Increasing Attendance Through Asthma Prevention

Increasing Attendance Through Asthma Prevention

Superintendent Richard Middleton of San Antonio's (Texas) North East Independent School District knew that by increasing attendance rates his district would receive more state education funding.

San Antonio's (Texas) North East Independent School District (NEISD) grows by about 2,000 students per year, says Superintendent Richard A. Middleton, because when new families move to town, many prefer his district out of the 19 others in the city.

In 2005, facing cuts in state education funding, Middleton started looking at ways to maximize revenue. A review of the attendance rate from that year and a few previous years showed stagnant numbers. "In Texas, money comes from attendance," says Middleton, who knew if he increased the number of kids coming in every day by just 1 percent, NEISD would get an additional $3.4 million in funding.

The primary culprit was asthma, which afflicts between 8 and 11 percent of students statewide, according to Diane Rhodes, board member of the Asthma Coalition of Texas and a registered respiratory therapist. Asthma causes these students to miss over two to three weeks or more of school each year.

In 2002, mold was discovered in three of NEI SD's elementary schools. The cause: a combination of flawed construction, contractor error and failure of maintenance to notice. "It became clear to me that the construction management and maintenance departments did not share the common goal of understanding environmental health," recalls Middleton.

New Department

Ironically, the mold discovery was the first of three events Middleton calls "a positive perfect storm" toward NEI SD's wellness overhaul. From there, Middleton created a new Department of Environmental Health to oversee air quality issues and advocate and maintain a healthy environment for staff and students. He promoted Ron Clary, his first-in-command custodian, to executive director for facilities and maintenance to run that department. Says Middleton, "We then had departmental leadership that equally understood both their role and responsibility in building health."

Clary's department conducts classroom evaluations, removes mold on ceilings and handles teacher concerns regarding more absenteeism or respiratory-related issues among students. In 2008, the district was honored by the federal Environmental Protection Agency for implementing successful indoor air quality programs.

Asthma Education

In 2006, Rhodes approached Middleton about state and nationwide data showing how asthma affects school attendance and shared ideas for how to combat the district's condition. Middleton hired her that year as the district's director of asthma education for the new department.

Under Rhodes' guidance, communitywide "Asthma Blow-Outs" would inform parents and students about asthma and fostering wellness at home. School nurses, physical education teachers and asthma professionals ran those evening information sessions.

Seeing Results

The effect of the Middleton-Clary- Rhodes trifecta of asthma prevention has been staggering. According to Rhodes, in early fall 2006, the number of inhalers used districtwide due to asthma during the first six weeks of school was more than 9,000. After implementing education outreach and classroom strategies, in early fall 2007 inhaler use dropped to 4,500.

Surprisingly, these changes and improvements haven't increased NEI SD's overall budget. "We're the ninth-largest district in the state," Middleton says, "and of 100 districts in Texas, 97 spend more than we do on maintenance and custodial costs, yet we're achieving excellent results." In addition, Middleton says the district's attendance-based revenue from the state has significantly increased.

Jennifer Elise Chase is a contributing writer for District Administration.


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