Reopening K-12 Schools in the Era of Coronavirus Disease 2019: Review of State-Level Guidance Addressing Equity Concerns.

OBJECTIVE: To determine how state guidance documents address equity concerns in K-12 schools during the coronavirus disease 2019 pandemic. STUDY
DESIGN: Using online searches, we collected state-level documents from all 50 states and the District of Columbia discussing reopening plans for K-12 schools in the 2020-2021 academic year. We examined whether these documents explicitly mentioned equity as a concern, as well as if and how they addressed the following equity issues: food insecurity and child nutrition, homelessness or temporary housing, lack of access to Internet/technology, students with disabilities or special needs, English-language learners, students involved with or on the verge of involvement with the Department of Children and Family Services or an equivalent agency, mental health support, students/staff at greater risk of severe illness from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and students/staff living with someone at greater risk of severe illness from SARS-CoV-2 infection.
RESULTS: Forty-four of 51 states (86%) explicitly mentioned equity as a concern or guiding principle. At least 90% of states offered guidance for 7 equity issues. Fewer than 75% of states addressed homelessness or temporary housing, students involved with or on the verge of involvement with Department of Children and Family Services or an equivalent agency, and students/staff living with someone at greater risk of severe illness from SARS-CoV-2 infection.
CONCLUSIONS: Wide variability exists in state-level guidance to help K-12 schools develop reopening plans that protect those who are most vulnerable to learning loss or reduced access to basic needs. Interpretation and implementation by local educational agencies will need to be assessed.

As part of the attempt to reduce transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and control the coronavirus disease 2019 (COVID-19) pandemic, schools closed across the globe in February-March 2020. In the US alone, more than 55 million children have missed in-class instruction. Worldwide, schools have closed in more than 190 countries, affecting 1.57 billion children and youth, or 90% of the world's student population. When and how to reopen schools has been a difficult and sensitive topic on a national, regional, and local level. Despite uncertainties regarding the future of the pandemic, the American Academy of Pediatrics has released guidelines stating that it “strongly advocates” the goal of “having students physically present in school,” citing evidence that children and adolescents are less likely to be symptomatic, to have severe disease resulting from SARS-CoV-2 infection, and to spread infection.

Research has challenged the last of these points. A large study from South Korea showed that children between the ages of 10 and 19 years can spread the virus at least as well as adults, and another study found that children younger than 5 years of age with mild-to-moderate symptoms may have high amounts of SARS-CoV-2 viral RNA in their nasopharynx compared with older children and adults. At least 338 000 children in the US have tested positive through July 30, 2020. Regardless of differences in transmission potential between children and adults, it is increasingly evident that school re-entry can increase virus levels within a community.

However, long-term school closures can negatively impact students, especially those who come from disadvantaged backgrounds. Students from low-income families may lack access to a household computer, resulting in significant learning loss relative to their peers during periods of remote instruction. Without reliable access to free and reduced-cost meals, these students might also not have enough to eat. At the end of April 2020, more than 1 in 5 households in the US and 2 in 5 households with mothers with children 12 years and younger were food insecure. Furthermore, these rates of food insecurity were meaningfully greater than at any other previous point for which there are comparable data. Many parents whose jobs cannot be done from home also rely on schools as a source of childcare.

Beyond delivering academic instruction, schools provide students with a source of nutrition, as well as opportunities for socialization and physical activity. They are sites for physical, speech, and mental health therapy. For some students, they are also a precious source of safety. School closures may inhibit the reporting of child abuse. Using data from Florida, the number of reported child maltreatment allegations was approximately 27% lower than expected during March and April 2020, the first 2 months in which schools were closed in Florida. At the same time, child sexual abuse may have increased following lockdown orders. At the end of March 2020, the Rape, Abuse and Incest National Network reported that for the first time ever, one-half of the victims receiving help from the National Sexual Assault Hotline were minors. Of minors who discussed coronavirus-related concerns, 79% stated that they were currently living with their abuser.

Balancing these types of equity concerns with the safety concerns associated with viral transmission will be the key challenge to overcome during this school year. In the spring and summer months leading up to school restart dates, each of the 50 states, as well as Washington, DC, produced its own K-12 school reopening guidelines. Our aim was to compare these guidelines, focusing on how they intend to address equity concerns relevant to the students and staff who are especially vulnerable during this time. The results may be informative for state and local educational agencies as they continue to revise and finalize their plans for the 2020-2021 academic year.

