Testimony Before the Council of the District of Columbia Committee on Health at the Budget Oversight Hearing on the Department of Health

Apr 10, 2023

Good morning Chairperson Henderson and members of the Committee. My name is Rachel Johnston, and I’m 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.

My testimony today will focus on three investments we believe DC Health can make to better support charter schools and the nearly half of the public school students they serve: (1) investing in full-time coverage in the School Nursing Program, (2) improving the No Shots, No School data systems to ensure they run efficiently and provide accurate data, and (3) expanding the Administration of Medication (AOM) Training to make it more accessible to schools.

Investing in Full-Time Coverage in the School Nursing Program

As we’ve previously testified, we have a severe shortage of nurses in charter schools that’s impacting the health and well being of students and school communities. We need full-time nursing coverage in every charter school to ensure they can provide basic health services. Despite the 2017 law requiring a nurse to be assigned to each public charter school for 40 hours a week, the vast majority 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 understand that one of the lasting impacts of the pandemic is a dire shortage of nurses, not just in the District but nationwide. To immediately address this shortage, we strongly recommend the District join the Nurse Licensure Compact (NLC), which will expand the pool of nurses immediately available for hire. Currently, 39 jurisdictions, including neighboring states Virginia and Maryland, are part of the NLC. Nine additional states have legislation pending to facilitate joining the national compact. DC is an outlier.

Additionally, we appreciate the School Nursing Program’s ongoing work toward creative solutions to staffing problems. We hope the result of this is consistent coverage and continuity of care  because having the same nurse serving the same school every day allows them to build relationships with students and families. It is also critical that these nurses receive explicit trauma-informed care training on working with adolescent students.

Investing in DOCIIS 2.0 Fixes To Resolve Inconsistent and Unreliable Data

Similar to helping students meet their basic health needs, charter schools remain committed to supporting student compliance with No Shots, No School. But as we’ve repeatedly testified over the last year, the multiple, unreliable data systems DC Health asks schools to use make this already heavy lift more challenging. Schools reported glitches and accuracy issues with DC Health’s District of Columbia Immunization Information System (DOCIIS) 2.0, making it difficult to trust its validity. We also learned that systems used by some primary care physicians to track immunizations are not properly feeding DOCIIS 2.0. Ultimately, LEAs had to navigate several data systems, including a Salesforce reporting tool, as they worked to ensure compliance with No Shots, No School. None of these systems had complete or totally accurate information, which OSSE and DC Health recognize, because they are not designed to reflect compliance rates that align with the guidance the city has issued.

We strongly urge DC Health and partner agencies to invest in updating these systems now so that they report accurate compliance rates aligned with the city’s laws and guidance. School staff and nurses need to have accurate tools to determine vaccine compliance rates, and addressing these weaknesses now can help prevent similar struggles from happening next school year.

Given the shortage of nursing staff and challenges in fully implementing No Shots, No School, we also urge OSSE to continue funding Patient Care Technicians (PCTs) for next school year. PCTs provide schools with the technical support they need to ensure students receive all their vaccines and that paperwork is logged, which helps keep students healthy and in school.

Investing in the Efficiency and Expansion of Administration of Medication Training

Third and lastly, we appreciate the steps taken in recent years to streamline the Administration of Medication (AOM) Training for schools, including moving a significant portion of the training online to make it more accessible. This training is critical in making sure school staff are adequately trained to administer life-saving medications to students. As DC Health continues to further refine the program, we want to make sure it can train even more staff. That’s why we encourage the Council to support new investments that improve the AOM Training program’s efficiency, while expanding the training frequency, so that more school staff can participate.

Moving Forward

Charter schools value the health and well-being of their students first and foremost. It is because of this that we advocate for these investments. As always, the DC Charter School Alliance welcomes the opportunity to collaborate 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.