Testimony Before the DC Council Committee on Health at the DC Health Performance Oversight Hearing

By Rachel Johnston, Chief of Staff

Good morning, Chairperson Henderson and members of the Committee. My name is Rachel Johnston, and I’m a Ward 4 resident and the Chief of Staff at the DC Charter School Alliance, a 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.

Keeping students healthy so they are able to attend school every day is paramount to their academic success. Missing school means missing learning time, and opportunities to build social skills and develop friendships, which contribute to students’ overall emotional well-being and success.

Nearly 3 million children ages 5-17 experienced chronic absenteeism for health-related reasons in 2022, according to the Centers for Disease Control and Prevention. And students living in low income households were about two times more likely to have experienced chronic absenteeism than their peers.

Our charter schools work hard to support students’ health so they can actively engage in learning in the classroom. We have reached over 95% compliance with student immunizations in key grades, thanks to the deep engagement with families across the city, and the collaboration between DC Health and OSSE, which has incorporated school feedback on immunization processes. This is a significant feat. In addition, 112 public charter schools have fully staffed health suites by Children’s School Services (CSS) or private clinicians.And there are 373 certified Administration of Medication (AOM) public charter school personnel.

Thank you to the Children’s School Services (CSS) team and its leader, Dr. Boudreaux, for being a collaborative partner. The CSS program is currently providing more full-time health suite coverage than ever before. I also want to thank Dr. Danielle Dooley and the Community Affairs Team at Children’s National Hospital for engaging school communities on a number of issues, including the mental health needs of our students. 

Additionally, we want to recognize the work that DC Health does to coordinate with health care providers, like Children’s, to stand up mobile and brick and mortar pediatric clinics at schools and in communities. Their efforts to run LinkU, an online portal that connects families to resources, like medical care, food, housing and more in the DC, is also a vital service for our communities.

And lastly, we express our appreciation for Chairperson Henderson and DC Health’s leadership in such a time of uncertainty, as there are discussions of serious cuts to the District’s Medicaid funding. We present this testimony today with this context in mind. 

While much progress has been made to bolster students’ health across the city, we would like to highlight additional opportunities to strengthen existing health care support to create healthy environments for all students.

Recommendations for Improvement Around School Nurse Staffing and AOM Training

We are eager to build on the success of our collaboration with DC Health, OSSE and CSS by continuing to strengthen health suite staffing and its connection to our school communities, as well as communications between schools and the health department. 

First, we recommend developing systems for improving retention to ensure greater consistency in staffing so that the same health staff are in the school health suites every day. We know retention is currently a challenge. We appreciate that CSS has invested in additional training for nurses to help tackle this challenge. Investing in additional retention strategies will help health suite staff build stronger relationships with students, parents and school staff.

Second, we look forward to working with DC Health to further clarify day-to-day operations within the health suite for school staff. This includes the differences between roles within the health suite, since the cluster model now staffs a variety of roles. Improving clarity on what certain positions can and cannot do will help school staff better engage with the health suite staff, so that students are able to get the care they need. Additionally, providing an annual training schedule at the beginning of each school-year and any updates as the school-year progresses that identifies when health suite staff will be absent from schools would allow schools to better plan for interruptions in staffing.

Third, there is currently a cap on the number of school staff who can be trained in the existing AOM program. This impacts the number of trained school staff who can administer medication to students. We recommend DC Health develop a list of qualified approved non-governmental AOM training providers that schools could utilize to add capacity on their own teams. This would go a long way in addressing schools’ needs for well-trained health staff.

Lastly, transparency and efficiency of the health suite approval process can be simplified and streamlined. As we’ve mentioned in previous testimony, schools have shared that the process for health suite approval is opaque, complex, and can take up to two years from application to approval. And upon approval, schools often wait many months for staffing. While we are pleased to share that five charter schools were recently staffed after this lengthy process, there is more that we can do in partnership with DC Health to make this process less onerous. 

Moving Forward

As always, the DC Charter School Alliance is grateful for our partnership with the city and the agencies and organizations we collaborate with to ensure the health and well-being of our students is always prioritized. Thank you for your time and attention, and I welcome your questions.