Methods

We conducted Google searches to identify state-level documents from 50 states and the District of Columbia discussing the reopening of K-12 schools in the 2020-2021 academic year. For convenience, we will refer to DC as our “51st state.” Searches included various combinations of the following terms: [name of state], school, K-12, education, department of education, department of public health, COVID-19, reopening, guidelines, and plan. We used the most recent guidelines as of July 15, 2020, in our assessment, although we expect schools to continue to update their plans as the year progresses.

For each state-level document, we extracted the state, author, and date last updated as of our reading. We also recorded whether the document mentioned equity as a guiding principle and whether the state offered any specific guidance regarding the following equity concerns: (1) food insecurity and child nutrition, (2) homelessness or temporary housing, (3) lack of access to Internet/technology, (4) students with disabilities or special needs in education, (5) English-language learners, (6) students involved with or on the verge of involvement with the Department of Children and Family Services or an equivalent agency (this category includes students at risk of abuse and neglect, as well as students in foster care), (7) mental health support, (8) students at greater risk of severe illness from SARS-CoV-2 infection, (9) staff at greater risk of severe illness from SARS-CoV-2 infection, (10) students living with someone at greater risk of severe illness from SARS-CoV-2 infection, and (11) staff living with someone at greater risk of severe illness from SARS-CoV-2 infection. More information about how we defined each of these 11 categories can be found in Table I (available at www.jpeds.com). All documents were read by the same researcher, 1 researcher read all state documents and 2 other researchers read a subset of state documents (19 in total) to confirm data extraction. All disagreements were resolved through discussion.

Table I

Coding guidelines used in data extraction

Category (Y/N)	Coding guidelines
Mentions equity as a guiding principle	Check Y if any of the following:• Explicitly mentions “equity” as a concern or guiding principle • Acknowledges the importance of addressing the needs of “vulnerable populations” who have been especially affected by the pandemic • Acknowledges the need to address “disparities” Otherwise, mark N for this category, even if the guidelines go on to mention specific vulnerable populations (eg, students with disabilities)
Food insecurity and child nutrition	Check Y if guidance mentions policies relevant to food insecurity• Examples of policies that would be recorded under this category: plan for delivery of free and reduced-cost meals even if schools are closed • Examples of policies that would NOT count in this category: measures related to social distancing in the cafeteria, staggered mealtimes, or using disposable utensils. These measures are related to child nutrition but not directly related to issues of equity or food insecurity.
Homelessness or temporary housing	Check Y if guidance mentions students experiencing homelessness or addresses this population's needs• Examples of policies that would be recorded under this category: develop a COVID-19 transportation protocol for students experiencing homelessness
Lack of access to Internet/technology	Check Y if guidance mentions students without access to Internet/technology or addresses this population's needs• Examples of policies that would be recorded under this category: distribute map with free public Wi-Fi hotspots; survey families in advance about ability to access Internet; funding to provide students in need with devices
Students with disabilities or special needs	Check Y if guidance mentions this population• Examples of policies that would be recorded under this category: interventions to help students with visual or hearing impairments, students with autism, students who are wheelchair-bound • Examples of policies that would NOT count in this category: guidance for students with underlying medical problems such as asthma, cystic fibrosis, etc. Policies relevant to students with underlying illnesses that make a student at greater risk of severe illness from SARS-CoV-2 infection, but would not typically cause a student to have special needs in their academic instruction, should be placed in the “students at greater risk of severe illness from SARS-CoV-2 infection” category.
English-language learners	Check Y if guidance mentions this population• Examples of policies that would be recorded under this category: provide translation services during remote learning
Students involved with or on the verge of involvement with DCFS or equivalent agency	Check Y if guidance mentions this population (including students placed in foster care, OR students at greater risk of abuse and neglect), OR if guidance mentions DCFS or an equivalent agency• Example of policies that would be recorded under this category: continue mandated reporting practices for suspected abuse
Mental health support	Check Y if guidance mentions mental health resources for students OR staff• Mentioning a specific mental illness (depression, anxiety, PTSD, etc) is NOT required to earn a Y. • Examples of policies that would be recorded under this category: mindfulness practice in daily classroom routine, teletherapy resources
Students at greater risk of severe illness from SARS-CoV-2 infection	Check Y if guidance mentions this population• Examples of policies that would be recorded under this category: distance learning arrangements
Staff at greater risk of severe illness from SARS-CoV-2 infection	Check Y if guidance mentions this population• Examples of policies that would be recorded under this category: telework opportunities
Students living with someone at greater risk of severe illness from SARS-CoV-2 infection	Check Y if guidance mentions this population. States that mentioned allowing families to self-report as being high risk were also marked Y• Examples of policies that would be recorded under this category: distance learning arrangements Some states mention that some parents may not feel comfortable sending their children back to school, but for unspecified reasons. This is insufficient to earn a Y.
Staff living with someone at greater risk of severe illness from SARS-CoV-2 infection	Check Y if guidance mentions this population• Examples of policies that would be recorded under this category: telework opportunities

