House bill endangers at-risk students and disregards public health

PUBLIC HEALTH

As the chair of the board of directors and the associate medical director of pediatrics at Amoskeag Health, we are writing to educate the public about a harmful bill that the governor has vetoed, but will go back to the Legislature, which has a chance to override that veto.

House Bill 1131 would remove a school board’s ability to implement a mask requirement in the event of a medical emergency like Covid-19. We would like to explain how it is detrimental to Granite Staters who have medical complexities and would weaken New Hampshire’s public health response.

Amoskeag Health is a federally qualified health center in Manchester serving 14,163 patients and 5,259 children and employing 190 dedicated employees. In partnership with the NH Department of Health and Human Services, we offer four Special Medical Programs for children and youth who have chronic physical, developmental, behavioral and emotional medical conditions and disabilities.

Through these programs, our healthcare coordinators conduct in-person and virtual consultation with families, schools and other community agencies to ensure the children’s needs are met for an optimal learning environment Many of these young patients are immuno-compromised and in the highest-risk categories for severe illness and complications from Covid-19 infection.

HB 1131 disregards the needs of these children and any child who has complex medical needs or disabilities that make them particularly vulnerable to the Covid-19 virus and other infections. Implementing a blanket policy at Granite State schools stating that a school can never require teachers or students to wear a mask, even though a medical professional may determine that a child requires others to wear a mask for them to attend school, is a disservice to children with disabilities, including our pediatric patients at Amoskeag Health. Children with disabilities have a right to equitable access to a safe learning environment.

From our experience trying to protect families of patients with disabilities, we know that HB 1131 could put school districts at odds with federal law, including Section 504 of the Rehabilitation Act of 1973 and the Individuals with Disabilities Education Act of 1975. Section 504 ensures children with disabilities have equal opportunities to access their school buildings, programs and activities as students without disabilities.

IDEA requires school districts to develop individualized education programs that enable each qualifying student to receive an appropriate education in the least restrictive environment. This means that, to the maximum extent appropriate, children with disabilities should be educated in regular classes with peers who do not have disabilities. Due to medical conditions, some children with disabilities may require all faculty and students who work closely with them to wear a mask as an accommodation that would allow them to access public education safely. If HB 1131 is signed into law, New Hampshire would have a law on the books that, in certain circumstances, may run afoul of an individual’s rights under federal law.

Additionally, from a public health perspective, we believe that HB 1131 would debilitate New Hampshire’s response to public health emergencies and have a harmful effect on all Granite Staters who are high risk. If we have learned anything from this pandemic, it is that we cannot predict what is on the horizon, and we are not free from future public health emergencies.

Establishing a prohibition on a potentially needed public health intervention is impractical because it constrains school boards and public health experts who need flexibility to respond in real time to communicable diseases. Implementation of face masks in schools and leaving the decision up to school districts to require masks has been key to success in mitigating community spread throughout the pandemic. Having the option to use layers of protection allowed schools to use their own judgment to assess the number of cluster outbreaks in classrooms and determine an appropriate multi-tiered strategy for infection control. This system of localized control not only kept school children safe, but it also prevented additional virus spillover into Granite State communities and helped keep more children in school.

Our team at Amoskeag Health is extremely concerned about HB 1131’s disregard for the health and well-being of our patients and community members, especially those who have underlying health conditions and disabilities. A onesize-fits-all response to masks does not work for our children, our school districts or the Granite State.

Kathleen A. Davidson is chair of the board of directors at Amoskeag Health, and Dr. Lisa A. Di-Brigida is associate medical director of pediatrics at the Manchester-based clinic.