Epinephrine: Saving lives, when administered
To the Honorable Ricardo Lara:
My son’s child care center does not “accept the responsibility of Nebulizer care or the administration of Epipen or similar injections.”
It refuses responsibility based on recent changes to Title 22, Division 12. It almost certainly does so with reference to the Community Care Licensing Divisions’s July 2015 Transmittal No. 15FCCH-01 (http://www.ccld.ca.gov/res/pdf/FCCH.pdf) describing administration of EpiPen as an “Incidental Medical Service” which “a licensee may choose to provide.”
Offering child care providers the choice to administer EpiPens means, conversely, they have the choice not to administer. My son’s child care providers are exercising this freedom to enroll severely food allergic kids at their centers while also choosing to withhold life-saving epinephrine from them. By this choice, they endanger the lives of the severely allergic children in their care. They do so in contravention of the Americans with Disabilities Act.
In 1997, the Department of Justice entered into settlement with La Petite Academy (http://www.ada.gov/lapetite.htm). The academy’s allergy response policy prior to settlement was to wait for paramedics to deliver epinephrine to the suffering child. This was determined to be unacceptable. The settlement included a new EpiPen policy requiring the academy to immediately administer medicine per the child’s medical authorization form.
The DOJ additionally addressed this in its ADA FAQ for child care providers (http://www.ada.gov/childqanda.htm). In its answer to question 19, it states that children “cannot be excluded on the sole basis that they have been identified as having severe allergies to bee stings or certain foods.” It continues by stating providers must be prepared “to take appropriate steps in the event of an allergic reaction, such as administering a medicine called ‘epinephrine.'” It is clear based on the La Petite Academy settlement that waiting for a medical professional to deliver epinephrine does not qualify as an “appropriate step.”
Severe food allergy is an ADA covered disability. Any child care provider who chooses not to administer epinephrine to a severely food allergic child in the throes of anaphylaxis not only discriminates against such child in violation of the ADA, but does so with potentially fatal consequence.
Epinephrine saves lives in seconds, but it can only do so if actually administered.
As the mother of a severely allergic child, I am heartbroken. I am heartbroken that any child care provider would choose not to administer epinephrine, and refuse to do so under the banner of law.
I am heartbroken to imagine my sixteen-month-old son struggling to breathe as his tiny, beautiful heartbeat grows erratic nearing cardiac arrest. I weep at the thought of his confusion and terror as his caregivers, those entrusted to keep him safe, fail to take fifteen seconds to administer the drug that could save his life.
I urge you not to enable this outcome by your silence. Please immediately amend Title 22 to clearly, emphatically align with the ADA, mandating child care providers to adhere to federal law.
Please protect severely allergic kids, and do so before any mother’s baby dies needlessly.
With great thanks,