DCFS, Department of Children and Family Services; PTSD, post-traumatic stress disorder.

After extracting data from each state document, we determined what proportion of documents overall mentioned equity as a consideration when planning for the upcoming academic year. We then determined what proportion of documents contained guidance for each of the 11 aforementioned equity issues. To identify examples of how these equity-related policies are being considered at the local level, we also compared school reopening guidelines from 4 major cities in 2 randomly chosen states to their respective state documents.

Using data from all 51 states, we examined relationships between the degree of equity guidance and a state's political affiliation, poverty rates, percent urbanization, Gini coefficient (a measure of income inequality), educational attainment, and health score as defined by the United Health Foundation. Lastly, we compiled guidelines in aggregate to identify how states are planning to address concerns of equity in the coming academic year.

Results

In our review of planning documents, we found that 44 of 51 states (86%) explicitly mentioned equity as a concern or guiding principle. The 7 states that did not mention equity included states from the West, Midwest, and Southeast regions of the US (Figure 1 ). On average, states addressed 8.6 of 11 equity issues. Despite lacking an explicit mention of equity, 2 states—North Dakota and South Carolina—performed above this average, mentioning 10 and 11 equity concerns, respectively. The remaining states—Alaska, Mississippi, South Dakota, Louisiana, and Wyoming—offered guidance for a range of 4 to 7 concerns (Table II [available at www.jpeds.com]11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61 shows equity concerns mentioned by each state).

Figure 1

States with planning documents that did not explicitly mention equity as a concern or guiding principle. Dark gray = did not explicitly mention equity; Light gray = did explicitly mention equity.

