The Other 60 Percent

Tackling food allergies at school

For parents of children with food allergies, school can sometimes seem like a minefield, with danger lurking everywhere.

Some students at Aurora's Park Lane Elementary eat lunch. The cafeteria pizza - unlike most pizzas - is made with whole wheat and lowfat cheese, so it's a "Slow" food. The lowfat milk is a "go" food.
PHOTO: Hayleigh Colombo
Students at Aurora’s Park Lane Elementary eat lunch.

It’s not just the peanut butter and jelly sandwiches that pop out of lunchboxes in the cafeteria. It’s the constant stream of food in the classroom, for snacks, parties, rewards, and even crafts like paper maché planets or peanut butter bird feeders.

Colorado Springs parent Katie Prichard knows the feeling. Her kindergarten daughter is allergic to peanuts, eggs, soy, sesame, green peas and apples, and while Pritchard is very pleased with the precautions in place at her charter school, Rocky Mountain Classical Academy, she said there are always worries. Sometimes about safety and sometimes about her daughter’s inevitable sense of being different.

“At school you should get to be like your friends…to have equal access to your classroom,” she said. “It’s kind of a barrage for a young kid in kindergarten.”

Pritchard, who leads Colorado Springs Mosaic, a group for parents of children with severe food allergies, said despite the challenges, she believes schools are moving in the right direction when it comes to accommodating food allergies.

“I’ve heard so many struggles other parents had before I came along,” she said “I definitely feel like things have improved.”

Kathleen Patrick, assistant director of student health services at the Colorado Department of Education, agreed, saying state laws and policies have enabled several key measures, such as allowing students to self-carry epinephrine auto-injectors, ensuring school districts have allergy policies and educating school staff about allergies.

Today, about 8 percent of children have food allergies, an average of two per classroom.

Patrick said when she was a school nurse years ago, she sometimes heard stories about school staff not taking a student’s food allergy seriously.

Today, she said, “We’re on the right road in terms of the education and getting the information out there…I think food allergy awareness is very high.”

Precautions vary

Nicole Smith, co- founder of the AllergicChild website and mother of a teenage son with food allergies, said the landscape for Colorado students with food allergies can vary depending on their school and district.

“Even within a school district you can have different levels of awareness,” she noted.

Patrick said sometimes the successful dissemination of food allergy information can hinge on how school nurses are deployed in a district. Compared to schools with a full-time nurse, there may be less overall awareness about allergy precautions, not to mention fewer trained staff members to administer epinephrine injections in an emergency, in schools where nurses work part time because they cover multiple buildings.

Another factor in how schools and districts measure up, she said, can be the presence of a parent, nurse or other staff member who serves as a champion for food allergy awareness and preparation.

Despite the differences between schools and districts, state policies and resources have created some uniformities in the last several years. Under a state law Smith helped pass in 2009, school districts are required to have policies to accommodate students with food allergies.

In Academy School District 20, which has a Food Allergy Task Force and is widely considered a leader on food allergy issues, the district’s five-page policy weighs in on food allergy issues large and small, from training staff to choosing field trip chaperones. (It’s recommended that parents of students with food allergies get preference.)

“Academy School District 20 is amazing, just plain and simple,” said Smith, whose son attends high school there. “They have long looked at the safety of every child.”

Often, food allergy measures depend on the number of students with food allergies at a school, the severity of their reactions, what precautions are requested by parents and what is deemed feasible by administrators.

For example, at some schools cafeteria tables are set aside for students with food allergies and there are strict rules about sanitation procedures as well as hand-washing guidelines for students.  This is the case at Ralston Elementary in Golden, where peanut and tree nut products are banned in all classrooms, but are permitted at designated cafeteria tables.

Even when schools have comprehensive plans in place and staff are attentive, allergens sometimes slip through the cracks. Patrick started tracking the number of students who experienced anaphylaxis and needed epinephrine at Colorado schools in the 2011-12 school year.

There were about 30 cases reported that year, and so far this school year, there have been 24. The causes include students sharing food, which is prohibited at most schools, but can be hard to enforce. In one case, a parent brought in cupcakes containing peanut products after signing up to bring something else. In another, a student with a latex allergy touched a balloon while she was helping decorate a friend’s locker.

“You can be as careful as possible and something may still happen,” Patrick said.

House Bill 13-1171

In case something does happen, many in the food allergy community are hoping that a bill currently under consideration in the legislature will lead to additional potential safeguards for children with allergies. Bill 1171, also called the stock epinephrine bill, would allow schools to keep epinephrine auto-injectors on hand for trained staff to use on students experiencing anaphylaxis even if they don’t have their own prescription.

The idea is to allow teachers or other school staff to immediately curb a life-threatening reaction during the crucial minutes before paramedics arrive. In part, the measure would protect students who have undiagnosed allergies that are triggered at school.

“Twenty-five percent of first-time [allergic] reactions occur in the school setting,” said Jennifer Jobrack, director of major gifts and regional advocacy for Food Allergy Research and Education, a national advocacy group.

Christianna Fogler, principal at Rocky Mountain Classical Academy, knows firsthand how that scenario plays out. Last fall, a first-grader at the school’s elementary campus came in from the playground and began experiencing anaphylaxis. The girl had no known allergies but her throat was closing and her breathing was labored, said Fogler, who will testify before the state Senate in favor of Bill 1171 this week.

After school staff called 911, paramedics arrived in just a couple minutes because they happened to be at a building down the street. They treated the girl, who may have reacted to a bug bite, and she recovered.

Fogler, who worries about what would have happened if the paramedics had taken 10 or 15 minutes to arrive, said the bill would empower school staff to do the right thing without worrying about liability or other legal issues. The school already trains all teachers, substitute teachers and lunchroom monitors how to recognize anaphylaxis and administer and EpiPen.

Currently, 17 states have laws covering stock epinephrine in schools, though the language and requirements range widely. Only Nebraska, Virginia and Maryland require schools to stock epinephrine auto-injectors. In most states, as would be the case in Colorado, the practice is voluntary.

Among the objections to the law are the expense of the auto-injectors, which typically cost $180 for a two-pack, and the extensive training needed to ensure school staff besides the nurse know what anaphylaxis looks like and how to use the auto-injectors.

Jobrack noted that Mylan Speciality, the distributor of EpiPens, has a program providing free and discounted EpiPens to schools, and that her organization has training resources available.

Trends toward protection and prevention

As a result of the Americans With Disabilities Act Amendments Act of 2008, students with severe food allergies are also increasingly getting 504 plans, which provide children with disabilities accommodations to fully participate in school.

Holly Camp, administrator for food service operations for JeffCo Public Schools and a registered dietician, said she helped execute the first food allergy-related 504 plan in 2009. Today, about 50 students in the 85,000-student district have such plans, usually because of allergies or intolerances to gluten, dyes or casein, a protein found in milk.

As part of the plans, the students’ parents, physician and often the school nurse make a list of accommodations, which may range from using extra sanitizer at the student’s lunch spot to allowing them to be first through the cafeteria line to ensure their food is prepared and wrapped first.

Patrick believes the increasing use of 504 plans for food allergies is a good development. In addition to helping individual students who have the plans, it can raise awareness overall, she said.

“What they are doing for one, they will very often understand that it’s important for another student with a recognized food allergy,” she said.

Smith, of AllergicChild, said another encouraging trend she’s noticed is that school wellness initiatives aimed at reducing obesity are being coupled with efforts to reduce allergy risks. Thus, many schools are getting away from using food as rewards or as the focal point of class parties.

For example, a few elementary schools in the Thompson School District in Loveland  adopted regulations this year eliminating edible treats for student birthdays and sometimes communal snacks where every child gets a portion from a large box of crackers or cookies. Wellness coordinator Kathy Schlepp said the changes came because school staff were trying to respond to food allergy concerns and also “the extra calorie piece.”

The district’s wellness plan, which is currently being revised, will also include some version of these restrictions next year.

“It will definitely be trying to cut down on unhealthy classroom snacks or treats,” she said.

Kids eat free

Colorado could expand lunch subsidy to high school students

PHOTO: Helen H. Richardson/The Denver Post
Bernadette Cole serves food to students at Prairie View High School in Brighton.

When Colorado expanded a school lunch subsidy to middle school students, the number of sixth- through eighth-graders eating lunch at school went up in districts across the state.

Twenty-sixth percent more middle school students ate lunch at school in the Greeley-Evans district, where a majority of students live in poverty, but even in the more affluent Littleton district in Denver’s south suburbs, 11 percent more middle school students ate lunch.

For school nutritionists and children’s advocates, these kinds of results make the case for extending this same lunch subsidy to high school students.

“We know the co-pay is a barrier because of the large uptick in participation when it goes away,” said Erin Miller, vice president of health initiatives for the Colorado Children’s Campaign.

The “co-pay” is the 40 cents per meal that families who qualify for reduced-price lunch — but who make too much money to qualify for free lunch — are responsible for. The federal government picks up most of the cost for these lunches, and since 2008, Colorado has covered the 40 cents for the youngest students, rendering those lunches free to their families. This program has gradually expanded, reaching middle school students in legislation passed last year.

A bill that passed out of the House Education Committee Thursday would cover the 40-cent cost difference for high school students, a longtime goal of advocates.

