bill, Danette Simmons.
Actually, I'm Danette Simmons, and I'm not against the bill. Would you have a seat, and then you're the last one signed up, so we'll hear from you, whether you're for or against, okay?
Danette Sims
Unverified
1:29:22
Identify yourself with the record plate. My name is Danette Sims. I have a son named Nigel Hall that's an eighth grader. He has type 1 diabetes. His school nurse is Nurse Kathy. She's great. But on the day that she's not there, she may not be there.
she may be attending to a student down the hallway. She may have a student on the third floor. Who's going to take care of him? As a parent, I make it my business, my business to be at every game, every activity, everything that's possible, but on the off day that I can't be there. I would like to think that the school would take into consideration to have somebody there to take care of my child or someone else's child. It's not rocket science. is not hard. You're either going to do the right thing or you're not. It's just that
simple. And when my child moves on to another school, I would like to think there's someone else at his school that will be there to take care of another student that will come through there because this won't stop. They're not going to go away. We have more type 1 diabetes coming in now than you could possibly imagine. So we can either deal with this now or we We can wait until a student dies, which I really don't think that's what everybody wants. But if we don't do something about this, the correct thing about this now, and care about
our children, we can sit here and debate back and forth, back and forth. But in the meantime, what happens? Because my son, really, this could have happened to him a week ago. He was sent to the school nurse alone. He was shaking. His blood sugar was 40. sent him to the nurse
Speaker 229
1:31:04
alone. The nurse wasn't there because she was attending to another student and that's fine, that's her job.
Danette Sims
Unverified
1:31:11
But what would have happened to him? Who would
have been there if he had fallen down the stairs and fell into a coma? No one on the floor knew how to give this shot if he needed it. I guess at the time, I don't know, whatever the situation was, he went to the nurse on his own. But think about it. This is not hard. And as a parent that has a student that's moving on, I would like to think that we care enough to maybe consider this and not just leave them hanging. Because one day, who knows, someone else's child sitting at this very table might be
diagnosed. And you would want the same thing for your child, that someone would be there at a game, a tournament, a band function, cheerleading function, to be there just to do the right thing. Thank you very much.
Thank you. Committee, anything? Seeing none, I think that's everyone who signed up to speak for or against the bill. So, committee, we're back to you. And what is your
pleasure? May I close? I'm sorry, Rep. Hutchison. You certainly
may close. I thought you closed several times
while I go, but we'll let you close again.
Representative Donna Hutchinson
Unverified
1:32:20
You have experienced in a short amount of time what these parents have been living through. Let's talk about it. Let's work out the details. Lawyers get in it. No one can reach a consensus. That's what they've been living with for years. I am surprised they bring up liability if someone might give the shot wrong. What about the liability if the student dies because they're in a coma? Why aren't they
concerned about that liability? But you can tell everybody loves these children. We all agree on that. We love these children. We want them to have a healthy life. The school nurses have done a wonderful job. The parents have always put their children first. The school districts, most of them want to do the right thing, but they just aren't sure what the right thing is. With this federal court ruling, we know what is right. Enough personnel will be trained so there will be someone at all times available
to give these shots if, God forbid, a child needs them. So thank you, ladies and gentlemen. We'll let the board and the nurses and others work out the details, but we need a law that requires the schools to have someone there all the time trained to give these shots. I appreciate a good vote, and so do the parents
and the students. Yes, Deputy Minister, I'm sure we can.
Representative Randy Stewart
Unverified
1:33:49
I've learned today that this is something really needed. But I also learned that I think we have problems with the bill. All the players are right here today. It would be, I think it would behoove you to pull the bill down, get with these players and get this bill ready to run again by next week because I don't think I can vote for it today the way it is. But I do think we need it. All the players are right here, right now, and they've all agreed to work with you. So I'm just asking you if you would consider that. I'd have
Representative Donna Hutchinson
Unverified
1:34:19
to check with the parents because they've been trying to work with
the players for years. Rep. Hutchinson, if you don't mind me interrupting, and I know what Mr. Stewart's saying, but
due to time, and I'm not saying whether I'm far against this bill, but due to time that's involved in this session, if I were you, if the bill gets out of the committee, I would say do it between now and the Senate, is what I'm saying. As I had suggested that earlier. If you put it down, it's going to take another week to get
Representative Donna Hutchinson
Unverified
1:34:50
it back up. I had suggested that earlier, but we need an impetus.
