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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.

Final Report

Executive Summary



Relevant Legislation:

  • Senate Bill 793 (2017–18): An act to direct the State Board of Education to recommend a school nurse staffing standard and develop an implementation plan to meet that standard, to direct the Department of Health and Human Services and the Department of Public Instruction to develop a plan to consolidate certain school-based nursing funding programs, to require the Department of Health and Human Services to examine Medicaid rates for school-based nursing services, and to establish Medicaid reimbursement for school-based nursing services documented on 504 plans and Individual Health Plans, as recommended by the Joint Legislative Program Evaluation Oversight Committee.This legislation was not enacted.

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Press Coverage: