Good medicine

How do you fight chronic absenteeism? Put a nurse in every school.

Almost a fifth of Memphis students are considered chronically absent from school, and too often it’s because of an asthma attack, a toothache or an undiagnosed psychological condition.

Community leaders grappling with the city’s high rate of absenteeism frequently have cited challenges rooted in poverty — from students who struggle to get a ride to school to embarrassment over dirty uniforms. Now they’re zeroing in on a deeper related problem: chronic health conditions.

Last year, a staggering 44,000 Memphis students reported suffering from a chronic health condition, contributing to 18 percent of students missing at least 18 days of class in Shelby County Schools or the state-run Achievement School District.

“It’s clear that having a nurse at every school could greatly reduce the number of students who miss school for preventable health reasons,” said Lora Jobe, executive director of PeopleFirst Partnership, a coalition of business, government, academic and civic leaders. “The health concerns we’re talking about disproportionately affect impoverished children and children of color. In Memphis, addressing this should be a top priority.”

Community leaders came together Wednesday at the University of Memphis for a summit on how health disparities are causing youngsters to miss school. The gathering follows last month’s launch of an attendance campaign by Shelby County Schools, providing supports for 10 schools with the most-absent students.

Students in Memphis are mostly people of color and from low-income families, both groups with higher-than-average rates of asthma and untreated dental cavities.

Last year, in fact, Memphis was named the nation’s worst city to live with asthma, a chronic lung condition that leads to episodes of wheezing, coughing and shortness of breath, among other symptoms.

Panelists talk about chronic absenteeism and health at a summit spearheaded by PeopleFirst Partnership.
PHOTO: Caroline Bauman
Panelists talk about chronic absenteeism and health at a summit spearheaded by PeopleFirst Partnership.

The summit was attended by doctors, dentists, nurses and mental health professionals, as well as education and nonprofit leaders. Discussions gravitated frequently to the importance of having a full-time nurse in each school, not only to treat students but also to educate their families about how to manage medical conditions that might keep their kids home from school.

Tennessee law requires only one nurse for every 3,000 students, and budget cuts have made it impossible for Shelby County Schools to keep a nurse in every school building. Instead, nurses rotate across the district, usually giving each school one day of medical staffing a week.

That’s not enough, said Angela Hargrave, the district’s director of attendance and discipline.

“Parents aren’t comfortable that their children will be properly cared for at school,” Hargrave said. “People at schools aren’t comfortable with that responsibility. We’re not medical professionals. Our front office staff isn’t trained for that.”

A full-time school nurse can provide the medical care or information that makes the difference in coming to school or staying home, said Cindy Hogg, director of health services at Le Bonheur Community Health.

“A nurse in the school building is often the only care provider many children in low-income areas in Memphis see for years,” Hogg said. “Of course, nurses should send students home when they are sick. But so often students are missing way more school than they should because no one in the health world is communicating with them or their parents.”

Jobe pledged that PeopleFirst Partnership, which organized the summit, will lobby local and state officials to enact and fund a policy that lower the school nurse-to-student ratio.

“I hope this time next year, when we see Tennessee require a nurse in every school, you will be able to say, ‘I was in the room when this started,’” Jobe told the group.

Get moving

Requiring P.E. for Tennessee’s youngest students would help academics, too, advocates say

PHOTO: Alan Petersime

Tom Cronan was a lifelong outdoorsman who was passionate about fitness and its many benefits, both physically and emotionally.

Now, almost a decade after his death at age 64 of pancreatic cancer, a bill in the legislature would honor the East Tennessee educator by requiring that the state’s students spend more time playing sports and exercising during school.

The Tom Cronan Physical Education Act, which unanimously passed the House Instruction and Programs Committee on Tuesday, would serve as a living tribute to the professor emeritus of exercise physiology at Carson-Newman University in Jefferson City.

It also would act on research showing that physical education boosts children’s brain development, helps form lifelong exercise habits and promotes overall health and mental wellbeing.

