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Meeting Current Standards for School Nurses Statewide May Cost Up to $79 Million Annually (May 2017)


The need for school nurses is growing due to increased attendance by children with health issues as well as laws and policies expanding the health care responsibilities of schools. In the 2000s, the State created the Child and Family Support Teams (CFST) and the School Nurse Funding Initiative (SNFI) to address this demand. Although these programs increased the number of nurses, the Program Evaluation Division (PED) found only 46 of 115 Local Education Agencies currently meet the school nurse-to-student ratio of 1:750 recommended by the State Board of Education (SBE) in 2004. Achieving that ratio or providing one nurse in every school would cost between $45 million and $79 million annually. PED also found approximately 60% of medical procedures conducted in schools are performed by employees who are not nurses. Furthermore, few LEAs file for Medicaid reimbursement for nursing services. The General Assembly should direct SBE to formulate a new goal and strategic plan for school nurse staffing levels, and direct the Department of Health and Human Services and the Department of Public Instruction to combine CFST and SNFI into a single program and implement acuity models at state and local levels.

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PED Contact:

Program Evaluation Division, North Carolina General Assembly
Legislative Office Building, Suite 100
300 North Salisbury Street , Raleigh, NC 27603-5925