Table II

Equity issues mentioned by each state

States	Author	Date last updated (or, if unknown, date accessed)	Mentions equity as a guiding principle, Y/N	Child nutrition and food insecurity, Y/N	Homelessness, temporary housing, Y/N	Lack of access to internet/technology, Y/N	Students with disabilities/special needs, Y/N	English-language learners, Y/N	Students involved with or on the verge of involvement with DCFS, Y/N	Mental health support for students or staff, Y/N	Students at greater risk of severe illness from SARS-CoV-2 infection, Y/N	Staff at greater risk of severe illness from SARS-CoV-2 infection, Y/N	Student living with someone at greater risk of severe illness from SARS-CoV-2 infection, Y/N	Staff living with someone at greater risk of severe illness from SARS-CoV-2 infection, Y/N	Total (out of 11)
AL11	AL State Department of Education	June 26, 2020	Y	Y	Y	Y	Y	Y	N	Y	Y	Y	N	N	8
AK12	AK Department of Education and Early Development, AK Department of Health and Social Services	July 15, 2020	N	N	N	N	Y	N	N	N	Y	Y	Y	N	4
AZ13	AZ Department of Education	June 1, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	N	9
AR14	AR Department of Education	June 16, 2020	Y	N	N	Y	Y	Y	N	Y	Y	Y	N	N	6
CA15	CA Department of Education	June 8, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	11
CO16	CO Department of Education	June 22, 2020	Y	Y	N	Y	Y	Y	Y	Y	Y	Y	Y	N	9
CT17	CT State Department of Education	June 29, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	10
DE18	DE Department of Education	July 9, 2020	Y	Y	N	Y	Y	Y	Y	Y	Y	Y	Y	N	9
FL19	FL Department of Education	June 11, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	11
GA20	GA Department of Education and GA Department of Public Health	July 11, 2020	Y	Y	N	Y	Y	Y	Y	Y	Y	Y	N	N	8
HI21	HI State Department of Education	July 8, 2020	Y	Y	Y	Y	Y	Y	Y	N	Y	Y	N	N	8
ID22	ID Department of Education, ID Department of Health & Welfare, ID State Board of Education	July 9, 2020	Y	Y	N	Y	Y	Y	N	Y	Y	Y	N	N	7
IL23	IL State Board of Education, IL Department of Public Health	June 23, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	Y	N	9
IN24	IN Department of Education	July 15, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	N	9
IA25	IA Department of Education	July 15, 2020	Y	Y	Y	Y	Y	Y	N	Y	Y	Y	Y	N	9
KS26	KS State Department of Education	July 15, 2020	Y	Y	N	Y	Y	Y	N	Y	Y	Y	N	N	7
KY27	KY Department of Education	July 13, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	11
LA28	LA Department of Education	July 15, 2020	N	Y	N	Y	Y	Y	N	Y	Y	Y	N	N	7
ME29	ME Department of Education	July 13, 2020	Y	Y	Y	Y	Y	Y	N	Y	Y	Y	N	N	8
MD30	MD State Department of Education	June 26, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	N	9
MA31	MA Department of Elementary and Secondary Education	July 15, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	N	9
MI32	MI Return to School Advisory Council	June 30, 2020	Y	Y	Y	Y	Y	Y	N	Y	Y	Y	Y	N	9
MN33	MN Department of Education, MN Department of Health	June 18, 2020	Y	Y	Y	Y	Y	Y	N	Y	Y	Y	Y	N	9
MS34	MS Department of Education	June 8, 2020	N	Y	N	Y	Y	N	N	Y	Y	Y	N	N	6
MO35	MO School Boards' Association	July 9, 2020	Y	Y	Y	Y	Y	N	Y	Y	Y	N	N	N	7
MT36	MT Office of Public Instruction	July 2, 2020	Y	Y	N	Y	Y	Y	N	Y	Y	Y	Y	N	8
NE37	NE Department of Education	July 15, 2020	Y	Y	Y	Y	Y	Y	N	Y	Y	Y	N	N	8
NV38	NV Department of Education	June 9, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	10
NH39	NH Department of Education	July 15, 2020	Y	Y	N	Y	Y	Y	Y	Y	Y	Y	Y	N	9
NJ40	NJ Department of Education	June 26, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	N	9
NM41	NM Public Education Department	June 20, 2020	Y	Y	N	Y	Y	Y	N	Y	Y	Y	Y	Y	9
NY42	NY State Education Department, NY State Department of Health	July 13, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	N	9
NC43	NC State Board of Education, NC Department of Public Instruction	July 15, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	10
ND44	ND Department of Public Instruction	July 15, 2020	N	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	10
OH45	OH Department of Education	July 9, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	11
OK46	OK State Department of Education	June 3, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	10
OR47	OR Department of Education, OR Health Authority	June 30, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	10
PA48	PA Department of Education	June 26, 2020	Y	Y	Y	N	Y	Y	N	Y	Y	Y	N	N	7
RI49	RI Department of Education	June 19, 2020	Y	Y	Y	Y	Y	Y	N	Y	Y	Y	N	N	8
SC50	SC Department of Education	June 22, 2020	N	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	11
SD51	SD Department of Education	July 13, 2020	N	Y	N	N	N	N	N	Y	Y	Y	Y	N	5
TN52	TN Department of Education	July 15, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	10
TX53	TX Education Agency	July 2, 2020	Y	Y	Y	Y	Y	Y	Y	Y	N	N	N	N	7
UT54	UT State Board of Education	June 26, 2020	Y	Y	N	Y	Y	N	N	Y	Y	Y	Y	N	7
VT55	VT Agency of Education	July 15, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	N	9
VA56	VA Department of Education	July 1, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	Y	10
WA57	WA Office of Superintendent of Public Instruction	July 8, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	N	9
WV58	WV Department of Education	July 15, 2020	Y	Y	Y	Y	Y	Y	N	Y	Y	Y	Y	N	9
WI59	WI Department of Public Instruction	June 29, 2020	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	10
WY60	WY Department of Education	July 1, 2020	N	N	N	Y	Y	Y	Y	Y	Y	N	Y	N	7
DC61	DC Office of the State Superintendent of Education	July 13, 2020	Y	Y	Y	Y	Y	Y	N	Y	Y	Y	N	N	8

Y indicates that guidance was found for a particular issue; N indicates that guidance was not found.

