OLYMPIA – The effects of two years of quarantines, switching between in-person and online school and being isolated from peers have prompted children’s health advocates to call on the government to take action on supporting children’s mental health services. And the Washington state Legislature is trying to do that.
The Legislature is considering two bills that would increase the minimum amount of funding schools would receive to spend on physical, social and emotional support staff.
A bill in the Senate would increase the minimum funding allocation for elementary, middle and high school nurses every year through 2024. Allocations for social workers, psychologists and counselors would increase at the start of the 2022-23 school year.
Sen. Lisa Wellman, D-Mercer Island, is the prime sponsor of a version of the bill going through the Senate. She said increasing funding for student support services has been on the Legislature’s radar and now is the time to act.
“For quite a long time, we have felt that we can be very helpful in terms of student safety and wellbeing by focusing on this,” she told The Spokesman-Review. “But we have not either had the money … or the will to keep moving it up.”
Last December, Governor Inslee included support for student’s academic, social and emotional needs as one of his priorities in a supplemental budget proposal. He proposed funding the priority by using $900 million the state saved as a result of reduced K-12 enrollment.
According to a fiscal note produced by the state Office of Financial Management, the Senate bill would cost the state about $173.8 million in 2021-23, about $616 million in 2023-25 and about $703.8 million in 2025-27.
Historically, districts have had a degree of discretion when spending money that had been allocated for certain staff types. For example, funding allocated for nurses could be used for other costs such as hiring teachers and purchasing technology. Under the bill, funding allocated for nurses, social workers, psychologists and counselors must be spent on salaries and benefits for those positions.
Wellman said students need increased support after going through two years of challenges posed by the pandemic, whether it be switching from in-person to online school or losing loved ones to COVID-19.
“Students are under a significant amount of stress,” she said.
According to data published by the Centers for Disease Control and Prevention, emergency department visits for suspected suicide attempts have increased among adolescents during the COVID-19 pandemic.
In 2020, the proportion of mental health-related visits to an emergency department among adolescents increased 31% from 2019. Between February and March of 2021, suicide attempt-related visits to the emergency department for girls 12 to 17 increased 51% from the same period in 2019.
The American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and Children’s Hospital Association came together in October of last year to declare a “national state of emergency in children’s mental health” and called on lawmakers to take action and support youth.
Becky Doughty has witnessed the challenges firsthand. As executive director of student support services for Spokane Public Schools, she has seen her nurses stretched to their limits even before the pandemic hit.
Even though her nurses mainly provide physical health services, they’ve been filling in gaps in the mental health realm as well – primarily at the high school level.
“Probably 80% of what they do on any given day is mental health in the health room,” Doughty said. “Even though they are not mental health therapists, they do have an open door policy and try to fill the gaps in whatever way they can in addressing the other needs besides the physical for our students.”
Most of the district’s 42 nurses split their time between two buildings to ensure each school has adequate health coverage. Some students have to change schools in order to be in a building with a full-time nurse. Being able to serve a school full time is critical to delivering the best levels of care, she said.
“We know that having a nurse in the building full time, all day long, allows that nurse to develop a relationship with the school building and the families that are connected to that building,” Doughty said.
And as the pandemic continues on, school nurses have added test referral, quarantine and contact tracing responsibilities to their already full plates.
“That is done in addition to taking care of our students with diabetes, taking care of our students with seizure disorders and taking care of our students who need some kind of medical care during the school day.”
Doughty said her nurses are doing the best they can with what they have. The district has plenty of nurse applicants, but doesn’t have the money to make additional hires. To Doughty, increased support from the state will go a long way.
“We’re really starting off from a place where any changes that can be made to that allocation is going to be very impactful and very supportive of what we’re trying to do by providing health care during the school day,” she said.
Zach Pugh, a junior at Shadle Park High School, said he has had mixed results with accessing support services at school. In the past, he got the help he needed. But currently, he often feels like he can’t. He said his peers have had similar experiences.
“I have been told and heard it doesn’t help or meet their needs all the time,” he wrote in an email to The Spokesman-Review.
A similar bill in the House would go further in requiring school districts to prioritize allocated funds for support staff with an educational staff associate certificate and mandating that each public school have at least one nurse and one counselor on site.
An initial fiscal note for the House bill estimated the move would cost the state about $45.5 million in 2021-23, about $275.1 million in 2023-25 and about $348.5 million in 2025-27. However, those estimates do not account for the one nurse, one counselor per school mandate. A new fiscal note considering that requirement is being drafted.
The minimum one nurse, one counselor staffing requirement became a sticking point for some on the House Education committee. Rep. Monica Stonier, D-Vancouver, voiced concerns that smaller districts with a handful of staff and students would be forced to replace staff members with a nurse and counselor. She said Centerville School in southern central Washington would have to replace two of their six teachers to meet the mandate.
“While I think that increases the access to nurses and counselors in that particular building,” Stonier said at a hearing on Jan. 21, “I don’t think that making that personnel decision from the state level honors our local control decision making there.”
Dave Larson, school board director with the Tukwila School District, said he was concerned about both bills providing equal, rather than equitable, funding allocations for support staff.
“A school with 90% poverty would get the same allocation for social workers as a school with 5% poverty,” Larson said at a House Education hearing on January 13. “This makes no sense. It’s not equitable and will not close any gaps.”
The Senate bill has been sent to the Senate Ways & Means committee for further review. A hearing date has not been set yet. The House bill has been referred to the House Appropriations committee for further review. A hearing date has not been set yet.