Improving Nursing Care in Chicago Public Schools: Creative and Meaningful Solutions Left on the Table

This RYH research report and summary of several meetings with CPS, entitled Improving Nursing Care in Chicago Public Schools: Creative and Meaningful Solutions Left on the Table, was delivered to CPS at the February 2019 monthly meeting of the CPS Board of Education.

You can find the full report here- it is downloadable, printable, and contains links to resources.


Executive Summary

A group of CPS parents organized through RYH (the RYH Nursing Group) has been meeting regularly with CPS Administrators from the Office of Diverse Learner Supports and Services (ODLSS) since September, 2018, to discuss the current alarmingly inadequate, inconsistent and unreliable level of nursing care available for many students with medical care needs in CPS (see Attachment A, Members of RYH Nursing Group). Our hope in requesting these meetings was to shine a light on the ways parents see the current system putting our children at risk and to provide recommendations to improve the quality and consistency of nursing care in CPS. At each meeting, the RYH Nursing Group provided numerous suggestions for new ways that CPS could manage nursing services and improve care. In October, CPS personnel assured these parents that they would be releasing a plan in December that would address the parent concerns about the competence of nurses and the need for continuity of care.

The plan provided after the meeting in December of 2018 consisted of increasing the budget for temporary nursing services by $26M and increasing the pool of temporary agency nurses. The RYH Nursing Group fears that the use of temporary agency nurses will remain a resounding failure. The budget may increase, but CPS will continue to have no meaningful oversight or assurance of competency, accountability or placement of non-CPS nursing staff.

RYH Nursing Group’s Concerns Regarding CPS’ Delivery of Health Services to Students

  1. Lack of nurse leader(s) at the high administrative level
  2. Failure to notify parents that their child may be entitled to a 504 Plan and in-school nursing services
  3. Untrained and/or temporary agency nurses
  4. Absence of a nurse or another qualified staff member to provide nursing care
  5. Failure to notify parents of the absence of a nurse
  6. Inconsistency in staffing
  7. Improper assignments
  8. Lack of communication between all entities (CPS, RCM, Parents, etc.)
  9. No meaningful oversight of temporary agency nurses
  10. No guaranty of competency of temporary agency nurses
  11. No clear process for resolution of complaints
  12. Inconsistent support from administration
  13. Lack of creative solutions around staffing
  14. Inadequate pay for qualified nurses
  15. Inadequate pay for nurses providing acute care
  16. Unreasonable travel time between schools for Certified School Nurses (CSN)
  17. No formal process for making parents aware of their rights under the law
  18. Lack of transparency surrounding temporary agency nurse training and competency


RYH Nursing Group’s Recommendations to Improve Nursing Care in CPS

  1. Create a supportive environment for the delivery of nursing services
  2. Create a culture of inclusion for students with medical needs in schools
  3. Provide appropriate training for all nursing staff on specific tasks related to specific medical conditions
  4. Deploy appropriately trained nurses to deliver medical care to students with specific medical conditions
  5. Provide appropriate training for all nursing staff on new medical technology and devices in use by students in CPS
  6. Create a formal CPS process to inform parents when healthcare staff fails to appear at their assigned school
  7. Create a formal CPS process for parents, students, school staff and administrators to file complaints about nursing care or temporary agency nursing staff
  8. Create accountability measures when a nurse from a temporary agency fails to appear at their assigned school
  9. Create accountability measures when healthcare staff does not follow protocols
  10. Deliver nursing care with a “least restrictive environment” model and minimize disruptions to learning
  11. Provide continuity of care so nurses providing direct care can become knowledgeable about specific student needs and build trust with individual students
  12. Provide adequate staffing by qualified and competent personnel
  13. Create a new position of a healthcare manager/ liaison/ facilitator to coordinate care
  14. Create a system that ensures nursing staff has access to, time to review and are following orders in IEP and 504 Plans
  15. Develop training for nursing staff around the social-emotional challenges for students with medical needs
  16. Expand the Diabetes Care Aide role in schools
  17. Contract at a higher and stratified level of pay with individual agencies that are currently staffing home health care for Medically Fragile and Technology Dependent (MFTD) students and identify a pool of backup nurses trained to deliver these high levels of care
  18. Create a new “Health Care Aide” (HCA) position in every CPS school to provide routine daily medical care, minor first aid care, maintain immunization records, pursue immunization compliance and assist CSNs in preparing required documentation
  19. Hire a Systems Design Manager to redesign CPS’ nurse training and deployment system to include HCA position and oversight of temporary agency nurses


You can read the full report here.

Here are direct links to the appendices shared in the report:

Attachment A

Members of RYH Nursing Group

Attachment B

MFTD Waiver Families: CPS Nursing for Children  who are Medically Fragile and Technology Dependent

Attachment C

Nurses assigned to CPS students still sidelined, awaiting background results, Chicago Sun-Times, dated 09/09/2018

Attachment D

Parent group, teachers' union decry CPS nursing deficiencies, ABC 7 News Chicago, dated 09/24/18

Attachment E

CPS Press Release, dated 6/24/2015: New CPS Nursing Contract To Improve Efficiency in Services and Better Meet Student Needs

Attachment F

CTU Report on Nursing Services at CPS, dated 02/24/2016.)

Attachment G

List of Other Illinois Districts Utilizing Health Care Aides in Schools

Attachment H

List of other States Utilizing Health Care Aides in Schools

Attachment I

Illinois Council of School Attorneys Answers to FAQs Care of Students with Diabetes Act

Attachment J

Attachment J, CPS Policy Manual Administration of Medication Policy Section: 704.2, Board Report: 12-0125-PO2, Adopted: January 25, 2012


You can read our prepared statements for the CPS BOE meeting here.

You can watch videos of our speakers PLUS the CPS BOE and Central Office response to the speakers here.