As schools around the state re-open for in-person instruction, public health benchmarks, health advice and insurance play key roles in their plans to welcome students back to campus.
The Arizona Department of Health Services worked closely with Superintendent of Public Instruction Kathy Hoffman and the Arizona Department of Education to develop a roadmap for re-opening schools and public health benchmarks to determine when to return safely for in-person instruction.
“We all know the critical importance to get our children back in the classroom, but we want to make sure that we’re doing it safely for our students, their families, and their teachers,” said Dr. Cara Christ, director of the Arizona Department of Health Services, during a news briefing on Monday.
Four counties met public health benchmarks to return to the classroom last Thursday and more counties are expected to do so this Thursday when updates are released, Dr. Christ said.
“We cannot wait to have our students back on our campuses when it is safe,” said Dr. Lupita Ley Hightower, superintendent of Tolleson Elementary School District. “We miss our treasures tremendously, and school is not the same with distance learning.”
Morenci Unified School District students returned to school with a split cohort/hybrid model on Monday, Aug. 31 after its small, rural, mining community in Greenlee County met public health benchmarks.
“I was expecting to receive some negative feedback about not returning on a daily basis with all students – that has not happened,” said Supt. David Woodall.
“Today, was the first day on the new model. As I walked thru classrooms, there was a nice feel of energy and excitement from teachers and students,” Dr. Woodall said on Monday.
About 11 percent of students’ families opted to continue learning from home, “although a few of these may be due to masks, I think most are not comfortable sending their students back yet,” Dr. Woodall said.
Morenci parents have supported the decisions the school has made, including wearing masks and other school safety protocols, Dr. Woodall said.
“As I walked around today, I could see they were extremely excited about their kids returning to school, but were also maybe just a little apprehensive as well,” Dr. Woodall said.
“Greenlee County has had very low COVID-19 numbers. We are in a great place for returning to school,” Dr. Woodall said. “Hopefully, we can stay in a good place as school starts.”
How medical advisory teams help school leaders
To assist in their re-opening decisions, Peoria and Paradise Valley unified school districts established medical advisory boards.
Peoria Unified School District’s Medical Advisory Team is made up of leading medical professionals in the areas of pediatrics, child psychology, nursing and epidemiology and helps interpret AZDHS public health benchmarks so the district’s governing board and school leadership can make informed decisions about reopening their 42 schools, said Danielle Airey, chief communications officer for Peoria Unified.
“As we continue to monitor the health benchmarks specific to our district, we look forward to beginning Classroom Instruction in a phased-in approach,” said Peoria Unified Superintendent Dr. Jason Reynolds, in a letter to students’ families on Friday, Sept. 4. “We are targeting Monday, September 21 to have our Kindergarten through second graders, our youngest, most vulnerable students, return to the classroom. If the positive trend in our data continues, we will invite the remainder of our students to return on September 28.”
Paradise Valley Unified School District created a COVID-19 Response Team, which includes medical experts such as lead nurses, doctors, to help inform decisions regarding reopening, mitigation strategies, health protocols, and reopening criteria, said Superintendent Jesse Welsh.
The district also consults other medical experts from universities and local health organizations.
“Having a wide range of expertise, including those with medical expertise, has been instrumental in our reopening plan, establishing protocols and operating procedures, and developing our criteria for reopening in alignment with the benchmarks established by the Arizona Department of Health Services,” Dr. Welsh said.
“These medical experts have not only helped with decision making, but also have helped to educate all of us on best practices, current research, and understanding the ‘why’ behind the science,” Dr. Welsh said.
The PVSchools community has been working tirelessly through the pandemic, Dr. Welsh said.
“To say it has been an adjustment for everyone – our students, families, and staff – would be an understatement,” Dr. Welsh said. “All of us are learning to work in new environments, navigating through challenges, and planning for changing scenarios and evolving health recommendations. Through it all, our school community has come together and collaborated in creative ways using their expertise in order to best support our students.”
Rural, remote or low-income districts may have difficulty finding physicians or other health officials to serve on an advisory board, but some have partnered with their local health department, their insurance provider, medical companies or sought advice from local health providers.
