School Nurses: Three Years (And Counting!) of Short Staffing

On January 10, the chair of the council education committee, David Grosso, introduced legislation to ensure that the minimum staffing level for nurses at each public school in DC would be 40 hours per week.

Suffice it to say that this would be a sea change in our city.

Hopefully, the new legislation will include a council hearing (or two) on school nurses, to shine some much-needed sunlight on the issue–as well as the data on which nurse staffing decisionmaking is based.

For the latter, here are some quick numbers on school nurse staffing I gleaned from nurse staffing datasets (links below) I obtained in part via FOIA from the DC department of health (DOH), which administers all school nurses in DC public schools:

School year 2014-15:

DCPS: 110 schools; 30 w/o FT nurse (27%)
Charters: 48 schools; 14 w/o FT nurse (29%)

School year 2015-16:

DCPS: 112 schools; 16 w/o FT nurse (14%)
Charters: 57 schools; 12 w/o FT nurse (21%)

School year 2016-17:

DCPS: 113 schools; 49 w/o FT nurse (43%)
Charters: 62 schools; 28 w/o FT nurse (45%)

Proposed January 2017:

DCPS: 110 schools; 19 w/o FT nurse (17%)
Charters: 61 schools; 14 w/o FT nurse (23%)

Here are the documents those stats are based on:

2014-15 nurse staffing for charter schools and DCPS

2015-16 and 2016-17 nurse staffing for charters and DCPS

Missing page of Ward 1 charter school data for 2016-17 from dataset above

For DOH’s proposed nurse staffing starting this month (Jan. 2017) and going forward, click at the following links for DCPS and charter schools.

In my quick stats above, I counted any staffing listed as less than 40 hours per week to be not full-time.

But more than a superficial glance reveals a few issues with these datasets:

–Each school year has a different total of schools. This is not on its face surprising, given that every year, we are closing on average 5 public schools (see footnote 9 at the link) and opening uncounted numbers of new ones. But this churn of schools does make accounting for nurse staffing a bit more difficult. After all, the nurse contract is a set budget for a period of many years. The same money has to be spread over a larger pool of schools if that number grows–even as this is de-coupled from the number of students (you could, for instance, have a stagnant or even declining number of students and still have a growing number of schools). Given that our school growth has outpaced our growth of students (see footnote 10 at the link here), that differential could be a factor in the rationing of school nurses that the statistics above show.

–DOH appears to have varying ways of accounting for schools and nurses by each school. For instance, the charter school data for 2015-16 shows the KIPP DC Blaine campus (at 5300 Blaine Street NE) with three different schools, with three different grade levels served in three separate groups. However, it has one nurse listed, for 40 hours a week. Did this nurse serve all three campuses/schools? Or just one?

–The charter school dataset for the next year, 2016-7, shows what appears to be that same KIPP campus—at 5300 Blaine St. NE—but lists it as KIPP DC Smilow, with one nurse and one set of grade levels. This is not the only school, or dataset, with such an apparent discrepancy between school years. It may mean nothing–but it is impossible to know from this data alone. Moreover, enrollment totals in such potentially complicated situations do not appear to adequately account for the actual enrollment at each separate campus. Again, this KIPP school at 5300 Blaine St. NE is instructive: the listing for 2015-16 shows three sets of enrollment figures, whereas the listing for 2016-17 shows one.

–Similarly, DCPS’s Bell high school is listed in the 2016-7 stats as having a nurse for 40 hours a week—with a note that it is co-located with Lincoln middle school. The list then contains a 40-hour-per-week nurse for Lincoln. Is that the same nurse? Or a different one? Bell is not alone in such co-location—but in no case is it clear whether the nurse listed as 40 hours per week serves both co-located schools or just one.

–Both the 2015-16 and 2016-17 datasets have charter schools listed as being in Ward 3. This is incorrect, as there are no charter schools in Ward 3–and the addresses listed for those schools put them well outside Ward 3. It also makes calculating the by ward rationing more difficult, if not impossible—even though in the past DOH has attempted to ensure that the burden of not having a full-time nurse is shared across wards. For instance, below is a list of part-time nurses for DCPS schools in school year 2013-14 that I obtained years ago (and have been unable to obtain for school years since):

Ward 1 – HD Cooke, Lincoln Campus (part of CHEC), Adams Campus (part of Oyster-Adams)
Ward 2 – Ross
Ward 3 – Hearst, Mann
Ward 4 – Powell, Truesdell, West
Ward 5 – Dunbar
Ward 6 – Watkins
Ward 8 – Simon

–The datasets I obtained and linked above are PDFs of scans and thus not searchable (at least by me) in their current format. I have thus presumed that there are no duplicate listings (either within wards or between wards)—but this may be an unfair presumption. (Also, when I received the datasets, there was a page missing from this year’s Ward 1 charter school listings. I requested it again, received it, and have added it to the links above.)

–The proposed listings of nurse staff starting this month (January 2017) do not list schools by ward nor give their enrollments.

–There is no analysis of the ratio of enrollment to nurse staffing hours at each school. This is necessary, however, not merely because we the public do not have any deep insight into DOH’s decisionmaking in this regard, but also because schools with large populations; medically fragile populations; or a combination of both may need more than one full-time nurse, even if the minimum standard is 40 hours per week.

All of this is to say that having a 40 hour per week minimum for school nurses is a great start for equity and student safety.

But it is still just that: a start.

What remains is sussing out the lack of clarity in these datasets and DOH’s relationship with the public that agency serves.

In this, we can begin with basic tenets of democracy:

Those datasets for 2015-16 and 2016-17 above took me nearly half a year to obtain. After I unsuccessfully requested them from the council committee on education; my council member; the education ombudsman; OSSE; and DOH, I obtained them the other day via FOIA from DOH. For me, they are neither easy to read nor easy to search.

I find it hard to believe that either is true for DOH or the other city agencies that depend on these data.

In this, and most especially going forward, we need to let the sunshine in.

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