You know, I will work with the players. May I have Mr.
Speaker 146
1:34:57
Swearingen come back up and ask him? He sort of represents the parents, what he would want to do. That's your
bill. You can do what you want to. It's really not proper, but we'll let him, since you're down there, we'll let
Representative Donna Hutchinson
Unverified
1:35:11
him make a few comments. Well, I just need
Speaker 239
1:35:25
for him to tell me what he wants to do. Okay.
Jim Swearengen
Unverified
1:35:28
Mr. Chairman, I've been fighting this battle since 2007, and, you know, yes, all the players
are here, but you know what? They were all there since 2007. I was begging for help. I was willing to sign releases to get my daughters some help, and so why is it now they're all saying, oh, we're so concerned about the children? Well, the school district had contacted the state. They contacted all these people, and they said, no, you can't do anything. If you do anything, we're going to fire those people. The time to act is now, because I'm tired of waiting.
This is something that affects us every day, all of us parents. And I just urge you, please, do it now. Don't put it off. At least give us and our kids some hope. Thank you, sir.
Representative Donna Hutchinson
Unverified
1:36:18
Mr. Chairman, I would like a vote today.
Okay. Representative Hutchinson, I want to ask one more question of Dr. Kimbrell. Where is he? Is he still in
the room? Yes. I just want to know. You can just shake your head yes or no, Dr. Kimbrell. What is ADE's position on this bill?
We have no position. No position. Okay. Thank you. I want to clarify for myself. Okay, committee, we're back to you. What's your pleasure? I just didn't get
my promotion. No, I'm sorry. Did you make a motion, Representative Hutchinson? I did not. Did you make a motion?
Speaker 146
1:36:51
Yes, I make a motion to pass. I forgot I'm a member of the committee.
We have a motion to do pass. All those in favor say
aye. All opposed, like sign. I believe the ayes
Representative Donna Hutchinson
Unverified
1:37:04
have it. Thank you, committee. All the parents are very grateful.
Committee 15 to 12, I believe we were not. And if someone on the committee wants to, still, you have a bill you want to run? Yes, Mr. Chairman. Okay, we will do that. Committee, don't run off. 1936.
1936. And there's an amendment we're passing out right now.
Thank you. So, committee, while we're waiting on the amendment, I would like to say that it looks like we're going to meet Thursday after adjournment. We've got quite a few bills on our calendar. I know some of y'all, well, we'll work Friday, so you won't be going home. But we will meet Thursday
Speaker 247
1:38:07
upon adjournment. So we'll meet twice Thursday.
Okay. And also, Ms. English has requested we
pull that special order we put on a while ago.
She has changed her mind about that, so she wants to pull that special order. Representative Hobbs,
you were waving your hand. Was there anything important? Well, to me,
Representative Debra M. Hobbs
Unverified
1:38:39
sir. Okay. I just want, since Representative English pulled her special order. You want to put yours on special order?
Yes, sir, please. Oh, great. Yes, that'll be good. Thank you. Okay. Well,
excuse me. Let me ask the committee first. Committee, Rep. Hodge, has asked for a special order. What bill is that, Ms. Hobbs? 1893. 1893. 92. 3. 93. 1893, special order. All those in favor say aye. All opposed? It wasn't really very interesting, but we'll do it, it looks like.
Representative Steele, you're recognized to run your bill.
Representative Tracy Steele
Unverified
1:39:21
Thank you, Mr. Chairman. You have a motion to approve the amendment. Okay.
We need a motion to approve that amendment, Representative Klinner. All those in favor say
aye. Opposed? Aye. As have it, you may proceed.