“The state of Colorado has been trying to ensure that kids in poverty have access to food for a decade,” said Danielle Bock, nutrition services director for the Greeley-Evans district and a public policy and legislative consultant with the Colorado School Nutrition Association. “This is the final step.”

Miller said hunger affects children in school not just academically but also emotionally, with hunger even associated with higher suicide rates. Advocates have pushed to expand the state subsidy because participation in school lunch goes down as children get older, even as their caloric needs go up.

Currently, households that earn less than 130 percent of the federal poverty level, or $32,630 for a family of four, qualify for free lunch through the federal program. Families who earn between 130 and 185 percent of the federal poverty limit, or up to $46,435 for a family of four, qualify for a reduced-price lunch. It’s children from that second category families who will benefit if this bill becomes law.

Bock said the vast majority of school food service agencies in Colorado have unpaid lunch debt that, under federal law, they can’t just write off. School districts either pick up the costs out of their general fund or try to collect from parents, which sometimes leads to the controversial practice of “lunch shaming,” in which schools serve less nutritious and appealing alternative lunches to students whose parents owe money.

Lawmakers started out wanting to ban lunch-shaming, but school nutritionists convinced them it would be better to have the state cover some of the extra lunch cost for families who are struggling to make ends meet.

When Denver ended the practice of serving “alternative” meals to families who hadn’t paid for lunch, the amount of lunch debt skyrocketed, with a large portion of it coming from families who had not signed up for subsidized lunches and might have the means to pay.

According to a fiscal analysis, Colorado plans to spend $2.2 million on lunch subsidies this school year. Expanding the program to high school students would cost an additional $464,000 next year, with that money going into school food service budgets.

pass the microphone

This Memphis senior was kicked out of three high schools. Here’s how he got on track to graduate.

PHOTO: Gillian Wenhold, The Social Exchange
Despite what John Chatman calls a “really tough childhood” where he was often left on his own, he’s on track to graduate from alternative school G.W. Carver College and Career Academy this year.

In front of more than 100 people, John Chatman recalled the bullying he endured as a child for having a stutter.

Chatman was one of seven educators and students who took the mic at Chalkbeat’s February story storytelling night. The stories centered around school discipline practices, a topic we recently covered in this special report.

“Growing up in the area I grew up in, it’s hard to deal with that,” said the 18-year-old. “You’re an outcast. … It made me hate school, because I never could enjoy it. I may answer a question and stutter, [and other students would] get to laughing and cracking jokes.”

Kids stopped making fun of him in middle school when Chatman became a star middle school football player in Memphis — but the prestige that came with playing football disappeared when he was injured on the field.

“I took my injuries and replaced them with the streets,” Chatman said. “Throughout my ninth-grade year, I was starting to lose myself. … By 11th grade, I didn’t know who I even was.”

During that period, Chatman said he was kicked out of three high schools and eventually wound up at G.W. Carver College and Career Academy, an alternative school for expelled students, housed in former Carver High School.

“This school changed my life forever, Chatman said.

To hear more about how Chatman’s life changed, watch the video (or read the excerpt) below.

The storytelling night was hosted by Chalkbeat Tennessee, Spillit, and The Knowledge Tree. The video was filmed by Gillian Wenhold for The Social Exchange, a pay-as-you-can public relations and content creation firm for nonprofits, and businesses owned by women and people of color.

My 11th-grade year was the time I decided I had to change. The change was when I finally got kicked out of school. Well, I’d been kicked out of school but this was the kick-out-of-school that kicked me in my back real hard and said you only have one strike left. If you mess this up, this is it. It’s over with. You’re not going to see the light of day. Due to that, I ended up going to Northeast, and it still didn’t get better. In fact, I’m going to tell y’all the transitions of my schools. It started at ninth grade at Central, couldn’t come back to Central and I had to go to East , got kicked out of East and went to Northeast. Got kicked out of Northeast and now I’m back at Carver.

I’ll tell y’all, this school changed my life forever. I wouldn’t be here right now if it wasn’t for that school. It happened like this. There was a guy named Roger. We used to run together during the same time period. …

[During a presentation of past Carver graduates], an image of Roger popped up clear on the screen. It wasn’t up for nothing bad, he was on the road to making a six-figure [salary]. I was like, ‘This was the same person I used to shoot dice with?’… Now he’s living a life and I’m stuck here. I’m still doing the same stuff I’ve been doing and not getting no different result, and that’s called insanity… I took it, and I told myself if he can do it, I know I can.

Spillit, storytelling
PHOTO: Xzavier Bonds
Chatman speaks to a packed room during Chalkbeat’s storytelling event.