School nurse shortages are compounding Utah’s chronic absenteeism problem, with 1 in 5 kids missing nearly 4 weeks of school

More than one in five Utah students are skipping enough school to be considered chronically absent. That means they’ve missed 10% of school or more within an academic year, amounting to more than 18 days, or nearly four weeks out.

Like the rest of the country, Utah is facing an absenteeism crisis catalyzed by the COVID-19 pandemic.

Nationwide, the percentage of chronically absent students nearly doubled, rising from 16% before the pandemic to almost 30% by the 2021-22 school year, according to the U.S. Department of Education.

Utah was also hit hard. Here, chronic absenteeism jumped from 14.3% in the 2018-19 school year to 27.2% in 2021-22. Despite steady improvement, with rates dropping about 2% annually since then, absenteeism is still higher than pre-pandemic levels.

As public schools struggle to rebound, they are collectively looking to the state for additional resources and support, education leaders have said.

What’s driving the problem? The factors are complex, but research points to a few general causes, explained Sharon Turner, director of public affairs for the Utah State Board of Education.

Those include:

• Negative school experiences: Students may avoid school because of bullying, harassment, unfair disciplinary practices, or a chaotic school environment.

• Lack of engagement: Students may feel disconnected from school if they don’t have a relationship with a caring adult, or if the instruction isn’t culturally relevant or engaging.

• Health issues: Students with chronic conditions (like asthma) may be more likely to miss school.

• Student mobility: Families moving in and out of school districts can negatively impact attendance rates.

That’s why a one-size-fits-all solution to chronic absenteeism is unlikely to work — each school has students with different backgrounds and circumstances.

In an effort to more quickly move the needle, though, USBE is asking lawmakers next year for money to help create a real-time attendance dashboard and “attendance teams” dedicated to assessing and addressing the problem. The funds would also support a “statewide attendance campaign.”

But the request isn’t a guarantee, in part because getting more per-pupil spending dollars is the board’s top priority, USBE announced in October.

School nurses play important role — and Utah has shortages

Research shows that chronic absenteeism is linked to poor academic outcomes, according to the Brookings Institution, a Washington D.C.-based nonprofit.

Chronically absent students are less likely to read at grade level and graduate high school. Research also shows that chronic absenteeism in kindergarten is associated with lower achievement in reading and math later on — no matter a child’s family income, race or disability status.

In Utah, absenteeism rates for students of color, economically disadvantaged students and English language learners remain higher than the state average. American Indian students in particular hold the highest chronic absenteeism rate at 40.9%. English language learners are second highest at 35.6%.

A key part of addressing chronic absenteeism is offering adequate school health services, according to a recent report by the Utah Department of Health and Human Services.

Students with certain chronic illnesses — who may need medication or other medical treatment during the school day — are more likely to be chronically absent. During the 2023-24 school year, 20% of students diagnosed with Type I diabetes were chronically absent, the report states. Of those diagnosed with asthma, 16% were chronically absent.

The state health agency advises that there should be at least one full-time nurse working at every school in the state. However, it doesn’t always play out that way — particularly in smaller, more rural school districts.

The current nurse-to-student ratio in Utah is one for every 2,091 students. In districts like Logan, one nurse serves all of the district’s roughly 5,000 students, according to the report.

“Continued focus on improving school nurse-to-student ratios and integrating school nurses into attendance teams is essential for addressing absenteeism effectively,” the report states.

Can telehealth at school help? School districts are trying

An ear infection can sometimes keep a student out of school for three to four days — time that Jennifer Gerrard, school nurse specialist for the Canyons School District, calls “completely unnecessary.”

“While that’s not always the case, in our higher-needs communities, it’s not uncommon for kids to miss far too many days for illness-related reasons,” Gerrard said.

Typically, when students feel unwell, they visit the school nurse, who assesses their condition and determines if they can be treated at school. If the student needs care that the school can’t provide, like a prescription, they are usually sent home.

From there, families might wait several days for an appointment at a pediatrician’s office, during which time the student misses school.

But what if a student could see a doctor at school instead of being sent home? That’s the idea behind Canyons’ new school-based telehealth program launched this year. The program provides students with virtual access to a doctor — without having to leave school.

Here’s how it works: Once a school nurse determines that a doctor’s input is necessary, they can — with parental consent — connect the student and their parent to a doctor virtually. The services are provided by Intermountain Health’s Connect Care team, which collaborates with local health providers.

School nurses are equipped with blood pressure cuffs, thermometers, blood glucose monitors and other tools used to assess health. They can then connect them to a device that automatically feeds the information to the provider.

Using the example of an ear infection, Gerrard said the virtual appointments speed up the doctor visit process.

“I can give [the student] some over-the-counter medication to help them feel better, make it through the rest of the day. Mom picks up an antibiotic on the way home. They treat them that night. They come back to school the next day. There’s zero downtime, no days missed,” Gerrard said.

The school-based telehealth program was first launched in 2023 with the Wasatch County School District and is now being adopted by other districts across Utah.

“The most critical part is to continue to identify the barriers, find positive solutions, and build partnerships across the state that can help us continue to grow our attendance rates,” Turner, with USBE, said.

Canyons is pilot-testing the program at 17 schools this year. To participate, parents must sign a form and provide their health insurance information. If they don’t have insurance, financial assistance is available. A Connect Care visit costs $69. Employees can participate, too.

While it’s too early to know how the program has impacted chronic absenteeism, the district will measure the success of the program “in number of days saved,” Gerrard said.

It’s the same measurement the Wasatch School District has used. There, officials reported saving ​​5,500 days of education during the 2023-24 school year.

“​​It’s certainly not going to solve chronic absenteeism completely, but it’s just one more tool that we can put in our kit,” Gerrard said.

Margaret Swanicke, principal of Midvalley Elementary in the Canyons district, said improving attendance is “tricky.”

“A key part of attendance [is] the health pieces,” Swanicke said. “I think part of it, as well, is working with individual families to figure out what’s going on. … And coming up with incentives. We try to make it a group effort to get the kids to want to be here.”

She said that at Midvalley, they track attendance and award weekly prizes to the grade level with the highest number of students in school that week.

Parent engagement also plays a crucial role, Swanicke said, adding that some families are more engaged than others.

“I think it’s just getting parents to understand that we need [students] here so they can learn and build a school climate where kids want to be,” she said.

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