When the public school year gets under way in Montgomery County, parents, teachers, and students will notice some big changes. A $30 million budget shortfall forced the school system to make some tough choices.
The closing of MCPS’ Virtual Academy attracted a lot of attention this summer. However, the elimination of the school system’s Chief Medical Officer and her 5-person staff seemingly has flown under the radar.
Brief History
Dr. Patricia Kapunan served as the Chief Medical Officer. The County School Board approved the creation of the position in 2021 during the pandemic. Kapunan began her tenure in July 2022 after the big Omicron wave.
“I was brought on not to guide the school system through the pandemic, but to respond to the challenges that arose. The Superintendent, at the time, was very interested in the post-pandemic challenges for students and families. It was not just about Covid. It also was about mental health, and the change in social influencers of health that affected so many families such as economic instability, and job loss,” Kapunan said.
Top Priorities
During her two year tenure, Kapunan said she focused on a wide range of issues. At the top of her list was “helping schools strategize how to serve every child, regardless of their health status and to make sure that a child’s health care needs were not a barrier to the promise of public education.”
“When you think about everything from food allergies to anxiety, to dealing with more medically fragile kids how do you help schools take care of those kids. You need someone with the health knowledge and then you need someone who also has the capacity to understand how things work in the ecology of schools,” she added.
Kapunan is a pediatrician and public health physician. She had more than a decade of experience in school health and served as the medical director of the Adolescent Health Center at Children’s National Hospital in Washington D.C. before she joined MCPS.
Employee Health
In her role as Medical Officer, she also focused on improving employee health and safety.
“There are so many people who make school possible for children. They are just as important and necessary for the health and safety of children,” Kapunan said.
Tackling Substance Use
Another area she tackled was bringing greater attention to an increase in fentanyl related overdoses among young people. She addressed the issue in public forums. Her office helped facilitate access to Narcan training and supplies for students, school staff, and parents.
Laura Mitchell is a member of the Montgomery County Council of Parent-Teacher Associations (MCCPTA). She has been a long-time advocate for mental health and substance use prevention. She called the elimination of the Medical Officer position a “huge loss for the District.”
“The Medical Officer position was created because of strong advocacy by MCCPTA and community members to help manage the health aspects of the pandemic and ensure a safe return to school. Dr. Kapunan was hired because she saw a much larger need that extended far beyond Covid-19. She saw the increasing needs of students and staff around physical health, mental health, and substance use. Dr. Kapunan knew the best way to address all these issues was a whole child/person approach. That is how she structured her work. She used the Centers for Disease Control and Prevention (CDC) Whole School, Whole Community, Whole Child (WSCC) model,” Mitchell said.
Attention on Fentanyl
“During her tenure, we worked together to raise awareness of fentanyl and other substance use with letters to the MCPS community and the Family Forums on Fentanyl. We provided information and education, Narcan training, and distribution to the thousands of students and family members who attended. Last year, in school overdoses were less than 25% of what they were in 2022, and the reduction in fatal overdoses for youth were even greater,” Mitchell added.
“I am very concerned that MCPS was unaware of the many things her office was doing, and that much of that work is still not specifically assigned to others,” Mitchell said.
“If any of us had known that the Office was subject to elimination, we could have easily have secured grant funds to continue this life-changing, life-saving work,” she explained.
MCPS Statement
MCM reached out to MCPS about whether the elimination of the Medical Officer position might impact the school system. Liliana Lopez is a school spokesperson.
“In response to the unprecedented challenges posed by the Covid-19 pandemic, MCPS established the role of Medical Officer to provide essential expert medical advice. The Medical Officer’s guidance was instrumental in making critical operational decisions to safeguard the health and safety of students and staff during that extraordinary time. We have always and continue to collaborate closely with the Department of Health and Human Services to ensure the well-being of our school community.”
Budget Impact
The idea of having a Medical Officer is not new around the country. A number of school systems such as Los Angeles, Philadelphia and Chicago have Medical Officers associated with their schools.
While the County recognized the need to have a Medical Officer in 2021, that was not the case in 2024.
“The interim superintendent looked at the budget. She viewed the Medical Officer as something nice to have, but not something that was a must have. So she removed that office from the budget recommendation,” said school board member Lynn Harris.
Harris has a background in public health and previously worked as a nurse. The school system’s choice to eliminate the Medical Officer position disappointed her.
“I’m among those who felt the work that the Medical Officer was doing added tremendous value to the school system,” Harris said.
However, she explained some people inside the school system did not quite understand the need for the Medical Officer. Harris said she frequently interacts with people from other school systems across the country. She said the view within some in MCPS mirrored how others on the outside see the job.
“A position like a Medical Officer is simply viewed as not what education does. It is just not part of the work. Some people have a difficult time connecting the dots between what it is that a school system is and is supposed to do, and what a Medical Officer does. The view is, there is a health department that is available,” Harris explained.
“Some people thought once we got through the pandemic, okay, we do not need that anymore,” Harris added.
DHHS Partnership
While some in the school system may not have fully understood or appreciated the work of the Medical Officer that was not the case at the County Department of Health and Human Services.
“MCPS’ office of the Medical Officer was an incredible partner with DHHS over the past few years. Dr. Kapunan and her team established critical programs to strengthen the health and well-being of our students. DHHS continues to oversee and administer the School Health Services Program which includes school nurses. Unfortunately given the challenging budget year, DHHS does not have the resources to take on the work completed by the Medical Officer. As appropriate, we will identify where we can continue to provide a scaled-back version of certain services. For example, we cannot administer MCPS’ Narcan distribution program. However, each health room has Narcan available for emergency situations,” said Nina Ashford, Chief of Public Health Services with the Department of Health and Human Services.
Moving Forward
Harris said she remains hopeful the school system will reinstate the Medical Officer’s position in the future. She said perhaps reimagining the office with an expanded scope of work that reaches out to different offices, departments, and divisions in the school system might make the position more viable. She also said perhaps MCPS can examine and model how other school systems use Medical Officers.
Kapunan has a slightly different view. She does not necessarily see the position of Medical Officer as paramount. Instead, she is looking at the big picture.
“I think the real question is how do schools conduct health strategy? How does health strategy integrate with the mission of school systems to educate kids and provide a safe and healthy environment for teaching and learning? Do you need a Medical Officer to accomplish that? I think the work has to be defined. What is important for the County going forward is to really study the impact of what are the unmet health needs that need to be addressed in students and school community staff. How are they going to approach those needs, using the expertise and the resources they have? I think defining the needs will be a lot more important than saying you need a person,” Kapunan said.
