AIDS in the Schools: A Special Report Author(s): Sally Reed Source: The Phi Delta Kappan, Vol.

67, No. 7 (Mar., 1986), pp. 494-498 Published by: Phi Delta Kappa International Stable URL: http://www.jstor.org/stable/20403139 . Accessed: 19/12/2013 13:58
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Would McKanna allow the student to at tend school or not? Like most school officials in the U.S. today, McKanna hadn't had time to di gest all the medical information on Ac

quired ImmuneDeficiency Syndrome

Special bySally Reed

Rep

(AIDS), let alone to formulate any sort of policy on the disease for his 3,000 student school district. "I assumed it was an issue that would strike else where," he said. "I'd seen no reason to get involved in the discussion." But within two weeks McKanna was very much involved. And Longmeadow is only one of the latest in a growing list of U.S. school systems facing what has quickly become a hysteria-producing di lemma: whether or not to allow victims of AIDS - students or staff - to attend

school.
For school systems, the issues related to AIDS are extremely complex, cutting across socioeconomic, racial, and geo graphic lines and pitting the education and legal communities al, medical, against one another. Of course, AIDS is more than just a complicated situation for the schools; it is also a human trage dy. In addition to focusing on AIDS as an illness, however, it is important that we examine how AIDS has affected school systems this year, what policies on whose recommendations -based appear to be evolving, and the future educational and legal implications of the

disease.
ONE SCHOOL'S RESPONSE took an aggressive stance. McKanna Before the Longmeadow schools re in January, he contacted opened the Massachusetts State Department of Education, which had adopted guide for Massachusetts lines on AIDS schools in the fall of 1985. Those guide lines advised schools to handle AIDS victims on a case-by-case basis. On the day that the Longmeadow schools reopened, McKanna met with the victim's attending physician, who recommended that the student - a teen age hemophiliac who had been given a transfusion of blood contaminated with the AIDS virus - be allowed to attend school. On the following day McKanna

The growingepidemicof AIDS, Acquired Immune Deficiency Syndrome,has createda crisis for some school systems in theU.S. and has led to the devel opment of new policies in many others.How have schools responded? What are the implicationsfor the future?
494 KAPPAN PHI DELTA

Robert Mc AST DECEMBER of the superintendent Kanna,

Longmeadow Public Schools in western Massachusetts, was

faced with a problem he never expected to encounter. During the holiday break he learned that a high school student in his district had been diagnosed as hav often complex ing AIDS-related called ARC or "pre-AIDS." In other a test had shown that the stu words, dent's blood carried the AIDS antibody.

SALLYREED is an education writer based in Chicago.

informedtheboy's teachersof the situa tion; twodays laterhe cajoled thephysi cian who served as chief state health official and as amember of theGover nor's Task Force on AIDS to drive acrossMassachusetts in a snowstorm to meet with the entire high school staff and answer questions. Then McKanna convinced the local newspaper and the

Jim Chamberlain Illustration by

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local cable

television

station not to re

officials

have every

right to protect

the

lease the potentially controversial story school environment from it; these dis
until he had notified each parent in the district by letter and provided each par ent with a copy of the state department He also met with student guidelines. leaders in the high school, who request ed that they be given an opportunity to meet with a physician, as the faculty had done. So McKanna arranged to have a tricts have decided to flatly refuse to al low anyone with AIDS or ARC to at tend school. Finally, there are those is school systems that face personnel

blood transfusion, was prohibited from attendingWestern Middle School in

Kokomo at the start of the current school year. His mother sued while the boy received home instruction via a

telephone hookup to his classroom. sueswhen school employees acquire the However, the state courts refused to virus. Throughout the country there consider the case until school officials
have been debates - even lawsuits over who should report what to whom, and the parents exhausted previously es

tablished state administrativechannels.

At a special education hearing in late fall, an examiner ruled that the school to attend district must permit Ryan classes. The examiner found that - un der P.L. 94-142, the Education for All

local epidemiologist address the student how confidentialityshouldbe protected, be tested for the body and answer questions. Another who shouldor shouldn't physician conducted a workshop for virus, and what, if any, role schools
parents, which was videotaped for use should play exists in all of this.

in nearby school districts.

