Stanton mom concerned about son’s diabetic care at school

By Cory Smith • Last Updated 12:09 pm on Thursday, December 01, 2011

Nicole Ciganik sits with her son, Brandyn, who is a Type I diabetic and requires many tests performed throughout the day, both in and out of school. — Daily News/Cory Smith

STANTON — Nicole Ciganik alleges she had to pull her diabetic 10-year-old son from school to make sure he would receive the proper medical attention there.

School officials say they were looking out for the health and safety of all students by barring Brandyn Ciganik from testing his blood sugar level in class.

Brandyn, a fifth grader at Central Montcalm Upper Elementary School in Stanton, was diagnosed with Type 1 diabetes three years ago.

The disease is caused by the body’s inability to produce insulin, which converts blood sugar and starches into energy. Near constant monitoring and regular insulin injections are required to regulate the blood sugar level, according to the American Diabetes Association.

Nicole said school officials would not allow Brandyn to check his own blood sugar level. She said he would miss more than an hour of class walking to the school office, where his medical supplies were located, get tested by the school nurse, wait 15 minutes and get tested again to make sure his sugar level had regulated.

Brandyn also was not allowed to eat snacks or drink water when he needed because school policies prohibit students from keeping snacks or water bottles at their desks.

Competing goals

Nicole said the school policies violate the federal Rehabilitation Act of 1973, which requires public schools to provide equal access to academic and extracurricular activities for diabetic students.

Nicole had been battling administrators for months to set up a personalized treatment plan under section 504 of the act, which allows parental participation in decisions of how and when their children receive medical attention.

The upper elementary school had the Diabetes Medical Management Plan (DMMP) in place since Brandyn began attending as a third grader in 2009.

A DMMP is a physician’s order that outlines a child’s treatment regimen. It is prepared by the child’s health care provider in consultation with the child’s family.

The section 504 plan adds more specifics to a DMMP, such as who will carry out required blood sugar tests throughout the day. School officials prepare at 504 plan, but must include the child’s parents or guardians in the process.

Superintendent Jake Helms said administrators were looking out for the health and safety of all children in Brandyn’s classroom.

Specifically, he is concerned about having Brandyn bleed around other students and need to dispose of his medical waste.

“We did the best that we could for the family and trying to negotiate the 504 conditions to not only protect the individial student but all students in the building,” Helms said. “We are trying to do what is best for all the kids.”

He said school board policies prohibit blood sugar tests requiring a blood draw and special medical waste trash containers are not available in every room of the school.

“We took every measure possible to accommodate testing outside of the classroom,” he said. “He can’t test himself, it’s not safe to the other students. But he can be tested by our school nurse and our secretary, who is also trained to carry out the procedure.”

Brandyn Ciganik routinely has insulin manually injected into his system through a pump because his body no longer is capable of producing its own. — Daily News/Cory Smith

Seeking compromise

Nicole originally proposed a 504 plan in August.

“The school reviewed my 504 plan and told me there were portions of it that were illegal,” Nicole said. “They felt that their medical plan already in place was good enough.”

Helms said the portions of the plan in question were not illegal, but definitely violated school board policy.
Nicole learned this year that a 504 plan trumps the school’s Diabetes Medical Management Plan.

“They kept trying to push the medical plan as a 504 plan,” Nicole said. “The medical plan isn’t nearly as detailed as the 504 plan. Under the 504, Brandyn would be allowed to have his medical equipment with him, check his insulin, blood sugar, have a snack, water, at anytime anywhere.”

Nicole said her main concern with the school’s plan was how things would be handled in emergency situations.

“If my son were to drop into a seizure during gym class, are one of the other kids smart enough and fast enough to run for help?” she said. “They would have to be, because everything was locked in the office with the school nurse. With the time it would take to notify her and then get to the gym to assist my son, who knows what would happen? That situation was just unacceptable to me.”

Making a statement

Nicole hired an attorney through the American Diabetes Association when the school denied her 504 plan. Nicole’s attorney and the school’s attorney failed to reach a resolution after two and a half months of negotiating.

“I told the school, ‘If you don’t have my plan in place by (Nov. 4), I’m pulling my son out of school, end of story,’” she said.
Nov. 4 (a Friday) came and went without Nicole’s 504 plan in place.

On Nov. 7 (a Monday), her son stayed home from school. At 7:49 a.m. that morning, the principal called to set up a meeting with Nicole to put a 504 plan in place.

“I just don’t understand why it came down to this,” Nicole said. “Why did I have to take my son out of school, after more than two months of trying to put a plan in place, just to get them to take me seriously?”

Helms said keeping Brandyn home from school didn’t weigh in the district’s the decision to put Nicole’s 504 plan in place.

“We received a notice from her attorney that we had until the following Friday to get a 504 plan in place,” he said. “I was under the impression that had been done. When I found out it hadn’t, we called Nicole and set up a meeting later that week and we signed the 504 plan.
“If there was delay throughout this process of getting the 504 plan in place, it was through the legal process,” Helms said. “The delay didn’t have anything to do with Nicole pulling Brandyn out of school.”

Brandyn Ciganik now carries his One Touch Ultra Mini meter with him at school so the school nurse can test his blood sugar level at any time necessary. — Daily News/Cory Smith

Serving all students

Helms said there are six diabetic students at the upper elementary school but only Brandyn has a 504 plan. He said staff members are trying to do what is best for every student at the school.

“This is about what’s best for this kid and all the kids,” Helms said. “The school’s trying to do what’s best for the students.”
Other area school districts also strive for the same goal when dealing with diabetic students.
Greenville Public Schools Superintendent Pete Haines said the variation in needs of students with disabilities is too large to write any kind of district-wide policy.

“Every medical case is so specific to the child, diabetic students are handled on an individual case basis,” he said. “With a child in fifth grade, the level of maturity of the student would be taken into account, among other things. First and foremost, you need to keep that child safe and every other child safe as well.”

Haines said 504 plans in Greenville schools typically arise out of some difficulty with trying to manage a student’s disability.
“They are very handy especially when a student moves from one grade to another,” he said.

Amicable resolution

Nicole still believes taking her son out of the school was necessary, but said it was the last thing she wanted to do.
“Brandyn absolutely loves it at the Upper Elementary,” she said. “It’s a great school. He loves his classes and has lots of friends and the school nurse is very good with him. I shouldn’t have had to remove him from school in order to make sure he was being taken care of properly.”

The school nurse, Vicki Olsen, and school principal, Susan Koster, referred all questions about Brandyn’s care to Helms.

Nicole met with Koster on Nov. 9 and put into place Nicole’s original 504 plan with slight modifications to correct grammar.

“They reworded and condensed the requirements listed on the 504 a little bit, but that was all,” she said. “It was very much the same 504 they originally told me was not entirely legal. If it was illegal to begin with, as they claimed, why is it accepted now? Because I pulled my son from school?”

The plan allows Olsen to test Brandyn’s blood sugar in the classroom. He also is allowed to keep snacks and a water bottle at his desk.

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