Speaker 175
1:39:34
Mr. Steele. Thank you, Mr. Chairman, committed. Thank you for your patience. We do have an important bill that we want to run, and we assure you we will not take will not take a long time to be honest is pretty much self-explanatory uh... what we have a problem in many of our schools
uh... with the improper manner that some of our young people dress in school and we certainly feel like that uh... education should be a conducive learning environment at all times uh... but something that started out as i understand that was a uh... a fad that we thought would go away and a year or two uh... several years later it is still is still very prevalent and many of our schools now you may not have
a big problems in your district but uh... i'm looking at some of you especially met bradford who knows in a lot of our schools this is really a problem it has become such a problem that that many of our people who used to go to school activities that used to support our schools as volunteers no no longer will even go to the schools because of some of the improper manner and the way that some of our kids come and dress in our schools. This is not to limit or try and to
try to eliminate any rights that they have as far as what they wear, basically how they wear it, and they don't expose their body parts. If you look at the amendment, it really speaks to that. They don't expose our body powers. The amendment also is very important that it speaks to the fact that this does not include cheerleaders, people who play in extracurricular activities, volleyball team, basketball team and so forth. Only those individuals who go to the school and the school activities. We feel it will cut down on violence
in some of our schools, but more important, make it a more conducive learning environment and help prepare our young people for the future. If we don't teach them why we have them and it captured audience, then they will leave our schools no better than they arrived. And this is something that I would ask for your support. It's not scientific, but we feel certainly it's the right thing to do. AEA supports this bill. The Department of Education have been involved in meetings
and helping to write the bill. And we would appreciate your support, and I'd be willing to answer any questions. I do have with me an expert who has worked with troubled young men and young women, especially throughout the state, if not the nation, Mr. Steve Nivojcik, who is also, Mr. Chairman, with your permission, will help me to present the
bill. Okay. Before, there's a little conversation going on. Members, about a physical impact, but this bill has been amended,
so it'll have to, before it can go on the House floor, it'll have to come
Speaker 258
1:42:36
back with fiscal impact. Yes, sir, I do recognize that. It did have initially a fiscal impact before the amendment, so we just need
an additional one. You may proceed, sir. Identify yourself with the record,
Speaker 259
1:42:54
and then you may proceed. My name is Steve Nevojcik. Okay. And currently I'm employed at the Division of Youth Services for the Department of Human Services as the staff development and training administrator.
Prior to that, I was the director of youth services in the city of North Little Rock, and prior to that, I served over 25 years in the death investigative business as the county coroner in two counties and as the director of the state crime laboratory. My thoughts about this are that it certainly gives the schools another tool to use to help engage children in perhaps a social conversation about the reasons, not so much why they shouldn't
wear sagging pants, but maybe to show them how they can be much more successful by not wearing the sagging pants. There was a lot of controversy about the origins of it. It did start probably in the prison system, primarily sort of the latest trend and the latest rumor about why they did that in prison was to express a sexual preference or advertise, basically. However, the actual reasons that it started in the prisons were simply because many prisons
You don't have a tailor when you show up for prison, and you get clothes that might or might not fit, and most of the time those clothes were too large, and of course they don't supply belts to prisoners for obvious reasons, so it was born in the prison system. Now, it's taken sort of a life of its own over several years about why it began, and So really, it's irrelevant, but I will tell you that it has no particular meaning on the
street. You can't say just because a person sags that they're a bad kid. In the early 1990s, the trend was popularized by the hip-hop media and by the media. This is certainly something that has continued over the years, and I think that that's why it would be important to give the schools the ability to develop a social sort of interaction about telling young men by having people come in from the community to talk about the reasons that you should not do this, and you can be more successful in life if you don't do that.
I will never forget that Joycelyn Elders one time in a speech said that kids can't be what they can't see. So many times kids that we deal with are exposed to only negative influences, and I think this It might be an avenue to open up positive influences in their lives by providing people that the school district can have come in and work with them as mentors on proper life skills. So I think that this is a good bill. It doesn't put any punitive sanctions on a child that would cause more problems.
It just gives, I think, the network around the child another tool to help maybe guide the child in the right direction. Keeping a child in school is very important. We know that education is very important to our kids. We know that 65% of the inmates in the Department of Correction dropped out of high school, so we at DYS have a very keen interest on keeping kids in school and keeping them educated. So I think this would be another tool to provide educators a way to do that.
Thank you. Thank you. Committee, any questions? I have one, but I'm a little afraid to ask it, so I'm
Representative Les "Skip" Carnine
Unverified
1:46:35
going to let Mr. Carnown ask it. Thank you, Mr. Chairman. I'm not sure that I'm going to ask your question, but as I looked at this bill, is there anything in this bill that actually is not available to a school board currently? In other words, indecent behavior, in my opinion, is, I don't know, I mean, maybe somebody else can answer the question,
but I thought all schools and school boards had the ability right now to do exactly what this bill says. And I'm wondering, are you telling me that
Speaker 261
1:47:08
the school boards and the school administration and the teachers and the parents haven't
Speaker 262
1:47:15
taken the action or they're allowing it? Mr. Cronin, I would say, Dr. Cronin,
Speaker 175
1:47:21
yes, on both fronts. This bill is meant twofold. One, to send a message. There is inconsistency across this state.