Tolleson Elementary School District partnered with HealthyVerify to receive certification on procedures developed in association with Barrow Neurological Institute and under the medical direction of Dr. Ana Moran, an infectious disease physician, said Superintendent Lupita Ley Hightower.
HealthyVerify has partnered with Arizona State University to reduce the workplace risk of spreading infectious diseases. Tools include the implementation of procedures, protocols and providing employees with health standards to establish and support continued monitoring.
“In addition, our district organized a Task Force comprised of many stakeholders including a representative for Banner Children’s Clinic, the Arizona Youth and Family, parents, teachers, and district staff to guide the plans for safely returning to school in a hybrid or in-person,” Dr. Hightower said.
Tolleson Elementary, which serves a large percentage of Latino students and low-income families, currently has a waiver from providing on-site student support services, because their community is considered a COVID-19 hot spot.
“In June, the rate of COVID-19 was 2,889.3 cases per 100,000 population in our area compared to Maricopa County’s rate of 1,220.8 cases per 100,000 population,” Dr. Hightower said.
In July, the rate of COVID-19 was 2,062 per 100,000 population within our school boundaries compared to 1,171 cases per 100,000 population in Maricopa County. The July case rate in Tolleson was 1.8 times higher than Maricopa County’s rate.
“In August, our area has not yet reached the metric of less than 1.5 times the county rate for two consecutive weeks; therefore, Maricopa County Public Health recommended that schools in Tolleson maintain their waiver status for on-site support services,” Dr. Hightower said, noting that this data is re-evaluated on a weekly basis.
Tolleson Elementary School District is keeping students, families and staff informed through Governing Board public meetings, letters, phone messages, social media, emails, community forums that included an infectious disease physician from HealthyVerify leading discussions in English and Spanish as well as public service announcements for free COVID-19 testing in the community, Dr. Hightower said.
Tolleson Union High School District uses a dashboard to track and plan COVID-19 resources, but does not have a medical advisory board, said Joseph Ortiz, director of public relations and marketing for the school district southwest of Phoenix.
The district is a self-insured member of Valley Schools Management Group, a non-profit created in 1987 by school districts to allow public entities to jointly purchase insurance and pool insurance risks.
Tolleson Union, which serves a large percentage of Latino students and low-income families, currently has a waiver for providing on-site support services for students because it is a COVID-19 hot spot with 96.90 cases of COVID-19 per 1000,000 population and 12.72 percent positivity, Ortiz said.
“Despite how prevalent COVID-19 is in the community, we have no transmission of COVID-19 on our district campuses,” Ortiz said. “Teachers are teaching from their classrooms unless on an accommodation.”
Since the beginning of the pandemic, Tolleson Union has communicated with students’ families and the community through a variety of methods, Ortiz said.
“We send letters electronically directly to parents via Peachjar. We use School Messenger to deliver text, e-mail and voice messages. We post information on our website and social media platforms,” Ortiz said. “We use our local community newspaper – the West Valley View – to place articles when needed. And of course, as was done most recently when our district received a waiver, we communicated through local media, including television news, local radio and print.”
In addition to reporting COVID-19 outbreaks to their local public health department, “schools must notify students, parents, guardians and staff about any outbreaks of COVID-19 at their school,” Dr. Christ said.
“They must also provide their parents with the actions they have taken to keep their students and staff safe,” Dr. Christ said.
Insurance coverage factors into decisions
For many school district leaders, finding out if their insurance would help cover any COVID-19 losses or liabilities was an important part of their re-opening decisions.
The Arizona School Risk Retention Trust, which provides insurance coverage for nearly 250 Arizona school districts and community colleges, said earlier this summer that it would not cover COVID-19 issues or claims.
“During the week of July 20, 2020, we communicated to our districts that our reinsurance partners — companies that insure the Trust against potentially catastrophic losses — had, despite our best efforts, elected to exclude COVID-19 coverage from their Trust policies,” said Ryan Cole, director of operations for Arizona School Risk Retention Trust.
“When we communicated this coverage exclusion to members, we also stated that the Trust would continue exploring coverage options. Many members expressed an interest in some sort of coverage solution,” Cole said.
