The Other 60 Percent

Coping with asthma leaves schools gasping

Castle Rock mom Heather Clark was so concerned that her 13-year-old daughter, Sami, would have an asthma attack at school and that no one would know what to do, she took to sneaking an inhaler into her daughter’s backpack, just in case. She calls it her “don’t ask, don’t tell” policy.

She didn’t realize that there was no need to treat the inhaler as if it were contraband. In fact, since 2005, Colorado law has given students with asthma the right to carry their inhalers with them and to self-administer their asthma medication, as long as they have a care plan on file with the school.

Last year, the legislature amended that law to remove the requirement for the care plan. But students and their parents are required to sign a contract with the school stating that the student knows how to properly administer the medication.

Douglas County schools, where Sami is a student, have adopted a policy in line with state law.

“I didn’t know that, but I’m excited to know it now,” said Clark, who also had asthma as a child. But she’s pretty sure that stated policy and actual practice don’t always coincide.

“The school doesn’t allow it,” the mom said. “I’ve gotten calls saying she couldn’t have it with her. I’m going to print out a copy of this law and make sure Sami has it in her backpack, along with her inhaler.”

Sami says she’s only had to sneak a puff on her inhaler a couple of times in the past two years, but she likes the security of knowing it’s there.

“At school, if you’re having a problem, you have to go down to the nurse’s office,” the teen said. “Unfortunately, for me that’s a couple of staircases away. That’s kind of scary, to be honest.”

The law is one thing, reality something else

Sami’s situation illustrates a greater problem confronting Colorado students with asthma, their parents and their schools:

The law is one thing. The realities confronting overworked doctors, spread-too-thin school nurses, perplexed school secretaries and anxious parents may be something else altogether.

Asthma facts

  • A CDC study shows 34 million Americans, or 1 in 9, have been diagnosed with asthma at some point in their lifetimes.
  • An estimated 22.9 million Americans – including 427,000 Coloradans – currently suffer from asthma.
  • Asthma prevalence is highest among blacks at 10.2 percent, followed by whites at 7.6 percent, and Hispanics at 6.8 percent.
  • Nearly a third of all children with asthma will miss three or more days of school this year.

“This is a topic that just needs more attention,” said Cindy Liverance, vice president of programs for the American Lung Association in Colorado. “One out of four people in Colorado has asthma. It can be viewed as commonplace. But people can die from asthma. If you don’t access to your medications, or you don’t know how to use them properly, you can end up in the emergency room.”

While Colorado law empowers children to carry asthma medication with them, health educators are now pushing for every school to develop an asthma action plan for every affected student.

That action plan would start with a long conversation between the student, their parents and the school nurse or health care provider. The school should have a list of all medications the child is taking, what the child’s symptoms are, what medications should be used and when, and at what point emergency medical responders should be called.

“Does that happen every time for every child? Sometimes not,” acknowledged Kathy Patrick, assistant director of the Office of Health and Wellness for the Colorado Department of Education and a state school nurse consultant.

“I’m coming from the perspective of a school nurse,” Patrick said. “When you have 4,000 or 5,000 students, how do you get to sit down with a student with asthma and make sure they know how to use their inhaler, make sure they know how to access help when needed?

“Nurses do what they can with the limited time they have available. But the nurse to student ratios, as they are, it’s unfortunate.”

Doctors, too, are often too busy to insure newly diagnosed young asthma patients get the education they need to stay out of trouble. The youngsters need to be made aware of things that will trigger their asthma, what to do if they start having trouble, and, above all, how to properly use their inhaler.

“If the doctor is well-versed in having these conversations, it takes five minutes tops,” said Eliza Lanman, senior director of programs for the American Lung Association in Colorado. “But if they’re not used to doing it, these conversations can take longer, and they just don’t see it as a priority.”

As a result, she said, newly diagnosed children with asthma typically end up in the emergency room an average three times in the first year after their diagnosis, because they don’t know how to minimize an oncoming asthma attack.

Lack of education in proper use can have devastating results

Sami Clark says she didn’t know how to properly use her asthma inhaler for the first two years she had it.

“Because I was never taught,” she said. “I finally learned the right way to use it at asthma camp. I sat down with a nurse there, and it took me two days to learn it.”