Some schools enforce dress codes. Some schools don't enforce it at all. And what happens when you get to things like extracurricular activities and you have one school that does not enforce dress codes and those kids show up dressed one way and you have another school that do enforce dress codes and they show up in a properly dressed manner, then oftentimes you have a clash with those young people. You know, back in your days as superintendent of the Little Rock School District, that that is real and it happens.
And the other measure is to assure them that where the state stands on this issue, that you can just not have a policy on the book and not enforce that policy. A lot of this for me comes from my personal commitment to the schools. I go to schools all over the state and try and share with the young people, And I am just appalled at the way that some, and it's not the majority, but that some of our kids, some of our kids dress. It is absolutely, and I don't think that's what we're here for and that's what we fought for,
trying to do everything we can to make that a conducive learning environment. I did not want to put penalties in the bill like we do so much legislation. I want to leave that totally up to the school districts. But I want the message to be loud and clear that
Speaker 188
1:48:56
you have dress codes, and you should enforce them. Well, that certainly answered my question. Okay. Thank you.
Committee, any other questions from the committee? Representative McLean.
Speaker 145
1:49:09
Representative Steele, I think this is a fully support this measure, As someone who's a stakeholder
Representative James McLean
Unverified
1:49:15
in terms of I have a kindergartner, and I see children even his age, maybe a little bit older, in the way that they dress, and I find it very troubling. I remember back in the dark ages of 1988 when I went to high school, I mean, if you wore a T-shirt, people looked at you funny. So, and these days, it's just as far as I'm concerned, we need some sort of tool, and I appreciate you bringing this forth.
And, Mr. Chairman, I'd like to make a
motion at the proper time. committee any other questions okay representative roebuck has a question for the
school board association of police recognize recognize yourself i'd recognize you
Speaker 268
1:50:10
but you recognize ron harter arkansas school
Representative Johnnie J. Roebuck
Unverified
1:50:13
Board Association. MS. Thank you, Mr. Harder. My question has to do with the School Boards Association model policies. Do you give to all districts in the state a
model policy on dress codes, or do you allow them to view
Speaker 267
1:50:38
I could answer the second half of that question, we do not have language in, I mean, I can't
Speaker 271
1:50:48
believe I can't answer this question.
But the long and short is, I don't recall that we have a
Speaker 267
1:50:55
specific one on the dress code, but I know we don't have a policy that covers this territory. So in
Representative Johnnie J. Roebuck
Unverified
1:51:03
other words, it would be up to the individual school district to write such a policy that would include this language well it won't be if this bill passes understand that currently it's up to the local school boards to submit a policy to their board for adoption dealing with dress code and it
may or may not include this language currently yes okay thank you
committee other questions from risk climber so let
Representative Ann V. Clemmer
Unverified
1:51:37
me get this straight school boards and schools can take care of this problem if they want to so is it the case evidently their schools out there that just to govern dress codes representative this certainly not
Speaker 175
1:51:52
a priority with with many of the schools
uh... now some of the schools and and and our districts uh... uh... and i would i would go further and say some of the more urban areas uh... and dr hopper has had been in some of the meetings uh... or writing this bill uh... but you know i'm nothing better i think in personal testimony i've been to school after school and and i would see kids walking down the hallway exposing their underwear i will tell them uh... uh... you know you're you're a nice-looking young man uh... but you need to pull up your pants
and they're learning yourself as a fuddy dud then I am, and my daughter booed me when I left home this morning. She kept asking me, when am I running this bill? But the problem with that is, Representative Klemmer, they have been in that school and walked past several teachers, administrators in the school who said nothing. None of them have been irrational, disrespectful in any way, but it's just not being enforced. And I think that we need to send a strong message.
Representative Ann V. Clemmer
Unverified
1:53:00
A follow-up, though. I mean, I really agree 100% that my kids' school, I think they made the boys put a pink bow around their jean belt loops to pull them up. But if we pass this, won't it still be those same schools that have to enforce this? If they're not interested in
governing it, how are we going to make them interested in enforcing it? I certainly think this
Speaker 175
1:53:24
bill would help send that message on where we stand in the state. But I'll let Dr. Hopper, if he wants to.