What were the results of these ef forts? As of mid-January, seven parents - but only to had contacted McKanna ask questions. No student had with drawn from school. The youngster with

Needless to say, tremendous variation

HandicappedChildrenAct - the school in each camp. Here are a few ex district must educate Ryan in the least amples. Youngsters with AIDS barred from restrictiveenvironment.But theKoko

AIDS-related complex was attending school regularly. And, although the

privacy of that youngster was all know McKanna. reported

ly protected, "the teachersand students

to who he is," according "But he goes about his busi

in school. In Dade County, Florida, three mo school board voted unanimously to appeal that ruling, and an 7-year-old girls with AIDS or ARC are December currently attending school - but in a appeals review by the state board of spe that the board of cial education was to have decided the separate classroom case in early February. education has rented in an unnamed fa "I made the decision [not to admit cility. The teachers of these AIDS vic to school] Ryan last summer," said total ano tims have been guaranteed of Koko James Smith, superintendent nymity, as well as periodic health ex

ness normally." Not surprisingly, McKanna views his

aggressive stance in dealing with AIDS as a "phenomenal success." But McKan na's approach is just one of the many in which schools have respond ways issue of AIDS. ed to the troublesome not all communities have Moreover,

aminations. mo's Western School Corporation. In Plainfield, New Jersey, the courts Smith noted that this decision preceded

were expected to rule at press time on a the publication of federal or state guide case involving a 5-year-old girl who had lines to help schools deal with AIDS. Would he make the same decision to been barred from school as a preschool er but whose guardian sued the Plain day? field Board of Education to allow her to "Yes," Smith responded. "I did what came naturally. We don't admit any attend kindergarten. child with tuberculosis, whooping Parents at the Washington Memorial takena superintendent's policy decision so quietly. School in Washington cough, measles, or mumps. And AIDS Borough, New In New York City last fall, 18,000 Jersey, removed their children from is one of the most horrendous com students boycotted classes while their school when the brother of a girl with municable diseases known." Students with AIDS admitted to parents protested the fact that one of the ARC was admitted. The boy was kept out of school until a court order forced schools. Last fall the New York City seven New York City children with the school to readmit him. The case is Board of Education decided to educate AIDS had been admitted to school. In still in litigation. three AIDS victims at home, to educate another highly publicized case, a Koko In Hobart, three victims in the hospital, and to ad mo, Indiana, teenager with AIDS was Indiana, teachers volun to an un barred from attending middle school. teered to work with an AIDS victim at mit one victim anonymously His mother in home when he was barred from school. named school. A boycott of 63 public sued. School boards and in The boy subsequently fled the state and schools ensued, as parentsprotested the Montgomery County, Maryland, admission of the one AIDS victim to moved to southeastern Missouri be Chicago were forced to develop policies a city school. Two parent groups in on AIDS - thus sparking vigorous de cause of reported harassment from other bates - when itwas learned that the re sued the Board of Education, students in the Hobart area. He now at Queens cent deaths of teachers in each school and a month-long tends school inMissouri. trial followed. The In Carmel, California, Superinten child is now too sick to attend school. system were attributable to AIDS. the legal arguments centered dent Robert Infelise kept an 8-year-old However, with AIDS out of school. He took this on who should be informed about the THREE CAMPS action in part, he said, because the enrollment of a child with AIDS. Na To date, school districts have divided school district's legal counsel advised than Quinones, chancellor of the New into three camps on the issue of AIDS. him that, even though a physician had York City schools, argued that no one at the boy's attendance, dis the a school needs to know that a student Some, such as the Longmeadow approved school district could not guarantee the has AIDS - except, perhaps, the school trict, have argued that AIDS is not tech nurse. nically a communicable since AIDS victim a "safe environment" free disease,

themedical community agrees that it is not spread through casual contact; therefore, individualswho suffer from AIDS have every right to be in school. Other school districts argue thatAIDS is clearly communicableand thatschool

from such viruses as chicken pox, which couldmake the child's condition worse. Inwhat has become a celebratedcase, RyanWhite, a 14-year-oldhemophiliac who acquired AIDS as a result of a

John McCarthy, superintendent of schools in Swansea, Massachusetts, claims thathe was the first superinten dent in theU.S. to openly acknowledge the fact that an AIDS victim was en rolled in his school system. "A few par

MARCH 1986

495

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An Educator's Resource
THE

Guide

ents withdrew their children," he said.

