September 2013
Nurse Corps
1.
Purpose: The School Nurse Corps (SNC) program provides nursing services to meet student health
care needs as identified by a 1997 Joint Legislative Audit and Review Committee (JLARC) study,
Survey of School Nurses (1997). The legislature funds the SNC program through OSPI to the
Educational Service Districts (ESDs), dispatching registered nurses (RNs) to the neediest small
schools to provide direct care for students, health education, and training and supervision for school
staff. The SNC first priority is to maintain and increase student safety through a system of direct
student services and regional technical assistance. The nine ESD nurse administrators are funded to
directly serve all districts in their region by assessing and analyzing student health needs, allocating
resources, consulting, mentoring, and building partnerships.
2.
Description of services provided: School health requirements 30 years ago dealt primarily with
management of communicable diseases, immunizations, and health screenings. Student health
needs and the regulatory landscape are substantially different today. The attached School
Obligations Requiring Professional Registered Nurse table displays these changes. SNC nurses assess
students and develop individualized care plans. They train staff to respond quickly and effectively to
an emergency situation (especially life-threatening) when the nurse is not present. Care plans
outline instructions for school staff to provide daily maintenance care and accommodations for
students with special health care needs, in accordance with federal requirements under Section 504
of the Rehabilitation Act and the Individuals with Disabilities Education Act. These services support
students with complex needs to: be in school, and to be safe, learning, and on track to graduate.
SNC nurse administrators, located close to school districts, support these interventions by providing
customized technical assistance regarding school health and nursing issues. Program staff attends to
quality assurance, guided by student safety, evidence, and cost containment.
3.
Criteria for receiving services and/or grants: Qualifying districts must (1) demonstrate a lack of RN
services existed prior to the inception of the SNC; (2) complete an assessment of district health
services; and (3) meet criteria used to determine the neediest schools. Technical Assistance is
available, without criteria, to all schools and families through the nurse administrators.
4.
Beneficiaries in 2012-13 School Year:
# of School Districts:
6.
141 received direct services, 90% of the
253 reporting districts received nurse
administrator technical assistance
# of Students:
82,779
# of student care plans:
4,047
FY 13 Funding:
State Appropriation:
$2.541 million
FTEs
1.2 FTEs
Are Federal or other funds contingent on state funding? No.
7.
First year funded: 1999
8.
State funding , number of beneficiaries, # services since inception:
5.
Fiscal
Year
FY13
# of School
Districts
141
Amount
$2.5 million
# of Students
Enrolled
82779
# of Nurse
Hours
566.843
# of Health
Conditions
8321
1
FY12
141
$2.5 million
FY 11
138
*$2.4 million
FY 10
138
$2.5 million
FY 09
138
$2.5 million
FY 08
149
$2.5 million
FY 07
145
$2.5 million
FY 06
152
$2.5 million
FY 05
155
$2.5 million
*$2.5 Million – 6.287% 10/01/2010 = $2.4 million
74,860
73,716
73,380
77,179
87,333
82,563
94,971
100,521
558.398
Before cut 644
638
638
692
815
921
1005
8247
Not Available
14,929
13,832
12,800
10,972
11,684
10,988
9.
Average and range of funding per beneficiary, 2012-13 school year: Each of the 9 ESDs are
awarded a grant ranging from $103,000 (PSESD) to $463,000 (ESD 101). The regional nurse
administrators analyze district data and a ‘greatest need’ matrix to allocate limited RN hours to
local school districts. The program flexibility allows SNC RN hours to be provided by (1) a district
hired nurse; (2) an ESD hired or contracted nurse; (3) a public health nurse; or (4) a nurse employer
that has a qualified nurse available.
10.
Programmatic changes since inception: Program objectives were modified in 2006 prioritizing
nursing hours to focus on direct services for student safety. In addition, the program evolved to
more fully recognize the value of having a regional nurse expert available to help districts and
families resolve student health issues.
11.
Evaluations of program/major findings: Annually, OSPI collects and aggregates data through the
Assessment of District Student Health Services and parent and staff surveys. Findings include 80% of
the parents surveyed agreed their child is safer at school because of the SNC nurse’s interventions;
and 96% of staff surveyed agreed having a school nurse in the district resulted in improved health
and/or safety for both students and staff(2008-09). Student health conditions continue to increase
in number and severity, requiring RN support (only RNs have the clinical expertise and legal
authority to create individual care plans and train unlicensed staff, increasing student safety).
12.
Major challenges faced by the program: Since the 2003-04 school year in the SNC program:
 Higher needs, higher costs, reduced capacity, resulting in significantly reduced direct RN hours
 Student health conditions and federal requirements have increased resulting in increased need
for RN student health counseling, training staff, health education, and other services in schools.
13.
Statutory and/or Budget language:
Budget Proviso: 2ESHB 1087, Sec. 501 (2) (a) HEALTH AND SAFETY (i) $2,541,000 of the general
fund -- state appropriation for fiscal year 2012 and $2,541,000 of the general fund – state
appropriation are provided solely for a corps of nurses located at educational service districts, as
determined by the superintendent of public instruction, to be dispatched to the most needy
schools to provide direct care to students, health education, and training for school staff.
Other relevant information: Data supports a link between increasing student health risk factors and
increased academic challenges. Nurses intervene to address health risks associated with academic
challenges including asthma to depression. If funding for the SNC continues to erode, many students
with critical health care needs will not be served. If the program is eliminated there would be districts
(and their students) without RN services. Each SNC nurse administrator typically receives more than 100
technical assistance questions per month. Examples include, (1) student’s with: oxygen, a heart
problem, an insulin pump, a feeding tube, cancer, (2) infections such as H1N1, or MRSA, (3) accepting a
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medication order from out of state, and (4) help finding resources for students with dental needs, eating
disorders, depression, anger outbursts, or vision problems.
The SNC connects community health partners with schools. Nurses collaborate with community health
and service organizations to provide coordinated school health systems that improve student outcomes,
result in optimal student health and wellness, and contribute to the health of the community. Local
health jurisdictions maternal child health funds were reduced as of 10/1/10 and the School-based
Medical Services (through DSHS) will be eliminated January 1, 2010. These reductions increase the
critical need to maintain School Nurse Corps services for students in rural Washington.
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