Speaker 267
1:53:33
First, I really appreciate Representative Steele's willingness to work with us on this bill because we had concern about the language that was in the bill, and he amended it to address those concerns so that both from a legal aspect, but especially from an implementation aspect, we think this is much better language. And so the other side, and we discussed it, is that if you have the law out there that says thou shalt have a policy in this matter,
it can help the districts be able to say, you know, we have to have this policy. Does
Representative Ann V. Clemmer
Unverified
1:54:13
that mean then that the School Board Association is on board with this bill and supports it? Yes, it does. Okay. Thank
you. Any other questions from the committee? not oh you just okay
I thought you were reaching we'll go to the audience anyone wants to speak against this bill for this bill go back to the committee
what's your pleasure committee motion do pass Mr. Chairman we have a
motion do pass as amended as amended Mr. Chairman thank you very much all in favor say aye opposed like signed Leave the ayes to have it. Still, you'll need a physical impact before it hits the floor. Thank you, Mr. Chairman. Committee. Committee, let's see.
We did have one other equation. Ms. Clemmer? Ten minutes. I think we'll be done. You've got three minutes. Can you do it in three minutes?
I'm doing less than that. You didn't. Okay. What's the number, is it, Ms. Clemmer? $19.99. She has never had a non-controversial bill,
so we'll see. Representative Cheatham,
Representative Ann V. Clemmer
Unverified
1:55:24
I beg to differ. You're recognized. Thank you. House Bill 1999, I'm actually bringing at the hopeful request of a constituent who I think is in an interesting position.
I kind of have her fingers crossed to be on the verge of receiving a governor's scholarship. She, however, wants to study meteorology, and we have no meteorology programs in the state of Arkansas. So she will be put in a position of having to refuse a scholarship or sacrifice her desired area of study. What this bill, 1999, does is to, would be to allow a student who is the recipient of a governor's scholarship,
before you get carried away here, to use that scholarship only at a school that we have an SREB waiver agreement with, that we enter into those negotiations. And I may be using the wrong term here. But only in those schools. She, for instance, is interested in going to study meteorology at Louisiana Monroe because we have an SREB agreement with them and they do not charge out-of-state tuition for our students who study meteorology,
this bill would simply allow her to use that scholarship at one of those schools or anyone else. But, for instance, my daughter had a classmate who studies meteorology at University of Oklahoma, and it would not allow him to have used a governor's scholarship in Oklahoma because we're not in agreement with them. Ms. Clemmer, the question I have as I
look at the bill, did you think about just adding that one item to?
Representative Ann V. Clemmer
Unverified
1:57:22
Well, I did about meteorology, but my hesitation there is that I'm not sure that that's the only one, the only program we don't have. Well, I guess that's my
Speaker 284
1:57:34
concern. We're going to open it up to every program that's not located in
Representative Ann V. Clemmer
Unverified
1:57:40
Arkansas. Well, again, it would only open it up to, and when I discuss this, I am okay with the student petitioning for this, but it has to be at the schools that we're currently already operating in agreements with for our students in a program of study that we don't have.
And I would be willing, I went to the governor's office and talked with Carol Willis, I've talked with Shane Broadway. We were interested in not doing this with a bill, but they felt that legislatively their hands were tied. I'm just wanting to untie their hands to let the Department of Higher Ed and the Governor's Office together work on this and make exceptions for programs we don't have.
Because I didn't want to get into, well, you know, there's a program that's only a three-hour difference. I didn't want us to get into splitting hairs and trying to over-legislate something. I just wanted there to be a tiny bit of flexibility added to that. And if it does not, if the governor's office, if Department of Higher Ed believed that there is an equivalent program in the state of Arkansas, then this request could be denied.
Mr. Broadway, do you mind coming to the table and just visiting a minute?
Representative Ann V. Clemmer
Unverified
1:59:02
I would also like to point out, as he comes to the table, that this was his constituent a few months ago, and he conveniently let his term expire before, and he left it on my death. I'm not even sure she's my constituent, but she is of Saline County. And again, she has not received the scholarship, but she is in a good position where she's hopeful that she might. So this is not even necessarily would affect very many students. Yes, sir, Mr. Chairman. Recognize yourself for the record, please.