"But they are all back in Swansea in school now." no reported

FOLLOWING organizations and publications provide information on AIDS that may be of interest to educators. In addition, many local communities and some state public health offices now have resources available. AIDS hotlines are also springing up throughout the nation.

ThatAIDS victim still attends classes

today, with

problems. "The students have been overwhelmingly supportive," McCarthy

said. "He is one of their own. If you saw

ORGANIZATIONS
American College Health Association, 15879 Crabbs BranchWay, Rockville, MD 20855. Ask for copies of theAIDS Task Force Recommendations and brochure, part of theACHA Health Information Series, "AIDS-What Everyone Should Know." American Council for AIDS Research, 40 W. 57th St., Suite 406, New York, NY 10019. Publishes general information, including fact sheets on dealing with AIDS in the schools. Association of California School Administrators, Communications Dept., 1517 L St., Sacramento, CA 95814. Ask for AIDS Issue Pack, $8. California School Boards Association, 916 23rd St., Sacramento, CA 95816. Ask forAIDS Information Packet, which includes copies of pertinent articles, a list of California health officers, and two sample school board policies (one that admits studentswith AIDS, one that excludes them). Centers for Disease Control, Department of Health andHuman Services, Public Health Ser vices, Atlanta, GA 30333. Ask for general information and reports on AIDS (including articles on children) published during the interval from June 1981-September 1985 in the Morbidity andMortality Weekly Report. National Association of Independent Schools, 18 Tremont St., Boston, MA 02108. Ask for NAIS Statement on AIDS. National Education Association, 1201 16th St., N.W., Washington, DC 20036. Ask for Recommended Guidelines for Dealing with AIDS in the Schools. National Institute of Allergy and Infectious Diseases, InformationOffice, ORRPR, Bethes da, MD 20205. Ask for Facts about AIDS brochure, August 1985.

the child walking down the street, you wouldn't know he was different from any other 13-year-old." An organization
in Swansea raised $9,000 to help the

familywith medical expenses.

In late October a female student at Dundalk Senior High School in Balti

more County,Maryland, donatedblood

at a Red Cross bloodmobile. Routine

screening revealed that she carried the AIDS virus. The principal decided to
keep the girl in school and not to reveal her identity - until health officials ad

vised him otherwise. School employees with AIDS. In Montgomery County, Maryland, two
teachers who died had AIDS. The school system was notified after the fact. This prompted a new board policy

BOOKS
Ann Guidici Fettner and William A. Check, The TruthAbout AIDS: Evolution of an Epidemic (New York: Holt, Rinehart & Winston, 1984). Updated and revised in 1985.

in Montgomery County. The policy states, in essence, that school personnel with AIDS will continue their employ
ment unless there is some special reason for the school system to exclude them. But cases will be evaluated individually. centered on the report Controversy ing requirement, but an agreement was finally reached: if an employee has the disease, he or she must notify the ad ministration. Mark Simon, president of the Montgomery County Education As sociation, noted that teachers were con

PERIODICALS
MEDICAL "HTLV-III InfectionAmong Health CareWorkers," JAMA, Journal of theAmerican Medical Association, 18 October 1985. "Education and Foster Care of Children Infected with Human T-Lymphotropic Virus Type HI/Lymphadenopathy-Associated Virus," Morbidity andMortality Weekly Report, 30 Au gust 1985. "AIDS in Children: A Review of the Clinical, Epidemiologic and Public Health Aspects," Pediatric Infectious Diseases, vol. 4, no. 3. EDUCATIONAL "Aids and Herpes Carry Weighty Policy Implications for Your Board," American School Board Journal, October 1985. Footnotes, No. 24, published by the Education Commission of the States. For single copies, at $2.50 each, contact theECS Distribution Center, 1860 Lincoln St., Suite 300, Denver, CO 80295. NEA Today, December 1985. LEGAL "AIDS in theWorkplace: A Medical Legal Overview," a paper prepared by the law firm of Morgan, Lewis & Bockius. (For copies, contact Anita Schoomaker, 1800 M St., N.W., Washington, DC 20036.) AIDS Policy & Law, a biweekly newsletter published by Buraff Publications, 1231 25th St., N.W., Washington, DC 20037. (A one-year subscription costs $337.) GENERAL "San Francisco: A Crisis in Public Health," Atlantic, October 1985. "AIDS: Epidemic of the '80s,"Dance Magazine, January 1986. "The Immune System inAIDS," Scientific American, December 1985. "TheAIDS Conflict," Newsweek, 23 September 1985.

