Every School Would Get A Nurse Under Budget Transfer

Covid-19 may have one positive — if temporary — impact on city schools: Each building should finally have its own dedicated school nurse.

City Director of Public Nursing Jennifer Vazquez and city Budget Director Michael Gormany laid out that comprehensive school nurse plan Monday night during a two-and-a-half-hour public meeting of the Board of Alders Finance Committee.

The virtual meeting took place online via the Zoom videoconferencing platform.

The committee alders unanimously voted in support of transferring $850,000 from the city general fund’s $4 million ​“Expenditure Reserve” line towards the public health department’s budget.

Vazquez and Gormany said that that money will be used to contract with one or multiple nursing temp agencies so as to hire up to nine or 10 new school nurses.

Those public dollars will be spent only once in-person education resumes and students are back in school buildings again, whenever that might be. Nearly all New Haven Public Schools students are currently learning exclusively online as new coronavirus cases surge throughout the region.

Vazquez and Gormany said that the new, temporary nurse hires should help ​“bridge the gap” between the number of full-time school nurse positions included in the city budget — 41 — and the number of school buildings covered by the city’s health department — 46.

The new hires will allow for a few subs left over as needed, and will allow the city to continue to assign two nurses to a few larger and higher-need school buildings, like the flagship local high schools Hillhouse and Wilbur Cross.

According to reopening plans laid out by the state Department of Education and the state Department of Public Health, Vazquez said, ​“nurses have been designated as Covid liaisons within the school building.”

That means they’ll be responsible for assessing and isolating any child who may come to school sick or develops symptoms over the course of the school day; answer any questions that students, staff, or family members may have about Covid; and oversee contact tracing and case reporting for their given school.

She said that the city health department, the Board of Education, and NHPS staff have worked hard to inspect schools, designate isolation rooms, and make sure that the buildings themselves are safe to return to during the ongoing pandemic.

“Now what we need is a nurse in every school building as the health professional to take care of these children, to recognize the symptoms of Covid-19, to rapidly isolate that child to decrease the risk of exposure to other children and staff, and to clear children following absences.”

Having a professional nurse in every building is the only way to ensure that such daily public health measures are taken as the pandemic continues, Vazquez said.

“They are our frontline defense in the school buildings against Covid-19.”

City Health Director Maritza Bond made a similar point in a letter she submitted to the alders in support of the proposed budget transfer, which now advances to the full Board of Alders for two readings and a final vote.

“This nursing support will allow us to provide safe care to all students in the New Haven schools while ensuring that in the era of COVID-19,” she wrote, ​“that the school community as a whole has guidance from public health professionals in each school.”

Alders: Great Idea. What About Details?

Just about every alder who spoke up Monday night praised the goal of having a nurse in every school — a goal that parents, teachers, students, and nurses have been advocating for across years of tight city budgets.

“Finally our kids will all have their own nurses,” said Dixwell Alder Jeanette Morrison. ​“However which way this money comes, our children should have a nurse. They shouldn’t only have a nurse on Tuesdays.”

Edgewood Alder and Finance Committee Chair Evette Hamilton agreed. ​“I am in support of this item because the need is there,” she said. ​“With the Covid epidemic that’s all over our world, it’s more imperative than ever to make sure that we cover our children.”

“I definitely agree with the goal,” added Westville Alder and Finance Committee Vice-Chair Adam Marchand, ​“which is to comply with state recommendations in regards to having nurses in all the public schools in order to take care of our young people, especially now in this time of Covid.”

Marchand also pointed out that the $4 million ​“Expenditure Reserve” line was established by the alders in this fiscal year’s budget for causes just like this one: unexpected expenditures — directly Covid-related or not — that are bound to crop up over the course of a year overshadowed by a globe-spanning pandemic.

Where the alders pushed back against city staff was in the details: Which temp company will be hired? How long will these new nurses be employed? And how quickly will a contract be signed?

Gormany said that the city put out a Request for Proposals (RFP) earlier this spring when looking to hire new temporary nursing staff. The city received 17 responses. Vazquez then went through those proposals and came up with a list of nurse temporary staffing agencies that the city should turn to during this process.

“We were going through this process over the last four to five months,” Gormany said. ​“Obviously, things have changed with the Board of Education not actually doing hybrid or any type of in-school learning” by the originally scheduled return-to-school date of Nov. 9.

The general fund money covered by this requested transfer, he said, will only be spent if and when schools reopen for in-person learning. Gormany said that the city and the Board of Education are also looking to see if they can have the cost of these new nursing hires covered by state or federal grants or by Federal Emergency Management Association (FEMA) reimbursements for Covid-related costs incurred by municipalities.

“All the funding for these nurses may not actually come out of the general fund.”

Are we paying a flat agency fee to an organization to provide seven to 10 nurses on any given school day? Marchand asked. Or is the city hiring new full-time equivalent employees in a durational position? ​“What is the nature of the business arrangement?”

Gormany said that this is a ​“strict contractor relationship.” The city is not hiring any new full-time employees, but rather will be engaging with one or multiple contractors to provide temp nurses through the end of the fiscal year, which concludes June 30.

Gormany said that the city hasn’t picked any one agency to use yet, but will rather hire from several of the 17 that responded because nursing temp agencies will likely be in high demand statewide once school districts across Connecticut return to full in-person learning.

Vazquez said that, in addition to covering every public school building, the city’s health department is also responsible for two local parochial schools as well as the semi-public charter school, Elm City Montessori.

And while the city has budgeted for 41 school nurse positions, resignations and retirements have left the department with six vacancies. Another nurse is currently on maternity leave.

Vazquez said that the city furloughed all of its public school nurses from August through mid-October ​“due to a lack of work while the schools were not in person.”

Those nurses came back to work in mid-October to prepare school health rooms, check isolation rooms, and go through health and safety reopening checklists in anticipation of the Nov. 9 hybrid learning start date.

Now that that districtwide in-person learning date has been pushed out, she said, 14 nurses are still working in school buildings across the city every week. Those include at the two parochial schools and one charter school, which remain open for in-person learning, and at 11 different city public schools that have very small numbers of children with autism and other learning disabilities coming to class every day.

Gormany stressed that the prospective contract(s) to be signed between the city and nurse temp agencies will only extend through June 30. These are not permanent new nurse hires for every school building.

Morrison cautioned that the city may have to build this extra $850,000 into the public health department’s budget for next fiscal year, too, given the high likelihood that Covid will be with us in some form or another a year from now.

“It’s better to be safe than sorry,” she said. ​“And that rule is not going to go away until every last person is vaccinated for Covid.”