[updated: see 9/23/16 update below]

The school nurse situation as we DC residents have known (and loved/hated) it will be no longer come January 2017, barring changes by the mayor and/or council.

Specifically: January is when the current contract for school nurses will expire. A new plan will provide what is effectively 1/2 nurse per public school, both charter and DCPS. The previous model had a required minimum of one full-time nurse in every school.

The DC Department of Health (DOH), which oversees all nurses in all public schools in DC, has indicated it wants a less clinically oriented model for school nurses, with schools staffed according to need (as determined by DOH) and a broader look at community health. The proposed new system will be funded by grants–and remains unexplained to, and unseen by, the general public (and, according to my council member’s office, unseen by the council as well).

For a city filled with low-income children with persistent and urgent medical issues like asthma, ensuring a whole community health system in public schools seems reasonable enough–except that absent some increase in funding, it will mean, effectively, that relatively few schools will retain the nursing coverage they already have.

As it is, it’s not like we’re doing well in the full-time school nurse category: every year recently, several public schools in each ward and in each sector (charter and DCPS) have been the unlucky recipients of nurse rationing, such that they lacked a full-time nurse (or, in some cases, had no nurse at all).

In this new plan (as is currently the case at those schools lacking a full-time nurse), regular school staff who have received four days of special training will step in to cover any medical situations that arise in the absence of a nurse on site.

All of this raises the question of why this community health model, as opposed to actually fully funding the existing school nurse contract, is being done: to ensure better care, or to ration and stretch the care we already have while not spending more money?

There appear to be no ready answers.

Last week, DCPS’s Heidi Schumacher, who oversees that system’s student wellness programs, presented the Ward 4 education alliance a first look at this new system of school nurses in DCPS. A summary of that meeting shows that parents had many concerns with lack of transparency in this process and the fact that what appears to be a different outlook in nursing coverage will effectively mean a loss of resources for most schools.

[updated 9/23/16] According to Cathy Reilly (one of the leaders of the Ward 4 education alliance), Dr. Schumacher had [on 9/22/16] noted that “parent letters on the new program are in the works, and we are working with our agency partners to finalize details on [future] community engagement meetings. Letters and meeting details will be translated and shared with families as soon as available.” Schumacher also noted [on 9/22] that the Ward 4 Ed Alliance queries [detailed above] were shared with DOH staff, and that the agency is “working to finalize a one-pager on school-based health centers including information on vendors, scope of services, etc. that we will share with school leaders to distribute to families.”

In the wake of that fateful Ward 4 Ed Alliance meeting, Ward 4 parent Joshua Hertzberg wrote a letter to DC public officials demanding a better plan for nurse staffing, noting that in a city filled with low-income children, a medical emergency at school is not at all easy for low-income parents to cover in the absence of quick and expert medical coverage at the school itself–not to mention that there appears to be no commensurate additional funding (or even time!) to cover the additional duties regular staff will now be expected to perform.

In addition, the Washington Teachers’ Union (WTU) has asked for a hold to the entire process of changing the school nurse contract, since there has been very little public knowledge of the new rationale (and rationing), much less public input into its creation. A quick question to the school nurse at my daughter’s school earlier this week, for instance, made it clear that the nurse had no idea what is going down in January.

As it is, for the last month, I have tried–and failed–to get from DOH a list of charter and DCPS schools that currently lack a full-time nurse. (My request is apparently as popular as the flu.)

Happily, the head of the WTU, Elizabeth Davis, has asked parents, teachers, and staff to let her know what the current nurse staffing of their public schools is. Davis has released the WTU nurse survey results in DCPS. (To contact her to report your school’s nurse situation, call 202-957-3119 or 202-517-0727.)

In the meantime, it’s not clear what, if anything, the charter board is doing for advocacy on this issue, although Scott Pearson, the head of the charter board, testified before the council this spring that the city would no longer have school nurses come 2017.

While I have wished that some public official somewhere would have explained before now that (otherwise completely unexplained) statement, the school nurse situation in DC has grown increasingly embattled over time.

Namely, the creation of more public schools and a lack of an updated (and more fully funded) nurse contract for nearly the past 10 years has made a full-time nurse in each school an increasingly stretched resource.

And as DC goes, so does the nation, apparently:

A few years ago, a child died after suffering an asthma attack in her public school on one of the days her school’s nurse was not on duty. Less than a year later in the same city, another child died at his public school after suffering a medical emergency–again, when there was no school nurse on duty.

Budget cuts were blamed for the lack of school nurses in both cases.