RYH Presents Report to the BOE: Improving Nursing Care in CPS, 2.27.19

At the February 27, 2019, unelected CPS Board of Education meeting, RYH delivered a parent research report entitled Improving Nursing Care in Chicago Public Schools: Creative and Meaningful Solutions Left on the Table. You can find the report here.

Below are the prepared statements from three RYH parents who delivered the report and explained the need for a complete overhaul of the CPS nursing design system. The fourth prepared statement below includes several questions from RYH on various CPS issues such as the ARA meetings, an overhaul of SQRP which hasn't involved parents, and implementation of a new IL CPS facilities law. 

You can find 3 videos of our speakers, plus a video of the CPS BOE and Central Office discussion after our 3 speakers here.

Joy Clendenning, CPS Parent and RYH Interim Executive Director

CPS parents with desperate concerns about alarmingly inconsistent and unreliable nursing care organized with Raise Your Hand and in good faith met four times with Dr. Keenan and other staff and administrators since September 2018.

We heard from parents struggling to get quality care for their children in three different areas, and tried to convey this and present solutions to CPS for an improved design system but did not get an adequate response.

Area 1: routine daily medical care, like for kids with Type 1 diabetes  – these kids often see a rotating crop of untrained, temporary agency nurses making dangerous mistakes and there’s no meaningful oversight or accountability.  

Area 2: emergency life-saving medications, like for students with epilepsy and other seizure disorders. We see that these kids often aren’t even getting nurses assigned for their care and many have “call 911” in their care plan.  Laurel Henson, who spoke at the October Board meeting and told you about her son who needs life-saving medication in case of a seizure still does not have anyone trained in the school to administer his medicine.  

Area 3: complex medical care, for students who need very skilled care, like those with feeding tubes and ventilators.  Parents like Guiller Bosqued at Wildwood elementary went a year and a half with no nurse assigned to her son. She missed work and sat at the school every day for a year and a half.

The most critical want of parents is to be able to rely on consistency of care and competency of care – neither of which are currently available for a lot of students.   

In October, CPS told us they would be developing a comprehensive plan to deal with the current dysfunction. Instead of taking on meaningful reform, you just went from one temp agency to multiple temp agencies -  a jaw-dropping blow after we told you how dangerously broken the current system of the use of temporary agency nurses is.

We’ve put our concerns and suggestions in a report, and ask that you urgently take on developing your promised comprehensive plan. A great start would be to create a new Health Care Aide position for every school. Other Districts in Illinois and other States have these positions to address the national nursing shortage. We don’t see it as a downgrade in care, but as a creative means to build consistency of care and actually meet student need by increasing the number of trained staff providing care.  

Catherine Diedrich, CPS Parent

My name is Catherine Diedrich, and I have two kids in CPS. Both my girls have Type 1 Diabetes and require nursing care. I’m here to talk about how deeply broken the CPS nursing system has become.  

The vast majority of nurses at CPS are temps provided by a staffing service.  This means that there might be a nurse at your child’s school, but there might not. The nurse might be someone who’s been there before, but they might not. The turnover rate is tremendous - we once had 23 different nurses over a four month period, in one school. That’s not unusual. Some schools have more.

The nurse assigned to the school may or may not be trained to provide the care your child needs. Parents can try to train the nurse and hope they’re up to the task, they can stay at school to provide the care themselves, or they can take their child home and hope the agency sends someone better tomorrow. Personally, I’ve done all three.

When my younger daughter was in 2nd grade, a nurse didn’t bother looking at the care plan or documentation. She overrode the insulin pump’s safety setting to give my 7 year old a massive overdose of insulin. The nurse didn’t even realize she’d done anything wrong.  

I got there in time, my daughter didn’t have a seizure, but we still couldn’t get a permanent nurse. The temp service isn’t accountable to CPS.

The nursing situation is so broken that they only way I was able to ensure this didn’t happen again was by filing a complaint with the Department of Education Office of Civil Rights. I couldn’t get a full time CPS nurse assigned to my child without getting the federal government involved.   