Speaker 287
1:59:32
Shane Broadway, Interim Director, Arkansas Department of Higher Education. What
is your stance on this legislation? Committee's stance, not necessarily yours. Yeah.
Speaker 288
1:59:41
Well, as I always say, it's up to the legislature to decide what the policy is of the state. So I will leave that to
Speaker 287
1:59:51
you all in terms of that. But currently, what Representative Clemer was talking about, we are part of the SREB compact, and what we have is called Common Market.
Part of the compact is obviously the ones you already know about, optometry. Those medical, chiropractic, podiatry, dental, optometry, all of those that we currently have a program with that does pay out of state tuition. We also do in the common market have some programs that I was hoping to get to my office this morning and bring a list in case it came up, but I have not been there yet, but programs that are not offered in the state of Arkansas, such as meteorology, but are offered in other
states where we currently do, as part of that common market, pay the out-of-state tuition. What this bill would do would change, they currently get that benefit. What this would do is if that student is also eligible for Governors Distinguished, then they would also be eligible for that scholarship along with, if the program is part of the common market, be able to have their out-of-state tuition waived.
Now, how much – that's one thing we're actually working on is actually how much cost-saving, how much the actual cost is of that out-of-state tuition waiver for that particular program, but obviously it would depend on which program and where you went. But that's what – that would change. It would change the governor's distinguished criteria from what it has ever been. It's never been changed to allow for an out-of-state – for an Arkansas student to attend an out-of-state school, but obviously this is a circumstance where you're talking about programs
Representative Ann V. Clemmer
Unverified
2:01:45
that are not offered with inside the state. If I could point out, though, and it is somewhat confusing to me, the existing language, this bill is not changing that, dentistry and optometry and veterinary medicine, podiatry, those are all graduate programs to my knowledge. So this is just dealing with perhaps, and Governor's scholarship, I guess some of it can carry over if they have some left into graduate school. No. Cannot. So the Governor's Scholarship then cannot be used for dentistry, optometry, and programs like that.
But this would just open up. I think we have, Mr. Broadway can help me out here, maybe 300 students that receive Governor's Scholarships. There's 300, yes. So we're talking about just the very few of those that want to go, and they can't just pick their school out of state. It has to be a
program we don't offer in the state of Arkansas. Representative
Speaker 270
2:02:44
Roebuck had a question, I believe. Thank you, Mr. Chair.
Representative Johnnie J. Roebuck
Unverified
2:02:50
Mr. Broadway, we do limit 300 of the scholarships. That is correct. And right now, what's the budget
Speaker 287
2:02:59
for those 300? I've got it right here. for Governor-Scholars is projected for FY11 at $12 million. That includes Governor-Scholars and Distinguished. Okay.
Representative Johnnie J. Roebuck
Unverified
2:03:13
And what's the criteria for Governor-Scholars compared to Distinguished? Oh, boy.
Representative Ann V. Clemmer
Unverified
2:03:23
that. Which is the higher? I
think I know. Distinguished is the highest. Okay. Distinguished is a 32 on the ACT. The governor's scholarship is one per county, so it's usually someone with an extremely high ACT that has also done a lot of other
extracurricular activities because it's just one per county, so it's very competitive. So
Representative Johnnie J. Roebuck
Unverified
2:03:47
let me see if I understand, Ms.
Clemer, you're saying that this would concern only the scholars?
It would – this is intended to refer
Representative Ann V. Clemmer
Unverified
2:03:56
to any of the governor's scholars, not distinguished or otherwise. Okay. They're all in the same light item, Representative Roebuck. Okay.
Speaker 287
2:04:03
So it would affect those students where we're only giving
Representative Johnnie J. Roebuck
Unverified
2:04:06
one per county? Yes, ma'am. It would include those. So let's think about that. You might have a student in a county that is competing for a scholarship. There's only going to be one given per county, and we give it to this student, and this student takes it out of state.
Speaker 295
2:04:25
Could that happen? Only at the SREB school, so. I understand. Where there's no problem. Yes,
Representative Johnnie J. Roebuck
Unverified
2:04:31
ma'am, it could. But it could happen. Yes, ma'am. So, in essence, it could happen in all 75 counties. We could have 75 students that receive this money, and all 75 of them find a major. They'd have to look
Representative Ann V. Clemmer
Unverified
2:04:44
real hard, but, you know. Yes, ma'am. I mean, to your argument, which is sound, it could happen. And I think the odds of it happening more than very few occasions, I think, would that happen.
