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

Mar 2, 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.

As always, charter schools are deeply committed to providing safe and nurturing learning environments for the nearly half of public school students they serve and the approximately 10,000 teachers, staff, and leaders who support them. We are grateful for the stronger collaboration and coordination we’ve seen between the Office of State Superintendent of Education (OSSE) and DC Health over the last few years to ensure our schools have crucial health supports, like COVID-19 tests, that keep their students safe and healthy amidst the pandemic. My testimony today will focus on two areas where charter schools are still facing challenges and ways we believe DC Health can better support them: (1) overcoming barriers in the school nursing program and (2) improving No Shots, No School systems and structures in light of lessons learned from this school year.

Overcoming Barriers in the School Nursing Program

Before I share some of the barriers schools have faced in the school nursing program, I want to thank the Children’s School Services (CSS) team and its leader, Dr. Boudreaux. She has been collaborative and gracious with her time, listening to our feedback and brainstorming solutions to our schools’ challenges.

We’ve previously testified that for the school nursing program to be effective, we need DC Health to provide greater clarity around what schools can ask nurses to do. We understand that DC Health is in the process of (1) updating the existing nurses’ manual that clearly outlines their responsibilities and (2) finalizing a concise 1-2 pager for easy reference that summarizes those responsibilities. We appreciate this and hope to receive an estimated timeframe for schools to receive these documents, ideally by June, so our leaders can plan for next school year.

Additionally, to ensure schools are able to provide basic nursing services, we need full-time nurses in every school to meet students’ health needs, which is a precursor to actively participating in learning. 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 CSS nurses, and many have no coverage at all. To fill these gaps, many of our schools are hiring or contracting with nurses with funds from their own budgets. We understand that one lasting impact of the pandemic is a nationwide nursing shortage, and we appreciate the great work that DC Health and CSS are doing to remedy this issue. While DC’s public charter schools are nimble, responsive, and innovative, they are not healthcare specialists and must rely on nurse support.

No Shots, No School

Similar to ensuring students’ basic health needs are met, charter schools care deeply about routine pediatric immunizations. They are fully committed to supporting their students with coming into compliance with No Shots, No School, which is evidenced by the increased student immunization rates across the city since last summer. We learned a lot this school year about what it takes to fully operationalize No Shots, No School. I want to elevate a major challenge for our schools and offer some next steps in overcoming it.

The multiple, unreliable data systems DC Health asks schools to use make an already heavy lift even more challenging. As we’ve testified previously, schools reported glitches and accuracy issues with reports from DC Health’s District of Columbia Immunization Information System (DOCIIS) 2.0, making it difficult to trust its validity. Ultimately, LEAs had to navigate several data systems, including a new 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. Since school leaders couldn’t rely on the DC Health’s systems, many maintained their own databases. This is an inefficient use of the time that they could have spent directly supporting students. Additionally, because these systems continue to report inaccurate data, publicly reported vaccine rates don’t truly reflect schools’ efforts.

Now that we know the current data systems’ weaknesses, we urge DC Health and partner agencies to take two important steps. First is updating these systems so that they report accurate compliance rates aligned with the city’s guidance. We were concerned to learn through a recent meeting that the District does not currently have a plan to update these systems for the next school year. We ask that system adjustments be made and it be online before July 1. That’s critical because the peak enrollment period for most schools is from April 1 to July 1, and LEAs and school nurses need to have accurate tools to determine vaccine compliance rates.

Second, given enrollment fluctuations at the beginning of the school year, we recommend the city advise schools to send notification letters to families whose children are subject to exclusion because of vaccine noncompliance after Count Day. This will provide schools with the time they need to review their students’ data and ensure their list of non-compliant students is accurate.

Moving Forward

The health and safety of our students will continue to be a top priority. We appreciate all the efforts that the city has made to address challenges schools face with nursing support and with implementing No Shots, No School, and we welcome 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.