05/04/2026
Hi all!
I know it's been a minute, so (now that life has slowed down a little...), I wanted to take some time to fill you in on where It Takes a Village stands.
In short, there are a handful of laws that oversee nursing care in the state of California. For our purposes, there is a law in place that prevents "nursing care" from occurring anywhere except in a nursing or medical facility. If you have ever experienced home-based nursing care, it is typically provided by an RN who is dispatched from a hospital or service to provide care because the client cannot get to the facility for some reason. This is still considered center-based care. And when all of the dialysis centers in the state were at risk of being closed down, it was also due to this law.
Another law allows a certain subsection of nursing care to be provided in "community-based" settings, but those setting are also facilities (read: buildings like an ADHC). These services are less invasive than what might be provided in a care facility--for example, no IVs can be placed, but trachs can be suctioned, ostomy bags can be emptied, catheters can be placed, etc.
A smaller subsection yet of that care can be handed off to non-nursing staff that has been formally trained by a RN or RT, while still within the facility. This allows for CNAs to do tube feedings and empty ostomy bags, for example.
It is this last subsection that controls school districts. School nurses can teach teachers and classroom aides to provide the services that most of our kids have received while in school--so that they don't miss educational time. They obviously leave the room for diaper changes, but most of the other services that they require were performed by non-nursing staff. It is also this subsection that has allowed San Diego Unified's TRACE program to operate. The teaching and support staff have been trained by the program nurse to provide the services that they do, which enabled kids like Cormac to be out in the community tearing around with his wheels on fire rather than stuck in one place without the stimulation he needs.
Now we come to The Wall.
That exemption for the care of school-aged individuals disappears once they reach the magical, terrifying, and abstract age of 22. No exemptions currently exist for the adult world. Which is why no programs like ITAV exist.
We have to change that.
I spent most of March and half of April researching (which is how I learned the above), and documenting each letter of the law. I've got pages and pages and pages of notes. Regional Center has refused to help me, even though they are obligated by law to do so.
The next step then, is to compile these data and present it to both the Department of Developmental Services and to my state representatives.
I have been away for the past two weeks--one week outside of Richmond, VA working my first race of the season and then Cormac and I headed north to my hometown of Lodi to visit friends and family. While there, I learned that the wife of a friend of mine is now working for DDS doing tech stuff, and was able to give me the names and contact info for all of the deciders and all of the branches in the DDS (that aren't anywhere to be found on their website!). Thank you, Universe!!
So after grocery shopping and laundry, I will sit down to start compiling and composing. My letter and request will go out to a handful of people at the DDS, my state reps, and every member of both the House and Senate Health and Human Services committees for California. If you know of anyone else that might help, please share! Because ITAV is a nonprofit, I am legally not allowed to lobby. I am, however, allowed to contact my representatives about injustices, and our community is being overlooked.
Onward!!
