School Health Care Realignment of Services

Stan Jester
Board Of Education
District 1

On Thursday Oct 1, ten(10) school nurses across the district were given two days notice they were being transferred to other schools.
I asked Superintendent Stephen Green to help us understand the guidance the district used to make these recent school nurse reassignment decisions.
Elementary Schools affected are: Bouie, Fairington, Kittredge, Vanderlyn, Oakcliff, Huntley Hills, Columbia, Oakview, Briarlake, and Hawthorne.  Reaction by the communities and many nurses:

DeKalb County Seal Logo

Parents angered over reassigned school nurses
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School Council Letters To BOE

Board Discussions About Nurses

March 2, 2015 note from Michael Thumond (Superintendent)
Based on feedback from the last Board of Education meeting, a revised proposal was developed that includes possible timeline for implementation, comparison of neighboring district service models and three options for consideration by the board. Please find the proposal attached at  Student Health Services In Schools Revised Proposal.pdf
Laws, Rules And Policy

Dr. Stephen Green sent this out Friday Oct 9:

Subject: School Health Care Realignment of Services
By: Superintendent Stephen Green

I have approved the realignment of health care services for students based on the need to have a registered nurse in place for students who have specific health care needs, i.e., diabetes, seizures, etc. This is with the understanding that there may be exceptions but any exceptions will be treated as such and will be addressed on a case-by-case basis. While we understand and appreciate the relational impact of this decision, priority has been given to our students and their health care needs.
School Health Care Realignment of Services
Some diabetic students in the DeKalb County School District were not being served in accordance with district practices. The practice as implemented in 2004 was to ensure that every student with diabetes was supported by a licensed nurse during the entire instructional day. In addition, the District ceased hiring additional School Clinic Assistants in 2004 and only hired licensed nurses to support the growing health care medical needs of students.
As directed by the BOE and Superintendent in FY2014 and FY2015 the administration assessed the current level of services for all students throughout the District. In our assessment we found that there were diabetic students in elementary schools without a licensed nurse. In these settings, nurses from neighboring schools had to be pulled for approximately 2 or more hours per day for support including insulin injections; leaving their respective locations unsupported. In addition to our audit, the Board of Education approved the addition of 5 nurses to support the middle and high schools for FY2016.
A plan was developed utilizing 2014-2015 as well as current 2015-2016 school enrollment data; along with a comparative analysis of practices in place in neighboring districts. Additionally, we reviewed state regulations regarding nurses and determined that the most viable solution was to continue with our current practice of ensuring that every student with diabetes was supported by a licensed nurse during the entire instructional day. This was predicated on the concerns of the District regarding insulin injection, incorrect dosages, corrective equations, interpretation of medical orders, school nurse best practices and the continuity of care.
The plan was shared with the Superintendent and permission was given to move forward. From our assessment, there were 5 elementary schools with students with a diabetic diagnosis or insulin dependent that were not being served during the entire instructional day by a licensed nurse. As such, the following plan was initiated;

  • On September 3, 2015 all school health personnel attended a meeting
  • During this meeting a 3 tier plan was discussed
  • The plan included reassignments based upon the needs of all students in the District;
  • Hiring of nurses to support the middle and high schools;
  • Providing opportunities for unlicensed personnel to earn Certified Nursing Assistant (CNA) credentialing by August 2017; and
  • The District went further to develop a collaboration with DeKalb High School of Technology South to develop the training for current non-licensed staff.

The selection method was based upon the proximity of staff within the Region, essentially wanting to keep staff as close to the current location as possible.
While the District understands that no person truly desires to be reassigned or leave their current location, we must do what do what is in the best interest of students. We are saddened that some have elected to end their service abruptly due to this reassignment; however, pursuant to BOE policy employees work assignments are at the discretion of the Superintendent according to the best interest of the District.
Moving forward we have already posted the 5 nurses positions added to the FY2016 budget for MS and HS and expect to interview candidates by the end of the week. Additionally, we will work with schools where the staff elected to resign abruptly to get the positions advertised for replacement and District licensed personnel will be in place to support the schools.


