Testimony Before the DC Council Committee of the Whole at the Hearing on School Nurses and Bill 25-278, “School Student Vaccination Amendment Act of 2023”

By Rachel Johnston, Senior Director of Operations and School Support, DC Charter School Alliance

June 22, 2023

Good morning Chairman Mendelson and members of the Committee. My name is Rachel Johnston, and I’m a Ward 5 resident and the Senior Director of Operations and School Support at the DC Charter School Alliance, the local non-profit that advocates on behalf of public charter schools to ensure that every student can choose high-quality public schools that prepare them for lifelong success.

I want to begin by thanking the Children’s School Services (CSS) team and its leader, Dr. Boudreaux for being a collaborative partner with charter schools. We’re also grateful to DC Health for sharing a two-pager that outlines roles and responsibilities, providing greater clarity around what schools can ask nurses to do. This will help charter schools as they plan for next school year.

I’m here today to share our appreciation for the effort we’re seeing to address nursing staff shortages in our schools and the commitment to provide 40 hours of health suite coverage as a part of the new school nursing program model that Children’s Hospital and DC Health have teamed up to propose. My testimony today will focus on a few key recommendations we believe can strengthen the new staffing model to better support charter schools and the nearly half of the public school students they serve.

Support for the School Student Vaccination Amendment Act of 2023

Before I dig into those recommendations, I want to share our support for the School Student Vaccination Amendment Act of 2023. Charter schools have encouraged and will continue encouraging parents to vaccinate their children against COVID-19 because they understand the public health benefit. However, we are in a different place now with the pandemic. The District has ended the Public Health Emergency and is no longer undertaking a citywide effort to promote these vaccines. Keeping this vaccine requirement means more students will be subject to exclusion from school. Excluding students from school not only impacts their academic performance, but also suspends their access to incredibly important wraparound services – things like after-school programming, meals, and vital mental health services. We must do everything we can to help students recover academically, and that means ensuring they are in the classroom every day.

Recommendations to Improve the New School Nursing Program Model

I’ll focus the rest of my testimony on the new school nurse staffing model. As we’ve previously testified, the vast majority of charter schools lack full-time coverage from the School Nursing Program, and many have no coverage. Many schools have had to hire or contract nurses with funds from their budgets to fill the gaps. We’ve called for full-time nursing coverage in every charter school to ensure they can provide basic health services because the severe shortage of nurses in charter schools impacts the health and well-being of students and school communities.

That’s why we appreciate the School Nursing Program’s ongoing work toward creative solutions to staffing problems that aim to provide consistent coverage and continuity of care. However, we want to share a few key recommendations that we believe will strengthen the program.

First, it’s critical that LEAs have a full understanding of how the staffing model will work and have the opportunity to ask questions before it goes into effect. This new staffing model proposal hasn’t yet been widely circulated and discussed with charter school leaders. DC Health hosted a session in May to discuss the new model, but our understanding is that leaders who were unable to attend have not yet received the materials or a recording.

Second, it’s important all students receive the care they need in any and all circumstances so training and process design is key. We understand this model is structured so that each school will not only have access to full-time nursing coverage, but will have the same staff consistently covering the same school. That’s something charter schools have called for, and we’re grateful for that consideration. However, to provide that full-time coverage and continuity of care, this model uses a team-based approach that will rely on nurse techs to fill in the gaps when an RN or LPN isn’t on site. We hear each school’s health suite will have telehealth equipment so that health techs can easily and immediately call an RN if they need help. We appreciate the creativity of this solution and believe it has potential to alleviate many of the problems charter schools may face.

However, we want to ensure that not only are these health techs properly trained, but the roles and responsibilities of both health techs and nurses are fully detailed and communicated with schools before the staffing model is implemented. That also includes detailing a series of processes and steps that health techs must take if a nurse is needed and the health tech cannot meet the need.

Third, we seek transparency with how staff are assigned to health suites. For example, how will it be decided which clusters receive additional staff or which schools in the cluster receive the nurses vs health techs? We understand ‘high-risk needs’ are a factor, but it would be helpful for schools to get clarity on what this means.

Finally, as schools will no longer have the support provided by OSSE’s patient care technicians (PCTs) program, we want to ensure that schools have the support they need to implement No Shots, No School and help students get into compliance this upcoming school year. Schools are relying on their nurses to fill this gap.

Moving Forward

As always, charter schools value the health and well-being of their students first and foremost. The DC Charter School Alliance is grateful for our partnership with the city and welcomes the opportunity to continue collaborating to make sure every student has their health needs met so that they can actively and safely engage in learning.

Thank you for your time and attention, and I welcome your questions.