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This lack of education can also lead to situations such as an incident in January in Monument involving two middle school girls. One of the girls loaned her asthma inhaler to the other girl because she thought her friend was having an asthma attack. When school officials found out, both girls were suspended because school policy prohibits sharing of any prescription drug. The girl who borrowed the inhaler was eventually expelled.

“These two girls are a perfect example of why students need to be educated,” Liverance said. “To think you can just hand an inhaler to a friend is wrong.”

Some Colorado school districts already have asthma policies in place and do a good job of making sure every student with asthma has a care plan on file in the office.

Denver Public Schools, in particular, has partnered with National Jewish Hospital to provide asthma education across the district. Liverance cites Cherry Creek and Aurora as other model districts for asthma care.

But she can’t say how many districts have policies in place, let alone how many actually follow them.

“It’s hard to figure out,” she said. “That’s something we’ve been working on since the bill went into effect last year. It’s in flux. The more districts we talk to, the more interested they are in implementing this.

“But it not only means more work for schools, it also means more work for doctors, more work for parents. It’s understanding that asthma isn’t something you can take lightly.”

Adopting and implementing asthma care policies isn’t something just limited to large districts. Jody Stroh, the school nurse in Creede, is a certified asthma educator. She’s traveled around southern Colorado training her peers in best practices when it comes to managing students with asthma.

“Our goal is to improve asthma literacy among all the school nurses in Colorado,” Stroh said. “But I know that it will probably be a school secretary doing the education about asthma with a child, so we’ve designed a file system with all the different worksheets about what asthma is, what medications you’d use, how to exercise without triggering asthma.”

“A tremendous amount of thought has gone into making sure kids have their medicines available to them immediately,” she said. “We find out who has asthma, who is carrying an inhaler, and those who’ve had any problems in the past year will get a care plan. If you have a child old enough to carry an inhaler, we have a document that we have them sign, and have their parents sign, that says they understand that they’re not to share that inhaler and that they’re must have it labeled.”

task force

Jeffco takes collaborative approach as it considers later school start times

File photo of Wheat Ridge High School students. (Photo by Nic Garcia/Chalkbeat)

The Jeffco school district is weighing pushing back start times at its middle and high schools, and the community task force set up to offer recommendations is asking for public input.

Nearby school districts, such as those in Cherry Creek and Greeley, have rolled out later start times, and Jeffco — the second largest school district in Colorado — in December announced its decision to study the issue.

Thompson and Brighton’s 27J school districts are pushing back start times at their secondary schools this fall.

The 50-person Jeffco task force has until January to present their recommendations to the district.

Supporters of the idea to start the school day later cite research showing that teenagers benefit from sleeping in and often do better in school as a result.

Jeffco is considering changing start times after parents and community members began pressing superintendent Jason Glass to look at the issue. Middle and high schools in the Jeffco district currently start at around 7:30 a.m.

The task force is inviting community members to offer their feedback this summer on the group’s website, its Facebook page, or the district’s form, and to come to its meetings in the fall.

Katie Winner, a Jeffco parent of two and one of three chairs of the start times task force, said she’s excited about how collaborative the work is this year.

“It’s a little shocking,” Winner said. “It’s really hard to convey to people that Jeffco schools wants your feedback. But I can say [definitively], I don’t believe this is a waste of time.”

The task force is currently split into three committees focusing on reviewing research on school start times, considering outcomes in other districts that have changed start times, and gathering community input. The group as a whole will also consider how schedule changes could affect transportation, sports and other after school activities, student employment, and district budgets.

Members of the task force are not appointed by the district, as has been typical in district decision-making in years past. Instead, as a way to try to generate the most community engagement, everyone who expressed interest was accepted into the group. Meetings are open to the public, and people can still join the task force.

“These groups are short-term work groups, not school board advisory committees. They are targeting some current issues that our families are interested in,” said Diana Wilson, the district’s chief communications officer. “Since the topics likely have a broad range of perspectives, gathering people that (hopefully) represent those perspectives to look at options seems like a good way to find some solutions or ideas for positive/constructive changes.”