Speaker 277
2:04:59
Okay. Rep. Stewart, you had a question? Yes.
Representative Randy Stewart
Unverified
2:05:02
I think my question is in the same line. My son was a distinguished Governor Scholar several years ago. At the same
time, we had several people in the county had equal scores, equal grades, but they only chose one Governor Scholar. The rest of those kids now would be getting the academic challenge or the lottery scholarship, but even with the same credentials, same grades, they would not have the opportunity to do what the Governor Scholar would have.
Is that true? Well, there's only one per county. You're correct. You may have, in Saline County, you may have 30 people with the exact
Representative Ann V. Clemmer
Unverified
2:05:41
same qualifications. They just choose one of them. Well, I mean, there are essays involved, so I would argue that, I mean, I mean, we made the decision that one stood out above the rest through their letters of recommendation or essay or something. MR. But that will be true that the rest of
Speaker 101
2:05:56
them would not qualify for the rest? MS. There's nothing for the runners-up. No, sir.
Representative Randy Stewart
Unverified
2:06:02
MR. Now, in the existing budget that we have, is there a – if this bill goes forward, then it will
Representative Ann V. Clemmer
Unverified
2:06:12
require additional budget? MS. What I would say is they would currently not be charged out-of-state tuition as it stands. So they are currently allowed. There should be no increase in budget. This student, let's just say it is the student in Saline County. She gets this scholarship. She's going to go to Louisiana Monroe.
She feels like regardless. This would allow her to take her scholarship with her. The scholarship is going to be given to one person in Saline County. She may not get it. but it will be given to one person in Saline County regardless. The out-of-state tuition will be paid regardless. So it does not represent an increase in cost. You could argue that it's not fair, but if this is the outstanding scholar of your county for this scholarship, you're also saying, well, you were the outstanding, but you're going to forfeit it.
And I don't know if there are provisions, if anyone can answer, if there's provisions for the runner-up. To be given it? There is.
Representative Randy Stewart
Unverified
2:07:14
Okay. But I'm still not clear. You said there was no additional cost for going out of state.
Representative Ann V. Clemmer
Unverified
2:07:19
Is that because of that? Well, we already waive that out-of-state tuition
Speaker 232
2:07:25
with those schools. We waive it or they waive it for
Representative Randy Stewart
Unverified
2:07:28
us? Well, the compact waives it, however. Okay. And on paragraph III, it says under
agreement with the Department of Education. So we have the programs or studies that are already under agreement,
Speaker 288
2:07:39
or we have to develop those programs? We have those in
Speaker 303
2:07:47
our common market agreement. Okay. And do you know how many we have? That's what he was
Representative Randy Stewart
Unverified
2:07:50
saying he left behind. I can get that back and bring it back to you. But to be clear, then, those people that are under those agreements can go to another state, and they do not charge anything above our in-state tuition rate.
Representative Johnnie J. Roebuck
Unverified
2:08:05
Yeah, right. But that's already in existence. Okay. Thank you. Mr. Roebuck, another question. So, in essence, Mr. Broadway, these students are already getting a pretty nice scholarship.
They're getting out-of-state tuition paid, correct? It would depend
Speaker 303
2:08:14
on what the out-of-state tuition would be. It would just be waived just like if they were going in-state.