Two weeks later, The Trust presented a solution they’d developed to their board, and “ultimately, the Trust board approved a coverage endorsement at a meeting on August 4, 2020,” Cole said.
“The contribution range for the coverage endorsement is anywhere from $5,000 to $150,000 per school district, depending on the district’s size,” Cole said.
“Subject to specific conditions, exclusions, and limits, the general liability coverage endorsement covers defense costs and indemnity payments related to COVID-19 claims,” Cole said.
Those conditions include that districts’ reopening plans incorporate guidelines issued by the Arizona Department of Education for K-12 districts and Centers for Disease Control and Prevention for community college districts, to promote on-campus health and safety, and that districts ask parents and guardians to sign a liability waiver OR an acknowledgment of risks form.
The Trust has developed two forms for school districts’ potential use, Cole said.
One is an acknowledgment form, which informs parents of certain risks of COVID-19, and outlines parent and student responsibilities to mitigate the risk of exposure. This form also notifies parents that no set of school health and safety procedures, no matter how comprehensive, can completely eliminate the risk of COVID-19 transmission.
The second form, the liability waiver, contains similar content, but also includes a provision whereby parents release all claims and agree not to sue the school, the district, or related parties if their child contracts COVID-19.
Both the acknowledgment form and liability waiver:
- Inform parents of the risks inherent in in-person education during the COVID-19 outbreak;
- Educate parents on the steps they will be expected to take to protect their child(ren) and others from COVID-19 transmission while attending school;
- Strongly encourage behavior that will reduce the risk of COVID-19 transmission; and
- Limit unfunded district liabilities for COVID-19 exposures.
“The purpose of these forms is to remind parents of their critical responsibilities, to confirm that parents understand that, despite schools’ efforts, it is impossible to reduce the risk of COVID transmission to zero, and to provide protection for schools against potential lawsuits related to COVID-19,” Cole said.
Parents, however, cannot be required to sign the waiver or acknowledgment form.
“The Trust does not require school districts to ask parents to sign a liability waiver before children can attend in-person instruction,” Cole said.
The Trust does require that school districts adopt one or the other form in order to be eligible for the new COVID-19 coverage endorsement, and make efforts to distribute it to parents, Cole said.
Responses to coverage, forms and waivers
More than 100 districts across the state have already added the COVID-19 coverage endorsement or have committed to do so, Cole said.
“We hope that this option gives Trust members a greater level of comfort as they begin providing in-person education and/or services in the coming weeks and months,” Cole said.
“Our district has not/will not be asking our families to sign liability waivers; however, we will be asking our families to sign an acknowledgement form,” said Tolleson Elementary Supt. Hightower.
The form supports families in understanding their responsibility in collaborating with the schools to mitigate the spread of the Coronavirus, Dr. Hightower said.
It include information that they understand their student(s) will:
- need to wear a face mask at all times
- be washing their hands constantly
- be asked to maintaining social distancing
Additionally, families will be expected to monitor their students for any potential cold-like symptoms, Dr. Hightower said.
“If any, they must keep their student at home. If the student shows up to school and they are sick, they will need to be picked up,” Dr. Hightower said.
Morenci Unified School District and Governing Board are still considering whether to take the coverage offered by The Trust, Dr. Woodall said.
“We have not taken it to the faculty or made a decision on waivers. I think we are leaning towards declining coverage,” Dr. Woodall said.
Sara Thompson, whose son attends Tucson Unified School District’s Schumaker Infant and Early Learning Center, told KOLD News 13 she was surprised to learn she had to sign a waiver before her son could return to classes.
“We have not and will not be asking parents to sign waivers for the return to in-person learning,” said Paradise Valley Schools Supt. Dr. Jesse Welsh.
In Tolleson Union High School District, the only waivers that have been issued were for athletics, and “since participation in athletics usually requires a waiver, there weren’t any concerns about the additional language,” Ortiz said.
“We know that the COVID-19 situation is evolving, and that our members’ needs are as well,” Cole said. “We’ll continue to monitor events and will remain in constant contact with Arizona schools.”