Certified Nursing Assistant
A certified nursing assistant, or CNA, helps patients or clients with healthcare needs under the supervision of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN). Also known as a Nursing Assistant (NA) a Patient Care Assistant (PCA) or a State Tested Nurse Aid (STNA), the individual who carries this title needs strong work ethic and ability, but issues of liability and legality prevent CNAs from performing certain procedures.
Role of the CNA
Your regular responsibilities as a nursing assistant will vary based on where you work or live. Nursing assistants can work in a wide variety of settings; nursing homes, hospitals, adult day care centers, personal homes and assisted living facilities all require nursing assistants to act as a helpful liaison between the RN or LPN and the patient. In many cases, the nursing assistant serves as the RN’s or LPN’s eyes and ears, and relays information between many patients and one or two RNs.
Medical Assistant
medical assistant is an allied health professional that supports the work of physicians and other health professionals, usually in a clinic setting Medical assistants perform routine clinical and administrative duties under the direct supervision of a physician or other health care professional. Medical assistants perform many administrative duties, including answering telephones, greeting patients, updating and filing patients’ medical records, filling out insurance forms, handling correspondence, scheduling appointments, arranging for hospital admission and laboratory services, and handling billing and book keeping. Duties vary according to laws of the jurisdiction and may include taking medical histories and recording vital signs, explaining treatment procedures to patients, preparing patients for examination, and assisting during diagnostic examinations. Medical assistants collect and prepare laboratory specimens or perform basic laboratory tests on the premises, dispose of contaminated supplies, and sterilize medical instruments. They instruct patients about medications and special diets, prepare and administer medications as directed, authorize drug refills as directed, telephone prescriptions to a pharmacy, draw blood, prepare patients for X-rays, take electrocardiograms, remove sutures, and change dressings. They also facilitate communication between the patient and other health care professionals.
Registered Nurse
A registered nurse (RN) is a nurse who has graduated from a nursing program and met the requirements outlined by a country or state licensing body in order to obtain a nursing license. An RN’s scope of practice is determined by local legislation governing nurses, and usually regulated by a professional body or council.

5 responses to “School Health Care Realignment of Services

  1. HeartlandHeartbeat

    Looks like Green’s pat phrases, “laser-like focus” and “resources matched to needs” — got put to the test and shown to be just PR cliches. He is not a strategic thinker, nor a problem-solver. Green is a reactionary who relies upon verbosity to “dazzle ’em with BS”.
    What he is “reacting to” now is a COMPLIANCE problem with the feds who protect students with disabilities through the federally funded Individuals with Disabilities Act (IDEA) or a students’ 504 Plan.
    Musical chairs is not the solution.His ill-conceived “plan” for solving the problem only made it worse — much worse.
    Students with IEPs or 504 plans need to have there healthcare needs met. Of course they do, but so do all DeKalb students. It’s clearly not one of Green’s priorities.
    He could have exercised his “laser-like focus” on the wide-spread need for good healthcare in all schools.
    He could have realigned “resources with needs,” and made personnel decisions that met the need.
    He did not, because he cannot.
    He lacks the capacity to solve important problems.

  2. So the root of the problem is basically a lack of appropriately qualified school nurses at schools with students who have identified health needs. (Cause truthfully, one doesn’t need skills to take a temp or put on a bandaid).
    However, this problem is made more complicated in DeKalb because the HR department and its “leader” are so incompetent that they lack the ability to staff the schools appropriately. (Teachers and now apparently school nurses.)
    I believe that Green’s first priority needs to be to replace the head of HR. Over and over again, she proves she can’t do the job. He is an outsider, she needs to be gone. Bring in a true HR professional and these kinds of issues become fewer.

  3. Cindy Pietkiewicz

    Ms. Sumi at Kittregdge Magnet School can get her CNA license in 4 weeks and would be smarter than most nurses trained for years or more as she is sharp as a tact and this was not given as an option.
    The letter says elementary diabetic kids were the priority and ours at Kittredge is 6th grade, middle school. This move caused a hard-to-recruit RN which is the priority recruitment for new staff at Dekalb to quit losing a valued staff and making Dekalb even less of a “place to work.” for licensed nurses as they have shown how they do not work to take into account the needs of nurses. Why could they simply not have allowed the Vanderlyn nurse to stay and given 4 weeks for Ms. Sumi to get her CNA. Why did they ignore the fact our child is a 6th grader that does not need insulin? This is all because it was laziness, incompetency and utter disregard for invaluable individuals who work hard each day to make our schools strong. Dr. Green says individual considerations may take place. We’ll let’s see it. Now the much larger Vanderlyn community is without a licensed nurse and Kittredge will likely be waiting 3 or more months for a nurse to be willing to work for this county with us pulling our principal and others out to worry about how our clinic is staffed. Absolutely ludicrous.

  4. Dekalb Inside Out

    One Spanish speaking school nurse has been at her Title I school for 24 years where 46% of the students speak English as a second language.
    The Bouie Elementary school nurse has been there 15 years.
    Another school nurse was at her school for over 20 years. Having no desire to work at another school, she has announced her retirement.
    The Vanderlyn school nurse is a stay at home mom who happens to have her RN. She was happy to work at her kids’ elementary school. The school district told her she works for the district and not Vanderlyn and that she was to report to another school, so she decided to go back to being a stay at home mom.

  5. Message From Vanderlyn Principal:
    Effective Friday, October 9, 2015, our school nurse officially resigned from the DCSD. The district has passed a mandate to reassign licensed nurses to schools with diabetic students. Unfortunately, Vanderlyn is one of several schools that have an RN but no diabetic students. While we are deeply saddened by the loss, we will receive a qualified replacement from Kittredge, Ms. Sumati Jayaraman.