Representative Johnnie J. Roebuck
Unverified
2:08:20
Okay. And my next question is, Ms. Clemer, if we've got a student that goes out-of-state, receives this, if your bill passes, becomes law, what if that student gets to this out-of-state school and then a semester decides to change a major, which so many of our students do, is that student going to be required then to pay that money back to the state? How would that work? Well, okay, I
Representative Ann V. Clemmer
Unverified
2:08:41
would say, first of all, if a student transfers and goes out of state,
the out-of-state tuition is paid. If they come back in-state, we're no longer paying the out-of-state tuition, but that's sunk regardless. The governor's scholarship does follow the student. You know, so many of our scholarships don't. So I would presume, and it is also reapplied for every year, and conditions have to be met like GPA and things like that. So if they're no longer at that school, they could come back to Arkansas and use it at a different school. No, I'm
Representative Johnnie J. Roebuck
Unverified
2:09:11
saying they would stay at that school, but they would change
Representative Ann V. Clemmer
Unverified
2:09:15
their major. But I think that on the form, that could be, if this changes,
then the implementation of that would be to require that they stay in that major because that's the exception for them being at that school. But you're correct. I think that's an issue that would need to just be specified in the implementation. Again, I don't have a huge vested interest in this, but when I spoke with the governor's office on this, they did not seem to be opposed to it but felt that the legislation currently tied their hands
and that could not be up to them. What I would like is for the governor's office and Department of Higher Ed to have that ability
Representative Johnnie J. Roebuck
Unverified
2:10:04
to allow that to be used at those schools. One other
question. Mr. Broadway, would you say that our scholarship accounts
Speaker 288
2:10:15
at this current point in Arkansas are stretched? Yes, ma'am. We
Speaker 287
2:10:20
will be having to reduce due to reducing some of the programs,
primarily because of the online application has expanded the use of all of our different programs. And so the fund balance that had been there accumulating for several years will be being spent down as we take on those additional students. But we are having to look at reductions in certain programs. On that 300
Representative Johnnie J. Roebuck
Unverified
2:10:48
limit, how many students did you turn away for that
Speaker 288
2:10:53
scholarship? Last year? Yes, sir. 92.
Representative Johnnie J. Roebuck
Unverified
2:10:56
And they all were going to go to in-state schools, correct, sir? That
Speaker 287
2:11:00
would have been the statute at the time. Yes,
Speaker 94
2:11:02
ma'am. Yes, sir. Thank you. Thank you, Mr. Chair.
Speaker 184
2:11:09
Committee, any other questions? Representative Hobbs. Thank you, Ms. Chair. I'll make it quick. Is part of the application process, does a student have to state where they plan on going to school and their major and so forth? Is that part of the process or not? That would be part of our process, yes, ma'am.
Okay, thank you. Additional questions? Seeing none, we'll go to
the audience. You want to speak against this bill, for this bill? Committee, we'll come back to you. We need a motion. We're going to do it. Ms. Hobbs. Move.
Do pass. We have a motion. Do pass. All do in favor say aye. All opposed? No. I believe the no's have it. Thank you, committee.
And that was a little more than 10 minutes, Ms. Flemers. Committee, we're adjourned.
Agenda
Call to Order
HB1447
HB1936
HB1999
Adjournment
Documents
No documents posted.
Speakers
Representative Eddie L. Cheatham Chair
Unverified
Representative Donna Hutchinson
Unverified
Jim Swearengen
Unverified
Representative Ann V. Clemmer
Unverified
Speaker 24
Representative Les "Skip" Carnine
Unverified
Speaker 35
Steve Lafrance
Unverified
Speaker 48
Speaker 60
Speaker 65
Speaker 58
Representative Johnnie J. Roebuck
Unverified
Speaker 74
Speaker 77
Speaker 69
Speaker 81
Speaker 85
Speaker 89
Representative Randy Stewart
Unverified
Speaker 96
Representative Homer Lenderman
Unverified
Speaker 108
Speaker 113
Speaker 120
Speaker 123
Speaker 105
Speaker 128
Representative Karen S. Hopper
Unverified
Speaker 139
Representative James McLean
Unverified
Speaker 148
Speaker 149
Speaker 162
Speaker 165
Speaker 169
Speaker 175
Speaker 179
Representative Debra M. Hobbs
Unverified
Kathy Farrington
Unverified
Speaker 192
Speaker 195
Tammy Daldano
Unverified
Speaker 184
Kathy Haney
Unverified
Steve Sparks
Unverified
Speaker 209
Speaker 213
Speaker 215
Speaker 207
Danette Sims
Unverified
Speaker 229
Speaker 146
Speaker 239
Speaker 247
Representative Tracy Steele
Unverified
Speaker 258
Speaker 259
Speaker 261
Speaker 262
Speaker 188
Speaker 145
Speaker 268
Speaker 269
Speaker 267
Speaker 271
Speaker 284
Speaker 287
Speaker 288
Speaker 270
Speaker 290
Speaker 295
Speaker 277
Speaker 101
Speaker 232
Speaker 303
Speaker 94