cerned about confidentiality, especially

"after the names of the two individuals who died of AIDS, together with their on the were photographs, plastered front pages of the local newspapers." In nearby Prince George's County, the school board likewise Maryland, adopted a policy after two employees with AIDS died. After considerable de bate, the board decided against screen It will evaluate each ing employees. case individually. A review panel made up of the attending physician, of the county health representatives and public school repre department, sentatives - will decide whether the school district should continue to em ploy an AIDS victim in his or her cur

rent capacity.
THE MEDICAL COMMUNITY'S VIEW

AIDS HOTLINES
Centers for Disease Control (24-hour recorded message about AIDS): 800/342-AIDS. National Institute of Allergy and Infectious Diseases (8:30 a.m. - 5 p.m. EST): 301/496-5717. New York State Hotline: 518/474-7354. Public Health Services AIDS Hotline (9 a.m. -7 p.m. EST): 800/447-AIDS (in Atlanta, call 404/329-1295).

Generally speaking, physicians and public health officials have tried to calm thepublic's fearsby noting that AIDS is not spread by casual contact and thus cannot spread throughnormal interac

496

PHI

DELTA

KAPPAN

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in school] should be made by the physi recommendations for schools. These cian, the victim's parents, and appropri are not legally binding, but they are in ate school personnel." tended to serve as workable guidelines. For classmates of an AIDS victim, there is no cause for concern, Rapoza said. The other children are not at risk THE CDC GUIDELINES unless the AIDS victims are engaging in The CDC recommends that students sex with them or are sharing needles for and staff members with AIDS be al drug use with them - which is "highly lowed to remain in the schools and that unlikely," in Rapoza's view. If a each case be judged individually. The 28,000 physicians who belong child is too sick to attend school, he or to the American Academy of Pediatrics tions among students or teachers. Ac she should receive separate instruction. that released a statement last October The CDC guidelines, released inOc cording to the federal Centers for Dis they hoped would calm nervous parents. ease Control (CDC) in Atlanta, 16,458 tober, included 11 suggestions for cases of AIDS had been reported in "The risk of acquiring AIDS among schools that are dealing with cases of children is low," explained Dr. Martin the U.S. by January 1986, and 8,361 AIDS. For example, the CDC suggests AIDS-related deathshad been reported. Smith, president of the Academy. that a team - including the attending "There has been no instance whatever of physician, public health personnel, the Ninety percent of AIDS victims are men between the ages of 20 and 49. child-to-child transmission." child's parent or guardian, and school - make But ignorance about the transmission a decision about Seventy-three percent are homosexual personnel the issue. A of AIDS has complicated or bisexual men; 17% are intravenous school attendance in each case. "For CBS poll conducted last September re most infected school-aged children, the drug users. Most victims are concen ported that 47 % of those polled believed would trated in New York City, San Francis benefits of an unrestrictedsetting that itwas possible to contract AIDS by co, Miami, Newark, and Houston. The outweigh the risks of their acquiring drinking from a glass that had been used CDC estimates that one million people potentially harmful infections in the set by someone with AIDS; 32% thought have been infected by the AIDS virus ting and theapparentnonexistent riskof that it was possible to catch the disease thus far. But a blood test showing AIDS transmission of HTLV-III/LAV," ac by kissing; and 28% thought itwas pos antibodies does not mean that the dis cording to theCDC guidelines. ease will eventually develop. Roughly sible to contract AIDS from contact The CDC document notes that, for in with a toilet seat. More than one in 10 fected preschoolers and some neurolog 10% of those who have been infected of those polled thought AIDS could be have actually developed the disease. ically handicapped children who lack This group includes approximately contracted by working in the same of control of their body secretions or who fice as someone who has the disease, or display such behaviors as biting, and for 215 children under the age of 18. They of from the touch of an infected person. A the District reside in 23 states, those childrenwho have uncoverable, in late October oozing lesions, "a more restricted en Columbia, and Puerto Rico, but 75 % of Harris poll conducted in four states: showed that more than 50% of those vironment them are concentrated is advisable until more is New York, California, and polled believed that one could contract Florida, known about transmission in these set New Jersey. In these children, as in AIDS from "casual contact." tings." adult victims, the AIDS virus attacks the reassuring statement by Despite The National Education Association of Pediatrics, to defend itself the body's the American Academy ability followed the CDC initiative and re not all physicians agree that AIDS vic is always fatal. against disease. AIDS leased its own guidelines, also in Oc in the tober. The NEA said that its guidelines of children with AIDS The majority tims should be in school. Writing were either infected at birth by their 12 January 1986 issue of the Chicago were in keeping with the CDC recom mothers (who may or may not have Sun-Times, Dr. Robert Mendelsohn, mendations. It further noted that the known that they had AIDS) or they pediatrician and former national medi same guidelines apply to school em received contaminated blood or blood cal director of Project Head Start, ar ployees as apply to students, and it products in transfusions. gued, "Children who have AIDS should urged schools "to protect the privacy Norbert Rapoza, a senior scientist be kept out of the public schools until rights of students and school em with the American Medical Association their presence is determined to be safe." ployees, and provide guarantees for in October 1985 the those who cannot remain in school."' in Chicago, does not recall any other Nonetheless, for issued its own statement epidemic - even polio - causing such CDC The National Association of Inde a furor in the schools. "We need to be schools regarding children with HTLV pendent Schools (NAIS) has reported III/LAV, or AIDS. That statement said, realistic," he said. "We are talking about that it knows of only one case of AIDS "None of the identified cases of the among its member a small number of children who have institutions - and infection in the United been infected. Of the 200 or so children HTLV-III/LAV that case involves a teacher. Nonethe who have had AIDS, 100 have died. Of States are known to have been transmit less, the NAIS issued a statement last those who remain, 50% are too sick to ted in the school, day-care, or foster November reiterating the CDC guide care setting, or through other casual attend school. That leaves 50 children lines and urging that blood tests to contact. Other than screen for AIDS not be required of stu with AIDS in America who are able to person-to-person the sexual partners of HTLV-III/LAV attend school, or one per state." dents or staff.