Although 6 of the 7 states that did not explicitly mention equity as a guiding principle have Republican governors, no significant difference was found between the total number of equity issues addressed for states with Republican vs Democratic leaders (P = .11) (Figure 2, A; available at www.jpeds.com). In addition, we found no strong correlation between the number of equity issues addressed and a state's poverty rate, urbanization level, Gini coefficient, educational attainment, or health score as defined by the United Health Foundation (Figure 2, B-F; available at www.jpeds.com).63, 64, 65, 66, 67

Figure 2

Factors that potentially affect a state's attention to equity: political affiliation, percent urbanization, Gini coefficient (a measure of income inequality), poverty rate, educational attainment, and overall health score (as defined by the United Health Foundation). A, Histogram comparing the distribution of equity issues addressed for states with Republican vs Democratic leaders (P = .11).B, Linear regression comparing the number of equity issues addressed and a state's percent urbanization (R2 = 0.05).C, Linear regression comparing the number of equity issues addressed and a state's Gini coefficient (R2 = 0.02).D, Linear regression comparing the number of equity issues addressed and a state's poverty rate (R2 = 0.003).E, Linear regression comparing the number of equity issues addressed and what percentage of a state's population holds a bachelor's degree or greater (R2 = 0.01).F, Linear regression comparing the number of equity issues addressed and state health score as defined by the United Health Foundation (R2 = 0.01). This score was calculated using 35 measures representing 5 categories: behaviors, social and economic factors, physical environment, clinical care, and health outcomes. A score of 0 represents the health score of the US. No score was available for DC.

Table III shows what proportion of states addressed each of our 11 categories. Overall, states performed well, and we found that 7 of our equity concerns were addressed by at least 90% of all states. The remaining 4 were addressed by fewer than 75% of all states and include homelessness or temporary housing, students involved with or on the verge of involvement with the Department of Children and Family Services or an equivalent agency, students living with someone at greater risk of severe illness from SARS-CoV-2 infection, and staff living with someone at greater risk of severe illness from SARS-CoV-2 infection.

Table III

Proportion of state government plans with guidance on specific equity concerns, listed in descending order

Equity concerns	Number of documents with policies addressing this group or issue
Students with disabilities or special needs	50 (98%)
Students at greater risk of severe illness from SARS-CoV-2 infection	50 (98%)
Mental health support	49 (96%)
Food insecurity and child nutrition	48 (94%)
Lack of access to Internet/technology	48 (94%)
Staff at greater risk of severe illness from SARS-CoV-2 infection	47 (92%)
English-language learners	46 (90%)
Homelessness, temporary housing	36 (71%)
Students involved with or on the verge of involvement with the DCFS or equivalent agency	31 (61%)
Students living with someone at greater risk of severe illness from SARS-CoV-2 infection	27 (53%)
Staff living with someone at greater risk of severe illness from SARS-CoV-2 infection	7 (14%)

We randomly selected California and Mississippi when comparing equity issues addressed by city-level vs state-level documents. Based on a reading of school reopening guidelines for a sample of cities in California (San Francisco, Sacramento, San Diego, and Los Angeles)68, 69, 70, 71 and Mississippi (Jackson, Gulfport, Vicksburg, and Biloxi),72, 73, 74, 75, 76, 77, 78, 79, 80 city-level guidance addressed the same or fewer equity issues when compared to the corresponding state-level guidance.

Table IV contains a summary of best practices for each of our equity concerns based on data from all 51 states.

