DC’s Continuing Need For School Health Professionals

Next Thursday March 23, starting at 10 am, our city council will hold a hearing on legislation the council put forth in January to ensure every public school in DC has a full-time nurse starting at the end of 2017.

Sign up to testify here. More information on the legislation is here.

To say that this full-time nurse legislation is overdue is an understatement.

For years, DC public schools have rationed school nurses, after years of no budget increases for the school nurse contract.

While the DC Department of Health (DOH) has created staff training protocols to ensure that there are (non-nurse) adults in each school who can, in the absence of a school nurse, address pressing health needs of students, parents, teachers, and health professionals have repeatedly stated that this is dangerously insufficient.

Not surprisingly, right now not every DC public school has a full-time nurse—see DOH’s proposed charter school nurse staffing here and DCPS nurse staffing here, both of which were supposed to have started in January 2017.

Sadly, school nurses are not the only medical professionals that our public schools are going without at the moment—and possibly well into the future.

The city’s school behavioral health program is proposing changes to mental health professional staffing at each DC public school. The proposed plan (to be presented to the council March 30) would sprinkle the current 68 mental health professionals working in about the same number of DC public schools across all DC public schools.

Each year, DCPS and the DC public charter board determine which of their schools has the greatest need for mental health professionals, which are staffed accordingly. The proposed changes would mean that the clinically oriented mental health services currently in those high-need schools will end.

To ensure that those high needs would be met, the new model would encourage the use of outside mental health providers retained through the insurance of individual students in need—such as Medicaid.

At a council hearing in February, held by the council’s committee on health, many people testified how terrible this change would be for students with deep mental health needs. This prompted former mayor Vincent Gray, who was chairing the hearing as the new Ward 7 council member, to hold up a stack of printed-out emails and note that everyone he had heard from was in opposition to the changes.

Since then, a petition to the mayor and deputy mayors for education and health and human services (who oversee our public schools and the school behavioral health program, respectively) has been created, to demand that these changes not go forward, as they would effectively deny the direct mental health services that children most in need receive now in their DC public schools.

(See and sign the petition here.)

Weirdly, such apparent rationing of school mental health resources mirrors the efforts of DOH to not increase the number of school nurses, but simply spread them across more schools. Both efforts attempt to address needs in a community health model. But coming ahead of the mayor’s FY18 budget, due soon, such spreading of limited resources appears as much about each agency’s bottom line as it does good use of resources.

Even without the proposed changes, the promise of mental health treatment in DC public schools has never been fully realized.

Created in response to the horrific murders of four DC teens in 2010, the South Capitol Street Act of 2012 called for mental health professionals to be on staff in each DC public school by this school year.

But the initiative was never fully funded.

The result is that the staffing currently in place serves only 900 students at a fraction of the total number of public schools in the city.

The proposed changes mean that those 900 students would lose the in-school clinical coverage they currently have.

Ironically, Dr. Tanya Royster, the head of DC’s department of behavioral health (which oversees the school behavioral health program), testified before the council in February not only about an increasing demand in DC for mental health services, but also about the fact that mental health issues often arise during childhood.

In our current climate, when DC school children are vulnerable to immigration harassment as well as the trauma of poverty and violence, city leaders will need to step up and ensure all school health needs are well-met.

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