Members Forum
Confidential Medical Appointments
The Rule Of Law Don't Leave School Without It
Nelda Mackey
At the end of October 2009, San Juan School District sent high school counselors what may have seemed by many to be a fairly innocuous e-mail informing them that the district was in the process of updating Board Policies (BP) and Administrative Regulations. The email explained that BP 5113, Student Absences and Excuses, was being considered for revision. It stated in part:
At the beginning of each academic year, district notifications shall be sent out to the parents/guardians of all students and to all students in grades 7 through 12, informing them that school authorities may excuse any student to obtain confidential medical services without the consent of the student's parent/guardian (ed. code, sect. 46010.1)
This e-mail, however, sent up a red flag for me. The Board was taking a look at the law that allows "confidential medical services." In the past several years this law has been at the center of a heated debate throughout California. Special interest legal nonprofits, which profess to be defending religious freedom and parental rights, have convinced at least three other school districts to adopt policies that violate the law.
As a school counselor I have always urged students to involve parents in personal medical issues; however, at times parental involvement is not in the best interest of the student. In some cases, a parent/guardian has abused the student causing the injuries that require medical care. In other cases the student may fear retaliation for disclosing sensitive medical issues, or a parent/guardian may be unwilling to recognize the need for care and will not provide consent. These are the students the legislature had the foresight to protect. The law is a way to keep California's youth healthy and safe. Support personnel, especially counselors and school nurses, have a legal, moral and ethical obligation to uphold this law.
When I would hear about other districts voting away students legal and human rights, I always wondered what I would do if this happened in San Juan. I was worried and concerned. I called my supervisor at the District office and asked, "by updating the Board Policy I hope they are not planning on getting rid of this." She assured me that there were no plans underway to violate the law. In fact she said they were looking at the Board Policy because it was NOT in compliance with ed. code. She explained, "Take a look at the parent handbook." The Board Policy reflected ed. code, but also stated:
Students should not be absent from school without their parents/guardians' knowledge or consent except in cases of medical emergency. It is the practice of the district not to release students without parental consent.
The proposed update was to change the Board Policy to comply with the law, and frankly with past practices. In my 14 years with the district, attendance clerks, counselors, administrators and nurses had been granting confidential medical appointments in compliance with ed. code. I was relieved, but still a bit skeptical about the board's intentions.
On Saturday, November 14, 2009, while enjoying my morning coffee and The Sacramento Bee, my eyes fell on an article in the "Our Region" section of the paper: "No-consent leaves for students proposed: Is San Juan parents' OK needed to excuse kids for medical services?" I was livid to find out that indeed the School Board would seriously consider disallowing confidential medical appointments. On Monday morning I contacted district personnel who again assured me that the School Board would never pass a proposal to violate ed. code. I was assured this issue had already been addressed through case law, California Supreme Court opinion (American Academy of Pediatrics et al v. Lungren et al) and Attorney General opinions (66 Ops. Cal. Atty. Gen 245, 249, 1983; 87 Ops. Cal. Atty. Gen 168, 2004). The attorney general opinion stated "A school district may not require that a student obtain written parental consent prior to releasing the student to receive confidential medical services (and) a school district may not adopt a policy pursuant to which the district will notify a parent when a student leaves school to obtain confidential medical services.
"Thanks for the reassurance," I said. "I'll see you at the board meeting."
The evening of November 18, 2009, the Board met to a packed and overflowing room of parents, human rights activists and members of the Pacific Justice Institute, a legal non-profit organization. At least 40 people spoke regarding Board Policy 5113 including myself. Although I could empathize with the parents who felt the law usurped their authority, I was appalled by the disrespectful and uncivilized manner in which many of these parents and their advocates made their point. People yelled and booed when members of the ACLU and Planned Parenthood got up to speak. For the first time ever I experienced anxiety as I approached the board to speak and for good reason. As I returned to my seat a parent harassed me. He had to be told several times by a district administrator to stop talking to me and move away from my seat.
The Board voted three to two to reject the proposal to align Board Policy to the current law. Department of Education spokespeople have been quoted in The Sacramento Bee stating that the district risks lawsuits and loss of state funding for its noncompliance. One spokeswoman said, "Sometimes (districts) don't understand the gravity of the situation… Sometimes they think they can make a decision and that is that."
The final question in my mind was, "Where does that leave pupil personnel support staff — do we follow the law or the Board Policy?" Counselors received a directive from the pupil personnel services director and the superintendent that we are to continue to follow the law, and that no district employee would be subjected to disciplinary action for doing so. Now we are back to where we were before — following a policy that is poorly written and doesn't reflect what district employees are legally obligated to do. Perhaps the most unsettling part of all of this is the message sent to our kids: the school board doesn't respect the laws of California, and they don’t respect the legal and human rights of their students.