Table IV

Summary of best practices for addressing equity concerns in K-12 education

Equity concerns	Guidelines
Food insecurity and child nutrition	• Deliver meals even if schools are closed • Communicate with families about meal services and options • Forge partnerships with community organizations offering meal services (eg, food pantries) • Allow families to apply for free and reduced lunch multiple times throughout the year • Use all methods of receiving free and reduced applications (online, mail, in-person) • Request any available flexibilities and waivers offered by the USDA to support districts in providing meals to students
Homelessness or temporary housing	• Ask homeless liaisons to maintain contact with these students and ensure that they have access to school- and/or community-based supports • Remove potential barriers to learning, including lack of Internet access • Set aside Title IA funds to support students experiencing homelessness • Consider prioritizing these students for in-person instruction • Deliver meals through buses parked in areas convenient for homeless families • Consider transportation needs if schools are open
Lack of access to Internet or technology	• Identify students in need (eg, by surveying families about access to technological resources) • Secure funding for devices • Share community locations with free Internet access • Provide free Internet access (eg, through business partners, or by allowing students to come into school with appropriate supervision during remote learning days) • Deploy devices offered by schools • Give assignments that can be completed without technology • Provide technological support, including opportunities for parents to learn how to use devices or online resources
Students with disabilities or special needs	• Review and revise Individualized Education Plans as necessary • Assess learning loss from school closures • Provide accessible routes of communication for individuals with visual or hearing impairments • Prepare for scenarios in which physical distancing is not possible (eg, consider enhanced PPE for staff) • Consider unique needs with daily health screenings, restroom use, paths of travel, use of campuses, and cleaning/disinfecting. Consider how cleaning/disinfecting needs may reduce time available for instruction • Face shields or clear face coverings may be helpful for instructors (eg, when students require clear speech or lip-reading to access instruction) • Prioritize these students for in-person instruction. If schools open, invite students who are visually impaired or have other buildings a day or two before the official start date so these students can develop some familiarity with the layout of the building • Ensure access to general education peers • Consider transportation needs, including a special COVID-19 transportation protocol, if schools are open • Consider recording videos for families to assist with at-home supports
English-language learners	• Engage parents in a language they can understand • Prioritize these students for in-person instruction • Face shields or clear face coverings may be helpful for instructors, or teachers may consider pre-recording demonstrations • Provide signs and messaging in alternative formats if they cannot be understood by students whose primary language is not English • Assess academic losses incurred from school closures • Provide remote learning support for students (eg, through translation services) and consider professional learning opportunities on teaching English learners remotely • English-language instructors and content area teachers should collaborate to meet the needs of these students • Encourage the continuation of native language learning through television programs, social media, etc. Foster a school culture in which multilingualism is seen as an asset
Students involved with or on the verge of involvement with DCFS or equivalent agency	• Continue mandatory reporting requirements, even during distance learning • Provide teachers with guidance on recognizing signs of abuse and neglect in a remote environment • Monitor absenteeism and partner with DCFS or equivalent agency to consider outreach strategies for difficult-to-reach students • Encourage regular communication between foster caregivers and teachers/school staff through multiple modalities (phone, text, etc)
Mental health support	• Inventory existing supports and identify needs • Provide access to mental health specialists (eg, through opportunities for teletherapy) • Make sure that any technology being used to deliver mental health services remotely is secure and HIPAA-compliant • Provide families or staff with community mental health resources • Provide resources for self-care (eg, resiliency strategies) • Conduct mental health screenings or check-ins for students and staff • Familiarize staff with remote suicide risk assessment • Provide professional learning opportunities related to compassion fatigue, mental health first aid, and trauma-informed practices
Students at greater risk, or living with someone at greater risk of severe illness from SARS-CoV-2 infection	• Consider providing a distance learning option • Provide opportunities to interact with peers even if they do not attend classes in person (eg, by recording classes live) • Ask students/families to consult with their healthcare provider on recommendations for re-entry • Designate special spaces for these students (eg, a seat on the bus that is not shared by other students) and disinfect these areas regularly • Do not penalize for failing to attend classes in person • Protect these individuals' privacy
Staff at greater risk, or living with someone at greater risk of severe illness from SARS-CoV-2 infection	• Consider providing a telework option • Modify job responsibilities to limit exposure risk • Ask staff to consult with their healthcare provider on recommendations for re-entry • Protect these individuals' privacy

HIPAA, Health Insurance Portability and Accountability Act of 1996; PPE, personal protective equipment; USDA, US Department of Agriculture.