A IDS is not spread by casual contact and thus cannot spread

through normal interactions among studentsor teachers.

Our first concern should be for the infectedpatients and infantsborn to in child who has AIDS, according to Ra fected mothers, none of the family poza. That child's health "mustbe con members of over 12,000 AIDS patients sidered in termsof school. Chicken pox reported toCDC have been reported to would be lethal for theAIDS child. But have AIDS." this decision [to enroll anAIDS victim The CDC then issued and distributed

While the CDC, the NEA, and the NAIS have released the only national guidelines to date, 17 stateshave adopt ed some sort of policy for dealingwith AIDS, according to Education Week. These state policies generally suggest

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that schools not bar AIDS victims auto matically, but instead use review panels

cally

ill school personnel

from contact

with children.
The rights of employees who have AIDS or who teach children with AIDS was the topic scheduled to be discussed at a mid-February meeting of the American Federation of Teachers.

to judge each case individually. The guidelines developed by theCon necticut StateDepartment of Education
are generally cited as a model for other states, because they were drawn up in

cooperation with the Connecticut De

partment of Health asked about AIDS. and they answer The the

questions that educators are frequently

Connecticut

IMPLICATIONS FOR THE FUTURE "The AIDS issue is more a social problem than a legal or educational one," according to Gwen Gregory, dep uty general counsel for the National School Boards Association (NSBA). the public, "And school board officials, educators, and parents need to get to gether to work out a solution," she said. The NSBA plans to release a video tape of the one-day "Forum on AIDS in the Public Schools" that it sponsored in Washington, D.C. However, the NSBA does not plan to issue to its members a policy on dealing with AIDS. "A policy is really useless," Gregory said. "A school board's current policy on com disease should suffice. But municable you can have a policy. That is easy. Yet how do you implement that policy when you have parents who say, 'I don't care what your policy says'?" "The whole issue is really the fear/ fact matrix," said Gary Marx, associate executive director of the American As sociation of School Administrators. "If we know what the facts are, we become more confident, and the fear level sub sides. If facts are in doubt, the fear level goes up. School districts have to deal with the reality of parents' fears. And it is important for school districts and ad to keep in contact with the ministrators

guidelines echo those released by the

CDC, including the need for confiden tiality and the use of review panels to weigh each case. Some states, such as

