Category Archives: Healthcare

Education Turns Into Social Services And Health Care

What do YOU believe is the role of school districts in providing health care and social services to families?

The Gwinnett Daily Post is reporting that with the failure of the Opportunity School District referendum, some state lawmakers expect the issue of how to improve failing schools to move toward providing more services, social and healthcare in particular, as an operational component of school districts.

Senator Renee Unterman, R-Buford, said one response to the proposed Opportunity School District being voted down in November is that the focus may shift from the academic nature of the issue, to reasons why children are sick, or have poor attendance.

Rep. Brooks Coleman, R-Duluth, suggested an audit for schools that have high poverty rates to identify the core issues.

“What are the problems, is attendance bad? Well, what’s causing that,” Coleman said. “Is it illnesses? Are they sick a lot? Is it the fact they’re not getting enough food? Let’s analyze, audit, what do you think is the root cause that your school is failing. … Well, what are you missing, and then analyze and try to provide those services. That’s the first step, is to provide those needs because let’s face it, (if) the child’s not in school, they’re late, if they’re not present, if they don’t feel good, you can’t start the learning. But if they come on time, they come fed, they come without a toothache, they come feeling good, then you can get about the learning.”
Unterman and Coleman each admitted that school leaders and those who work in education would push back at this notion because their main focus is education.



Stan Jester
DeKalb County
Board Of Education

The DeKalb Board of Education met with the county’s state legislators a few weeks ago. I asked them

1. Does the state believe that tax payers should provide health care and social services to families? If so, then who should do that and how is it funded?
2. What does the state believe is the role of school districts in providing health care and social services to families?

Many school districts across the state attribute poor academic performance to the effects of poverty and family dynamics. Numerous school districts have departments dedicated to “Wrap Around Services” that try to mitigate these effects by providing additional services to students and their family.

Wrap Around Services at DeKalb Schools
DeKalb Schools has created a Student Support and Intervention Division to provide “Wrap Around Services” and address the diverse needs of students and families. The current profile of “Wrap Around Services” available to support students and families in DeKalb Schools include School Counselors, School Social Workers and Homeless Liaisons, School Psychologists, School Nurses, Student Support Specialists, Post-Secondary Transition Specialists, Parent Liaisons, EL Success Facilitators and Check and Connect Mentors.

Furthermore, DeKalb Schools is
• Giving stipends and signing bonuses to attract and retain talented, motivated teachers
• Appropriating $1.9 million for literacy and mathematics initiatives
• Spending $750K for the 10 Horizon schools to partner with Discovery Education
• Spending $398K to partner with IIRP(International Institute for Restorative Practices) to reduce the number of suspensions

I couldn’t disagree more with Sen. Unterman and Rep. Coleman in their assertion that school leaders will “push back” on the notion of adding services via the school district so long as the funding is provided. Mr. Unterman and Mr. Coleman need to refer to the Rules of Bureaucracy.

Rule #1: Maintain the problem at all costs! The problem is the basis of power, perks, privileges, and security.
Rule #2: Use crisis, and perceived crisis, to increase your power and control.
Bureaucracies are famous for their mission creep. Their incentive is always to address inputs and never results. As Thomas Sowell reminds us, “You will never understand bureaucracies until you understand that for bureaucrats procedure is everything and outcomes are nothing.”

School districts that are already large and highly bureaucratic will be quite welcoming to enlarging their reach and responsibility. It makes them more powerful. The state has no enforcement mechanisms of any consequence. Giving the same people more money to do more things without any meaningful accountability measures means that your taxes are just going to purchase more failure.

What are your thoughts?

Licensed Nurses & the Care of Diabetic Students

Regarding the “School Health Care Realignment of Services”, Dr. Green said, “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.”