Discussion

The COVID-19 pandemic has negatively impacted the education and well-being of schoolchildren across the US. The most at-risk students include those from low-income families, students with disabilities, English-language learners, students at risk of abuse or neglect, and students with underlying medical conditions, among other groups. Some individuals may identify with more than 1 of these groups, along with historically marginalized groups such as racial and ethnic minorities, refugees, and LGBTQ + individuals, placing them at even greater risk of experiencing learning loss or lacking basic needs during this time. Teachers and staff members face their own challenges related to operating schools during an ongoing pandemic; many are worried about their safety if schools open in person and about how best to teach and support students if schools continue online.

In acknowledgment of all of these challenges, most states have made equity a guiding principle in drafting guidelines for the 2020-2021 academic year. Our study revealed that almost all states offer guidance for schools regarding food insecurity, lack of access to Internet/technology, students with disabilities, English-language learners, mental health support, and students or staff at greater risk of severe illness from SARS-CoV-2 infection. Some states may need to further consider how they can support students experiencing homelessness or temporary housing, students at risk of abuse or neglect, students in foster care, and students or staff living with individuals at greater risk of severe illness from SARS-CoV-2 infection.

We were unable to find a factor that strongly correlated with the total number of equity issues that a state's guidelines addressed. In particular, the lack of correlation between income inequality, educational attainment, health scores, or poverty rates and the degree of equity guidance suggests that state-level planning committees may be crafting K-12 school equity guidelines independently of state-level measures of inequity.

Different equity concerns may be of greater importance depending on whether schools are providing in-person instruction or distance learning. For instance, under distance learning, schools may not need to provide special support for individuals with underlying medical conditions, but they will need to devote greater efforts to supporting students without Internet access, as well as students who rely on schools for free- or reduced-cost meals. They will also need to develop practices that enable teachers to identify signs of abuse or neglect, despite only encountering students in a remote learning environment. Regardless of whether schools are opening in-person or not, continuous collaboration among families, teachers, school leaders, public health officials, and community organizations will be essential to achieving a balance of safety and equity in the coming academic year.

Our study has several limitations. First, we only reviewed publicly available guidance documents posted by state-level departments online. Certain states may have prepared relevant guidance documents that were not posted on the Internet and, as a result, were not represented in our data. As the pandemic continues to evolve, some states have modified their guidelines and their plans for reopening, but changes and addendum guidance documents added after July 15, 2020 were not included here. Readers looking for continuous updates may consider Johns Hopkins University's online eSchools + Initiative, which presents a regularly updated analysis of school reopening plans. However, our study and the eSchools + Initiative used different frameworks. For instance, the eSchools + Initiative included broader categories such as “children of poverty and systemic disadvantage,” and we considered 3 separate poverty-related issues: food insecurity, homelessness, and lack of access to Internet or technology. The eSchools + Initiative also included categories not specific to vulnerable populations, including “privacy” and “engagement and transparency.” In general, relative to our study, the eSchools + Initiative offers a broader overview of school reopening guidance while focusing less on compiling the specific equity-related practices proposed by different state guidelines.

A second limitation of our study is that local educational agencies may or may not follow state-level guidance. We examined this possibility when reading policies from cities in Mississippi and California. In this sample, city-level guidance did not conflict with the equity concerns raised by state-level documents. However, some local officials have announced an intent to depart from regional or state-level recommendations regarding school reopening; these local officials include leaders of private schools, which do not share many of the same regulations governing public school systems. Even at the local level, discrepancies might arise between stated guidance and implementation as schools begin the academic year. For instance, local educational agencies may intend to secure funding for technological devices to assist students in need, but this funding may not be available.

Third, our data extraction does not reflect differences in the comprehensiveness of state guidelines. Some state provided detailed guidance for a particular equity concern, whereas others only mentioned that a particular concern should be addressed. Policies with minimal guidance leave local educational agencies with the responsibility of figuring out how to support their students and staff in at-risk populations.

This review of state government guidance focused exclusively on equity concerns in K-12 schools during the COVID-19 pandemic. School leaders can use the findings presented here to identify best practices for a variety of equity concerns. Implementing some or all of these practices will help protect vulnerable populations in the 2020-2021 academic year.

Data Statement

Data sharing statement available at www.jpeds.com.