Parents have met with CPS, shared our stories and our ideas. We’ve looked at what other districts, even here in Illinois, are doing to meet student needs. There are districts with CNAs assigned to schools to handle daily medical needs like insulin, there’s health clinics staffed by nursing and PA students, there’s staff members trained to provide daily care. Parents want to work with CPS - we all have the same goal, to educate our kids and keep them safe while they learn. But we feel that the CPS must look beyond the current nursing system to fix the problem. These issues are not going to disappear, and every day we wait to address the nursing shortfall at CPS, more kids like mine are put in danger.

Danica Uzelak, CPS Parent

My type 1 diabetic child Anne has had 12 different nurses at school this year alone, some with absolutely no training, some who routinely go on break at the exact time Anne needs coverage and one who spent the whole day at the school and forgot to check Anne’s blood which left Anne with a critically high blood glucose. The next day, the RCM supervisor and principal pulled Anne out of class twice to tell her that she can’t forget about her diabetes.

No one has been able to tell me how the nurse was held accountable for not doing her job.

As a taxpayer, I am appalled at the broken system. As a nurse, I am disappointed by the lack of value CPS has for continuity of care AND competency of care.

In meetings with CPS and Raise Your Hand, I have concluded that there is a lack of accountability and lack of vision for something better. When pressed, CPS top officials could not tell us if they have any tracking system or historical data to show which schools have had voids in service. How can CPS contract with a company for millions of dollars and not know if the company is meeting their contractual obligations? They told us they handle calls on a day-to-day basis and redeploy nurses where necessary. Tripling down on the use of temps does NOT solve these problems.

We’ve provided the Board a report with recommendations for improving accountability. CPS is using unaccountable temp agency workers at 195 schools.

You should be collecting the same records for temp nurses as you do for CPS staff: Licenses, CPR cards, and health records.

You need to keep track of absentee rates and track service hours in a way that’s transparent. Where are your policies and procedures for medical conditions, and how are the temps proving their competency for their assigned job?

You need a team that has the ability to overhaul the current system and move to a system that prioritizes continuity of care, both by increasing your number of full time nurses but also hiring health clerks to fill in the many gaps at the school level as many districts in IL do.

At a minimum, you need to provide oversight and accountability of the 195 schools that are stuck with temp agency nurses and continually rotating staff.

Everyone here wants Chicago’s children to be healthy and well. We all have the same goal. The CTU, the parents, Raise Your Hand, and CPS. I am asking the Board to study our report and to provide a clear vision and strategic plan for nursing at CPS.

Andrea Tolzmann, CPS Parent and RYH Board Member

I'm Andrea Tolzmann, with Raise Your Hand. We have a few questions and comments today.

First, we know there were district representatives facilitating and taking notes at the small table discussions at the regional ARA workshops last fall. Some attendees received those notes. We would like to see all of the notes from these meetings and have them easily accessible on the CPS website. It is the input from these stakeholders that identifies what schools actually NEED to better support students. So, Mr. Johnson, could I please get ALL of the notes from ALL of the ARA regional workshops? I am happy to share my email address with you immediately following this statement.

Second, the new Facilities Law from August 2018, requires you to support under-enrolled schools. You rolled out an RFP process for programmatic investments last fall. At the time we questioned this approach. Now we learn that many under-enrolled schools did not even apply, and we’re not surprised -- they are so under-resourced, how were they supposed to find the time to apply? And of those that did apply, most did not move on in the process.  The school district is responsible for ALL the children in our schools. Why are you making children depend on school-by-school applications for the resources they desperately need? A truly equitable approach (and one that follows the law) would provide resources to those who need them most, not require individual schools to apply for them.

Third, we hear, that for 18 months you have been working on an update to the SQRP. When were you planning to involve, or at least inform parents and especially LSC members who are ELECTED to serve their schools, about this update?

Finally, the district’s FACE department has disseminated a parent survey asking us about transparency in CPS and how it can be improved. How about involving students, teachers and parents, those most impacted by these policies, from the beginning? That seems like a basic starting place.

Today we are one step closer to electing a new mayor who supports an elected school board, but your work here is not done. Improve district transparency by involving the people IN the school communities and talk to us about your plans. We can help find solutions that are what our students and our schools need.

Thank you.