Stan Jester
Board Of Education
District 1

A few weeks ago the school district exercised a School Health Care Realignment of Services. Superintendent Stephen Green explained the guidance the district used to make these recent school nurse reassignment decisions.
Dr. Vasanne Tinsley is currently the Director of Support Services and has been with the school district since 2007. The following are Dr. Tinsley’s answers to some follow up questions I had regarding practice, board policy and state mandated care of diabetic students.
SBOE Rule 160-4-8-.18, O.C.G.A. § 20-2-779, and DeKalb Schools Policy JGC-R(1) all say the same thing regarding schools with diabetic students, “The school nurse or at least one trained diabetes personnel shall be on site at each school and available during regular school hours to provide care to each student with a diabetes medical management plan being implemented by the school.”

Vasanne Tinsley

Question: Before the recent nurse shuffle in October, did all elementary schools with diabetic students have a school nurse or at least one trained diabetes personnel on site during the entire school day?
Dr. Vasanne Tinsley: Yes. Each elementary schools had either had a nurse or a clinic assistant. Clinic assistants had basic training to monitor students, but are unable to administer insulin. School nurses are able to monitor and give insulin injections as needed.
Question: Since the October nurse shuffle, do all elementary schools with diabetic students have a school nurse or at least one trained diabetes personnel on site throughout the regular school day?
Dr. Vasanne Tinsley: Yes. Based on current enrollment data, schools with diabetic students are supported by a licensed nurse. Licensed nurses are able to monitor students and administer insulin injections as needed.
Question: Does it comply with state law § 20-2-779 to not have a school nurse or at least one trained diabetes personnel on site during the entire school day at elementary schools with diabetic students?
Michael Walker (DCSD Interim Chief Legal Officer) : [The analysis provided to this question] is a privileged and confidential communication.
Note: Regarding the “School Health Care Realignment of Services”, Dr. Green said, “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.”
Question: What is a licensed nurse?
Dr. Vasanne Tinsley: A licensed nurse is either a Registered Nurse (RN) or a Licensed Practical Nurse (LPN). The licensed nurse credential requires completion of a nursing program of study (LPN- 18 months, RN- 2 -4 year program) and successful passing of the state license board examination. Licensed practical nurses must be supervised by a registered nurse. In our district, the lead nurse and consulting nurses provide this supervision.
Question: Can you elaborate on the practice that was implemented in 2004.
Dr. Vasanne Tinsley: Because of the diversity of the population of the school district and the shift in medical concerns noticed in students, it was recommended that the Student Health program only hire individuals with a higher level of training and more skill. The Board of Education and Superintendent Johnny Brown supported this recommendation and approved to cease hiring clinic assistants (unlicensed personnel) to support elementary clinics throughout the district.
Question: For at least the last few years there have been diabetic students at DeKalb elementary schools without a licensed nurse. When did said practice stop being implemented with fidelity?
Dr. Vasanne Tinsley: In the initial plan created many years ago, diabetic students in schools without a licensed nurse were supported by travel nurses from neighboring schools. Typical support was offered during the middle point of the day, when insulin most injections take place. The licensed nurse was required to travel daily to another site to support the monitoring of blood sugar, injection of insulin, and after meal monitoring. The travel nurses were often away from their base locations for up to 2 hours, leaving the base population without health support. This practice has been consistent and has not been implemented without fidelity.
Question: Dr. Green also mentioned, “The District went further to develop a collaboration with DeKalb High School of Technology South to develop the training for current non-licensed staff”. What is the status of that? How do current DCSD employees who are non-licensed school nurses become licensed nurses?
Dr. Vasanne Tinsley: The district has been in communication with the Principal and the teacher of the Certified Nursing Assistant (CNA) program at DeKalb High School of Technology-South to begin the development of this professional learning program for clinic assistants to become Certified Nursing Assistants/with the passing of the exam. We are hopeful that this program will be available for enrollment during the 2016-17 school year. Offering this opportunity would show our commitment towards retention of the clinic assistants, who have basic training in first aid, CPR and procedures of the school district. This may also offer possible employment to students who graduate from the district with the CNA credential through our Career Tech program. Clinic assistants would not be licensed nurses upon completion of this program brief training program. The licensed nurse credential requires completion of a nursing program of study (LPN- 18 months, RN- 2 -4 year program) and successful passing of the state license board examination.