California schools break from Health Center in setting COVID guidelines

The Moniteau County R-1 School District’s latest amended COVID guidelines were changed without input from the Moniteau County Health Center.

Earlier this month, the district’s Board of Education elected to adopt an addendum to its existing policies — risk levels denoting the transmission of COVID within the school community, from green to red, modeled after the Cole County Health Department’s guidelines applicable to schools in the neighboring county. The district’s other guidelines haven’t been replaced or removed, and protocols at each risk level allow for implementation of requisite PPE usage and quarantine if a close contact is identified. The low-level spread outlined in the “green” category — 0-3 percent positive cases among the district’s population of 1,591 students and staff — most basically eliminates mandatory quarantines for close contacts in order to keep students at school in person.

However, the school board opted for the addendum while only consulting with other administrators from area schools, not their local public health authority, as defined by the Missouri Department of Elementary and Secondary Education. The addendum was approved Nov. 10, and the Health Center was notified the same day. Health Center Administrator Andrea Kincaid then notified the Missouri Department of Health and Senior Services.

DESE’s Missouri School COVID-19 Operating Guidance document, last updated Oct. 8, recommends a school should work with their LPHA — the public health authority in the community that school is located in — to set COVID guidelines

A DESE representative said state officials have encouraged local school leaders and local health departments to work together to develop COVID protocols that best meet the needs of their immediate community throughout the pandemic.

“As we have from the outset of the pandemic, the Department of Elementary and Secondary Education urges local school leaders to work in conjunction with their local health department to establish policies and protocols that best keep students and staff safe,” DESE Chief Communications Officer Mallory McGowin said. “Guidance issued from DESE and the Department of Health and Senior Services reiterates that collaboration and communication are key during these (challenging) times.”

District administrators approached the Health Center about adopting the recent addendum ahead of the school board’s October meeting and were met with a negative response regarding breaking from the county’s current guidance. The Health Center, for their part, noted this was because they felt it best to get through fall — a time during which COVID spread spiked during 2020 — before considering any changes.

“I think, too, looking at our vaccination rate, looking at the full picture, I don’t think we were quite prepared to do that yet,” Michelle Wilfong, Moniteau County Health Center communicable disease program coordinator, said.

The Health Center pair also noted the potential domino effect of other county school districts following suit is a concern, but Moniteau County R-1 Superintendent Dwight Sanders said he doesn’t anticipate that happening given the differences between California’s schools and other smaller districts throughout Moniteau County.

Sanders and School Board President Derek VanLoo said the board has no plans to work with the Health Center for any future COVID-related changes to its guidelines moving forward. The board will, however, continue to follow the Health Center’s guidance as it relates to other issues of public health.

Representatives with the Health Center have voiced concerns that taking such steps without input from a public health authority could put the community at risk for a potential COVID outbreak.

“I told them, we’re responsible for six districts — plus nursing homes and work places — so in the bigger picture we have a lot of people to protect,” Kincaid said. “So if our largest school district does something totally against what we’ve implemented as a county, it’s kind of (alarming).”

But the sentiment from the school district’s perspective is that while there is an understanding of the Health Center’s prioritization of keeping the Moniteau County population physically healthy, the feeling from the school board was that goal comes at the expense of students’ mental and emotional well-being.

“I know that the Health Department’s main goal is to focus on the health of the child, and it’s primarily the physical health of the child, and as a school and as a school district and as school board members, we try to take in all of the aspects of health, whether that be mental, social, emotional,” VanLoo said. “That’s a hard thing to balance, it really is, to try to put one aspect of health before another. It was a big part of our discussion.”

There’s an impact — especially to elementary-age students — to being forced away from the “school atmosphere, VanLoo said.

Sanders and VanLoo also pointed to feedback from district patrons frustrated with their children being forced to quarantine as a factor in prompting the school board to seek an outside solution.

“I think our board does a really good job of listening to our patrons,” VanLoo said. “When the board comes together and we’re hearing similar stories from the community, we need to act upon those things. And it’s one thing when you hear one or two voices in the community, but when you start hearing it from the vast majority of the community, it’s time that you move your policy to agree with what they’re asking.”

And Sanders added such feedback is not just taken at face value but coupled with a “bird’s eye view” from the district’s perspective.

“It’s really assessing the entire situation from a bird’s eye view of okay, what are the pros and cons, what’s the benefit (compared) to the cost of each of these options that we’ve got available to us?” Sanders said. “If we thought there was a situation that was inherently going to result in lots of outbreaks of positive cases, then we wouldn’t do it. But if that starts happening, then we do have protocols in place to bring that back in line where it needs to be.”

Wilfong and Kincaid pointed to DESE’s “test to stay” guidance, introduced during October, as a sufficient existing solution to the school district’s frustrations with extended quarantines. The policy allows students who have been identified as a close contact to remain in school provided they don’t develop COVID symptoms, continue wearing a face mask for 14 days after exposure, and receive at least three negative rapid COVID tests during their first week after exposure.

They also voiced concern that policies differing from those set by the Health Center could lead to confusion among community members, on top of any additional risk for spread of the virus.

Sanders noted that up until now, the school district had taken care to work closely with the Health Center throughout the pandemic so far, and said the recent shift away from working together is in part due to a perceived lack of willingness to allow for “flexibility” in adjusting guidelines. Still, many of the district’s existing COVID protocols remain aligned with the Centers for Disease Control and Prevention, DESE and the Moniteau County Health Center’s recommendations.

Ultimately, though, VanLoo said the school board did not wish to fuel any conflict between the district and the Health Center as a result of its decision.

“I don’t think we were looking for conflict by any means,” VanLoo said. “That certainly was not our intent.”