Massachusetts, are also requiring physi

cians who and diagnose a case of AIDS of health of to that

notify the school system'scentral office

the department

fact.
LEGAL RAMIFICATIONS It appears, then, that children and staff members who have AIDS will be permitted to remain in the schools as long as their health permits. School sys tems that fail to follow the CDC guide lines will no doubt face lawsuits. Legal authorities are suggesting that the laws governing treatment of the handicapped will be tested in cases dealing with last September AIDS. A decision in volving a teacher who was dismissed because she had tuberculosis is being cited as a precedent. * In Arline v. School Board of Nassau the County, courts ruled that the teacher with tuber culosis should have been protected un der Section 504 of the Rehabilitation Act of 1973. There are other legal issues as well. According to the CDC, among the legal issues to be considered by school sys tems are "the civil rights aspects of pub

By contrast, Pat Howlett, communi cations director of the Association of California School Administrators, has said that, as she travels around that state, she observes more and more school boards voting to keep AIDS vic tims out of the schools. a national poll conducted Meanwhile, by the Los Angeles Times found a strong correlation between lack of knowledge about the disease and fear of it. And there are those who suggest that a mas sive campaign to educate the public is necessary, in order to clarify the issues and lead to "informed" policies. The New York City school system is apparently the first school system in the U.S. to formally introduce a curriculum on AIDS. In January New York City school officials began training six teach er volunteers from city high schools to teach a new two-lesson minicourse to all high school students in the city. Parents have been advised that they can remove their children from the classes if they wish. The school system is also prepar ing a $100,000 videotape on AIDS that should be available this spring. Ray Kelly, superintendent of schools in Bergen County, New Jersey, argues that educators "need to translate the technical language to the lay language and educate high school youngsters. We're all wrong to worry about the 5-, 6-, and 7-year-olds," he said. "The ma jor concern in education should be with the teenager who may experiment with sex or drugs. Those are the high-risk

groups."
Ian Mitroff, the Harold Quinton Dis tinguished Professor of Business Policy in the Graduate School of Business at the University of Southern California, sees parallels between in the ways which school administrators have re sponded to the AIDS crisis and the ways in which corporate executives have re to corporate disasters. sponded "We haven't educated people to the complex ities of the world, to think through the of their positions," Mit consequences roff said. "What people want is a quick-fix solu tion," he pointed out. "But school ad need to think through their ministrators decisions. are And, while managers thinking about the consequences of their decisions, they cannot forget the over whelming tragedy of all of this to a youngster, who - at a vulnerable age anyway - may be shunned and ostra

CDC."
There are indications that, as spring nears, the hysteria about AIDS in the schools may be waning. Experts predict that, although the number of cases of AIDS among children may double with in the coming year, new cases resulting from blood transfusions are likely to be thanks to a new blood eliminated, In addi screening test called ELISA. tion, public opinion regarding AIDS in the schools may be changing. A state wide poll in Maryland last December revealed that residents of that state agree, by a margin of 2-1, that victims of AIDS should be allowed to stay in school or to keep their jobs while re ceiving care. A recent national poll, sponsored by the Washington Post and

lic school attendance, the protections

for handicapped children. . ., the con fidentiality of a student's school record

under state laws..., and employee right-to-know statutes for public em

ployees sion that that and in some states."

Meanwhile, the Education Commis

of the States recently discovered some states already have statutes regulate the attendance of pupils school personnel who have AIDS. school attendance due to

Forty-six states already exclude pupils

from regular

illness, 17 states includechronic illness

as a condition entitling a child to special education, and 25 states exclude chroni
*See, Victims Law?," 466-67. "Are J. Flygare, for example, Thomas Federal of AIDS 'Handicapped' Under Phi Delta Kappan, 1986, pp. February

ABC News, found that six adults in 10 cized throughno fault of his own. The favor allowing children with AIDS to real question for schools is, 'How can attend public school if health officials this child attend school and be pro tected?'"[3 say there is no danger.

498

PHI DELTA KAPPAN

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