The bill would require all public elementary school students to participate in a physical education class taught by a P.E. teacher at least two times a week.

Currently, Tennessee requires physical education for its K-8 students, but doesn’t specify how much time students should spend in it.

Cronan’s widow Joan, a former women’s athletics director at the University of Tennessee at Knoxville, testified to lawmakers this year about the potential impact of physical education on student engagement and obesity. P.E. also could give students life skills that translate to academic success, she said.

“The Tom Cronan Physical Education bill could make a difference in people’s lives,” she said.  “We feel like that this discipline will make a difference.”

The bill is sponsored by Roger Kane, a Knoxville Republican, in the House, and Bill Ketron, a Murfreesboro Republican, in the Senate, where it passed the education committee last month. The measure now goes to the finance committees of both chambers.

Though the proposal wouldn’t cost the state extra money, it does come with a collective $253,000 price tag for three smaller school districts  — in Dyer, Hardeman and Carter counties — that would have to hire new teachers to meet the requirement.

The bill isn’t the first to address physical activity in schools, where more rigorous academic standards and preparation for high-stakes testing have challenged educators to strike the right balance.

In 2016, the legislature approved stringent playtime requirements that went into effect last fall. But lawmakers recently voted to roll those back to give educators more flexibility with recess.  But they didn’t scrap the requirements altogether. Under the bill that Gov. Bill Haslam is expected to sign into law, younger students would be required to have at least 130 minutes of recess a week.

Funding fight

Colorado poised to slash funding for controversial student health survey

Two years after a controversial student health survey sparked protracted debate at the State Board of Education, questions about the survey’s value have moved to the state legislature — and could mean a loss of $745,000 in state funding for the biennial data collection effort.

Funding for the Healthy Kids Colorado Survey, which comes primarily from the state’s Marijuana Tax Cash Funds, was not included in the proposed state budget earlier this spring and may not return despite requests by the state health department to restore the money.

The health survey is given to a sample of Colorado middle school and high school students in scores of districts every other year. It asks about topics ranging from nutrition to risky behavior, and proponents say it’s crucial for tracking trends and crafting interventions when trouble spots arise.

In addition to $745,000 in state dollars, the survey is funded with $89,000 in federal money. State health department officials said determining whether the survey could continue in a slimmed-down form if state money is stripped away depends on the federal budget.

“The Healthy Kids Colorado Survey is the only comprehensive survey on the health and well-being of Colorado youth,” Dr. Larry Wolk, executive director and chief medical officer of the Colorado Department of Public Health and Environment, said in a statement. “Without funding, we won’t be able to provide the kind of credible health information schools, community groups and local public health agencies need to improve the health of the young people they serve.”

The state Senate is expected this week to debate the state’s budget. The House will debate the budget after the Senate completes its review.

The health survey became the focus of a debate by the State Board of Education and dueling opinions from the state attorney general’s office in 2015 after some parents raised concerns about the explicit nature of questions on sexual behavior, drugs and suicide.

In addition, critics argued that parents should have to give advance written permission — called active consent — in order for their children to take the survey. Over the survey’s 26-year history, most districts have chosen passive consent, which means students are asked to take the survey unless parents sign a form opting them out.

Ultimately, neither the state board nor State Attorney General Cynthia Coffman mandated substantive changes to the survey or consent rules. State officials emphasized throughout the controversy that the survey is anonymous and voluntary. After the state board uproar over the survey, most districts continued to participate.

On Monday, Rep. Bob Rankin, a Carbondale Republican who helped write the state’s budget, said of the survey, “I think enough of us felt that it was just intrusive. I just don’t think it collects good data.”

Not all on the budget committee agreed.

“I support the survey,” said Rep. Millie Hamner, a Frisco Democrat. “Our school districts rely on that information for other grant programs. It is possible in the budget process we’re able to restore that.”

Chalkbeat Colorado’s deputy bureau chief Nic Garcia contributed to this report.