Schools disagree on definition of ‘significant medical condition’

Under Oklahoma’s school grading system, a measure of “chronic absenteeism” is one of the factors included in the calculation of schools’ A-F grades on state report cards. However, exceptions are allowed for students with significant qualifying medical conditions that result in long absences.

In the 2017-2018 and 2018-2019 school years, the State Board of Education oversaw the process for considering schools’ requests for medical exemptions to the absenteeism count. 
But under legislation (http://webserver1.lsb.state.ok.us/cf_pdf/2019-20%20ENR/hB/HB1988%20ENR.PDF ) approved this year, the board’s role was reduced and lawmakers effectively granted schools the ability to set their own definition for qualifying medical emergencies on a district-by-district basis.

The State Board of Education adopted rule changes implementing the new law’s provisions during the group’s December meeting.
A memorandum (https://sde.ok.gov/sites/default/files/documents/files/December%20Rules%20updated.pdf) provided to board members notes the new rule “authorizes school districts to develop chronic absenteeism medical exemption policies at the local level.”

Lori Murphy, assistant general counsel at the Oklahoma Department of Education, said the new rule “sets some very general criteria,” but allows districts to “drill down if they choose to more specifically about what conditions may or may not be included.”
Murphy said state law defines “chronic absenteeism” as “being absent for 10 percent or more of the school year.”

However, public comments from school officials suggest some districts want to define routine medical issues as significant medical events, even though those routine illnesses do not typically result in absences of more than 10 percent of the school year.

The ability to reduce chronic absenteeism at a school through broader exemptions could artificially inflate a school district’s letter grade, a fact alluded to in some public comments on the rule. The memo provided to the state school board included summaries of public comments received by the Oklahoma Department of Education, but did not identify those submitting the comments.

One self-identified school principal said, “It is critical for us to determine who receives a medical exemption since it unfairly jeopardizes our state report card.” The principal claimed the prior rule meant students with the flu or pneumonia would “be punished for helping to contain the spread of such illnesses.”
Another principal said, “I know my students’ needs in this building, actually better than some of their parents.” The principal suggested the chronic-absenteeism exemption should be granted to children “exposed in utero to chemical substances.”

Another commenter wrote, “If a child has a fever, we try to get the fever reduced with otc [over the counter] medications. If we can’t, that child needs to go home. If a child is nauseated and vomiting, that child needs to go home.” The commenter also argued that documentation of an illness should not be required, saying some parents may not take a child to the doctor due to financial constraints.

“In my small community and outlying rural area, my teacher staff and I know our kids,” the commenter continued. “We know their backgrounds, their socio-economic status, what type of home-life they have. Who better than me or my Principals, Counselors, and Teachers will know whether or not our kids are really sick.”
Another commenter claimed that measuring chronic absenteeism on schools’ state report cards “disproportionately reflects negatively upon schools serving large numbers of military children and Native American children due to the cultural expectations of both groups.”

The exemption rule approved by the State Board of Education defines a “significant medical condition” as “a severe, chronic, or life-threatening physical or mental illness, infection, injury, disease, or emotional trauma.” But the new rule does not include language that was originally proposed that would have included other criteria, such as saying a condition must affect a student “so severely as to incapacitate the student from attending school for an identifiable time period or number of school days” and that the student must be “unable to receive instruction through homebound education services.” Another provision included in the original proposed rule that was removed would have required districts to have “written documentation of the condition that is verified in writing by a physician.”

Tracking the differences in how districts implement the rule, and whether grade-inflation games are being played, may prove difficult under the new law. However, Murphy said the state will receive reports from districts that allow some level of review.

“For reporting purposes, when a district has adopted one of these policies and determined students eligible for the medical exemption, that’s something that’s then reported to the Office of Accountability here, rather than an application made to the state,” Murphy said.
On the most recent state report cards, 181 Oklahoma schools received F grades in the “chronic absenteeism” subcategory while another 221 received D grades.

NOTE: Ray Carter is the director of OCPA’s Center for Independent Journalism. He has two decades of experience in journalism and communications. This story first appeared at the website of the Oklahoma Council of Public Affairs (https://ocpathink.org/post/schools-disagree-on-definition-of-significant-medical-condition#ray-carter). Carter previously served as senior Capitol reporter for The Journal Record, media director for the Oklahoma House of Representatives, and chief editorial writer at The Oklahoman. His news stories are regularly “aggregated” by both CapitolBeatOK and The City Sentinel newspaper, and he is often featured on the websites of the two institutions, as in this case.