How such a large group will reach a consensus remains to be seen. Winner knows the prospect could appear daunting, but “it’s actually a challenge to the group to say: be inclusive.”

For now the group is seeking recommendations that won’t require the district to spend more money. But Winner said the group will keep a close eye on potential tax measures that could give the district new funds after November. If some measure were to pass, it could give the group more flexibility in its recommendations.

Battle of the Bands

How one group unites, provides opportunities for Memphis-area musicians

PHOTO: Rebecca Griesbach
Memphis Mass Band members prepare for Saturday's Independence Showdown Battle of the Bands in Jackson, Mississippi.

A drumline’s cadence filled the corners of Fairley High School’s band room, where 260 band members from across Memphis wrapped up their final practice of the week.

“M-M-B!” the group shouted before lifting their instruments to attention. James Taylor, one of the program’s five directors, signaled one last stand tune before he made his closing remarks.

“It behooves you to be on that bus at that time,” Taylor said to the room of Memphis Mass Band members Thursday night, reminding them to follow his itinerary. Saturday would be a be a big day after all.

That’s when about 260 Memphis Mass Band members will make their way to Jackson, Mississippi, for the event of the season: the Independence Showdown Battle of the Bands. They’ll join mass bands from New Orleans, Detroit, Georgia, Mississippi, and North Carolina to showcase musical performances.

“This is like the Honda of mass bands,” said baritone section leader Marico Ray, referring to the Honda Battle of the Bands, the ultimate competition between bands from historically black colleges and universities

Mass bands are designed to connect young band members to older musicians, many of whom are alumni of college bands and can help them through auditions and scholarship applications.

Created in 2011, Memphis Mass Band is a co-ed organization that’s geared toward unifying middle school, high school, college, and alumni bands across the city. The local group is a product of a merger of a former alumni and all-star band, each then about a decade old.

Ray, who joined what was called the Memphis All Star band in 2001, said the group challenged him in a way that his high school band could not.

“I was taught in high school that band members should be the smartest people, because you have to take in and do so much all at once,” he said, noting that band members have to play, count, read, and keep a tempo at the same time.

But the outside program would put that to the test. Ray laughed as he remembered his first day of practice with other all-star members.

“I was frightened,” he said. “I knew I was good, but I wanted to be how good everybody else was.”

Ray, now 30, credits the group for his mastery of the baritone, for his college degree, and for introducing him to his wife Kamisha. By the time he graduated from Hillcrest High School in 2006 and joined the local alumni band, he was already well-connected with band directors from surrounding colleges, like Jackson State University, where he took courses in music education. After he married Kamisha, an all-star alumna and fellow baritone player, they both came back to Memphis to join the newly formed Memphis Mass Band.

“This music is very important, but what you do after this is what’s gonna make you better in life,” he said. “The goal is to make everyone as good as possible, and if you’re competing with the next person all the time, you’ll never stop trying to get better.”

In a school district that has seen many school closures and mergers in recent years, Ray said a program like MMB is needed for students who’ve had to bounce between school bands. The band is open-admission, meaning it will train anyone willing to put in the work, without requiring an audition.

“[Relocation] actually hurts a lot of our students and children because that takes their mentality away from anything that they wanted to do, versus them being able to continue going and striving,” Ray said. “Some of them lose opportunities and scholarships, college life and careers, because of a change in atmospheres.”

With its unique mix of members, though, school rivalries are common, and MMB occasionally deals with cross-system spars. But Saturday, the members will put all of that aside.

“What school you went to really doesn’t matter,” Ray said. “Everybody out here is going to wear the same uniform.”

Asia Wilson, an upcoming sophomore at the University of Memphis, heard about the group from a friend. Wilson used to play trumpet in the Overton High School band, but she said coming to MMB this year has introduced her to a different style.

Jorge Pena, a sophomore at Central High School, heard about the group on YouTube. It’s also his first year in the mass band, and the tuba player is now gearing up to play alongside members of different ages, like Wilson.

They’re both ready to show what they’ve learned at the big battle.

“It’s gonna be lit,” Wilson said, smiling.

Need weekend plans? Tickets are still selling for Saturday’s 5 p.m. showcase. To purchase, click here.