Testimony Before the DC Council Committee on Health on the Public School Health Services Amendment Act of 2024

By Rachel Johnston, DC Charter School Alliance 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, 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.

Charter schools are committed to providing safe and healthy learning environments for the nearly half the District’s public school students they serve. For that reason, I’d like to start by thanking Councilmembers Parker and Henderson for introducing the Public School Health Services Amendment Act of 2024, which prioritizes access to health care at school, especially as our schools support communities where health conditions like asthma and diabetes regularly create attendance challenges. We appreciate the opportunity to collaborate with city leaders to ensure systems and structures meet the needs of all schools and the students they serve.

We are also grateful to the Children’s School Services (CSS) team and its leader, Dr. Boudreaux, for being a dedicated and collaborative partner. This program currently provides more full time health suite coverage than ever before, to 92 public charter schools. As a next step, we look forward to working with CSS to improve consistency of the same nurse or health tech staff in the suites, which is necessary to build strong relationships with students, parents, and school staff.

Finally we’d like to recognize DC Health for supporting schools' efforts in keeping students healthy by making requested changes to the immunization compliance system. It now more consistently provides schools the data they need to make targeted outreach to families, so together we can improve immunization rates.

We believe this bill, with a few adjustments, provides an opportunity to expand on the progress already made to serve students’ health needs while they attend school. My testimony today will focus on four key recommendations we believe can strengthen the bill and create a meaningful path to implementation.

Recommendations to Improve the Public School Health Services Amendment Act of 2024

First, we recommend adult charter schools be exempt from this bill. Adult schools are currently not eligible for the city-funded program through Children’s School Services, who we understand caps their services at age 21. These schools also operate differently. Adult charter schools naturally have different calendars and daily schedules than standard PreK-12 schools. They often have evening classes, and offer virtual, in-person, and hybrid options to serve the diverse needs of their adult student population. A far smaller percentage of adult students are in school buildings than PreK-12 students. This schedule is also counter to CSS’.

Our adult LEAs have independently put systems in place that support their students’ health needs. They offer ways for students to access routine care, and address chronic illness and emergency health needs. For example, Briya Public Charter School is co-located with Mary’s Center. The Next Step Public Charter School hires their own private nurse.

Second, we recommend adjustments for the implementation timing outlined in the bill. To ensure DC Health, CSS and charter schools have time to prepare, we recommend setting January 1, 2025 as the deadline for schools to notify DC Health of their interest to participate in the CSS program. We then recommend the 30 hour coverage requirement go into effect on August 1, 2025.

A runway is necessary. Generally, we’ve heard from schools that the health suite approval process is complex and can take up to two years to complete. Schools have expressed frustration that they receive inconsistent feedback from DC Health, which prolongs the process. And even after approval, the reality is schools then wait many months for staffing. We have 5 schools in that position now. These issues coupled with the 13 page checklist of health suite requirements (attached to my testimony) have made it prohibitive for many schools, including our smallest schools, to complete the process. We thus currently have 14 schools who pay for their own nurse. While we strongly urge DC Health to work with our schools to simplify this process, we also offer an additional option.

Our third recommendation is for the Council to add an alternative opportunity to this legislation for schools to access city-funded nurses: a grant program run by DC Health that would provide schools with funds to hire their own nurses. This grant program could be structured similarly to the DBH pilot for mental health clinicians, launched last fall. We’d like to thank DBH for creating this innovative alternative solution to staffing mental health clinicians. This type of program could create a pathway for compliance for schools whose buildings don’t support a health suite that meets all 13 pages of requirements. It would also relieve some of the pressure from the CSS program. We have several schools that would volunteer to participate in such a pilot if it were made available.

Our final recommendation is to further define the technical assistance outlined in the legislation so it meets schools’ needs. To support the everyday health needs of our students who are not at schools in the CSS program, our LEAs rely on technical assistance support.

Specifically, we believe the following technical assistance is most needed, some of which currently exists:

• Timely, priority access to training on health care systems and requirements (ex: DOCIIS II, Immunization Compliance Portal (ICP), Self Service Portal). This includes an initial orientation session.

• Our schools also need support navigating technical issues in real time, especially at key moments during the year. One example is in the fall when students are submitting their immunization records in compliance with No Shots No School. This includes assessing and entering health records into DOCIIS II.

• For the success of all models of care, whether in the CSS program or not, Administration of Medicine (AOM) training improvements to quality, efficiency, and access are essential. Currently, 377 school staff are AOM trained across charter schools. This demonstrates a high interest in ensuring many staff are trained to support student medical needs. However, the current training program restricts the number of staff who can participate due to capacity limitations. We recommend DC Health identify additional AOM trainers that schools could voluntarily engage to train more staff and add extra capacity.

Moving Forward

As always, charter schools value the health and well-being of their students. The DC Charter School Alliance is grateful for our partnership with the city. We welcome the opportunity for continued collaboration to ensure every student’s health needs are met so that they can actively and safely engage in learning.

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