Hey, Council: Why Can’t DC Do What Pediatricians Recommend And Have Full-Time Registered Nurses In Each Public School?

Today, at 2 pm, in room 123 of the Wilson Building (1350 PA Ave. NW), the health committee of our city council will be marking up some version of legislation to provide for 40 hours per week of health care coverage in each DC public school.

But exactly what version, and what health care coverage, remains unknown.

There are several versions of this legislation, all of which provide for some sort of rationing of school nurses.

But the latest draft from the health committee (see here) is much simpler than any in the link above and makes a firm and clear commitment for 40 hours per week per school of registered nurse coverage. This follows directly from a recommendation by the American Academy of Pediatrics for full-time registered nurses in every school as a matter of safety for all children.

So: if it is important to you that each of our public schools has a 40-hour-per-week registered nurse, be sure to call these members of the health committee TODAY:

At Large: David Grosso: 202-724-8105; dgrosso@dccouncil.us
Ward 1: Brianne K. Nadeau: 202-724-8181; bnadeau@dccouncil.us
Ward 3: Mary M. Cheh: 202-724-8062; mcheh@dccouncil.us
Ward 4: Brandon T. Todd: 202-724-8052; btodd@dccouncil.us
Ward 7: Vincent C. Gray: 202-724-8068; vgray@dccouncil.us

And you might also consider signing this petition and attending a town hall on October 11 to lobby for full-time registered nurses in all DC public schools.

A little background:

For years, our public schools have made do with a patchwork of registered nurses and others filling in for them, because while emergency legislation passed last year (which expired the other day) demanded full-time coverage in each school, that goal has been pathetically unfulfilled in DC.

Some city officials cry that it’s a budget issue. Others say it’s due to a shortage of registered nurses in DC. And yet others say that chronic mismanagement of school nurses by the city’s department of health has resulted in nurses leaving and none wanting to take their places.

And then there are those who think that not having a full-time nurse in every school is simply a great idea!

Regardless of ideas, in a rich city like ours, there really is no crying about money, especially for something relatively inexpensive like this, so the rationing of school nurses is a political football, first and foremost.

(Of course, adding to the political aspect is simply getting current nurse staffing information. After asking for this from the council and getting nowhere, I probably will have to request it again by FOIA from the department of health, whose website has only proposed staffing.)

Ironically, exactly what are the budget implications of any school nurse staffing model remain unclear. The original nursing legislation, from January, and a more recent version both mandate 40-hour/week nursing coverage in each public school.

But the actual mandate in those proposed laws is really only for 20 hours/week of a registered nurse, with a “health professional” (who is not a registered nurse, but defined in the legislation) filling in the rest of the time. As far as I have been able to see, the main difference between these versions is that in one, the department of health is explicitly given the power to determine which schools get 40-hour-week registered nurses versus 20-hour-week registered nurses.

While that power shift registers as a clear “gimme” to the department of health (and thus the mayor), the rest is as clear as mud:

–All school health personnel are no longer paid via a contract with Children’s Hospital, but by grants. This means that school nurse funding is way more politically fungible than before—and thus control by the department of health may be more of a power issue than delivery of better care. In this, consider that Hyesook Chung is the author of a report issued by DC Action for Children that recommended just such rationing—and shortly thereafter became the deputy mayor for health and human services, which oversees the department of health. Coincidence?

–Also consider that Chung donated $1000 to David Grosso in 2016–significantly more than she gave to any other council member. Is that reason for the apparent deference given to Chung’s department of health in the education committee versions of the bill, which Grosso shepherded?

–That old school nurse contract had been allowed to operate for many years without any updating or budget change—all the while DC approved many new (mainly charter) schools. The result has been widespread shortages of school nurses. To what extent the new grants actually make any difference in that funding shortfall and the shortages is not clear, although the shortages persist this school year.

–The department of health has argued that rationing of school health personnel is a better use of resources than granting registered nurses outright to every public school full-time. But what/whose resources: the money that the department gets or the nurses themselves and the care they provide?

–One version of the bill that implements rationing of some sort allows unlicensed professionals like medical assistants and techs to do the work of registered nurses. That appears a short step away from the prior work-around, which was to have regular DCPS staff—you know, the people in the front office, teachers, janitors, etc.—undergo a few hours of training to stand in for a registered nurse.

Sadly, even something seemingly as clear-cut and wholesome as providing a full-time registered nurse in every school cannot be free of horse-trading:

The committee report on this legislation makes clear a rift between David Grosso, who chairs the education committee that originally handled this legislation, and council chair, Phil Mendelson, who has since moved it to the health committee.

Expect lots of fireworks.

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