SENATE BILL REPORT

                   SB 6546

              As Reported By Senate Committee On:

           Health & Long-Term Care, January 30, 1998

                Ways & Means, February 10, 1998

Title:  An act relating to school nurses.

Brief Description:  Establishing nurse/student ratios for schools.

Sponsors:  Senators Deccio, Wood, Wojahn, Rasmussen, Hochstatter, McAuliffe, Finkbeiner, Prentice, Thibaudeau, Oke and Patterson.

Brief History:

Committee Activity:  Health & Long‑Term Care:  1/20/98, 1/30/98 [DPS-WM].

Ways & Means:  2/10/98 [DP2S].

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Majority Report:  That Substitute Senate Bill No. 6546 be substituted therefor, and the substitute bill do pass and be referred to Committee on Ways & Means.

  Signed by Senators Deccio, Chair; Wood, Vice Chair; Benton, Fairley, Franklin and Wojahn.

Staff:  Rhoda Jones (786-7198)

SENATE COMMITTEE ON WAYS & MEANS

Majority Report:  That Second Substitute Senate Bill No. 6546 be substituted therefor, and the second substitute bill do pass.

  Signed by Senators West, Chair; Deccio, Vice Chair; Strannigan, Vice Chair; Brown, Fraser, Kohl, Long, Rossi, B. Sheldon, Snyder, Spanel, Swecker, Thibaudeau, Winsley and Zarelli.

Staff:  Bill Freund (786-7441)

Background:  A recent survey of school nurses conducted by the Joint Legislative Audit and Review Committee (JLARC) during the 1997-98 school year showed that in Class I school districts (those with over 2,000 students) the ratio of school nurses to students is approximately one nurse to 1,650 students.  In class II districts (those with enrollments under 2,000) the ratio is one nurse to 2,300 students.

Recent studies have shown that an increasing number of school children in grades kindergarten through 12 have serious health conditions which need medical attention during school hours. 

There has been increasing concern that there is an insufficient number of school nurses throughout the state to deal with the health needs of students in school settings.

Summary of Second Substitute Bill:  The Joint Legislative Audit and Review Committee  is required to continue the study on the provision of health services in Washington's public schools and to submit the study to the Legislature and the Governor by December 1, 1998. 

The study must address the following:  workloads of school nurses and other health workers; optimal levels of health services; means of providing the health services including contracting with local public health districts and other public and private sources; and funding methodologies and potential sources of funds.

If specific funding for this bill is not provided in the budget, the bill is null and void.

Second Substitute Bill Compared to Substitute Bill:  The following are not included in the second substitute bill: 

Beginning with the 1999-2000 school year, each school district in the state is directed to maintain a ratio of not less than one school nurse for every 1,500 full-time equivalent students.  In the 2000-2001 school year, the ratio required is one nurse to 1,000 students. For the 2001-2002 school year, the ratio is not less than one nurse for every 750 students.

School districts need not hire certificated nurses.

School districts may contract with educational service districts (ESD) to ensure there is never less than one nurse for every 750 full-time equivalent students in the ESD.

School districts which currently have ratios that meet the terms of the legislation may not reduce their nurse/student ratio below 1 to 750.

For pay purposes, school districts must consider in-school and out-of-school experience to determine total years of service.

By December 31, 2001, the Superintendent of Public Instruction must report to the Legislature on the impact of the services provided and whether funding for school nurses should be an ongoing responsibility of the state and part of basic education.

Substitute Bill Compared to Original Bill:  School districts need not hire certificated nurses.  School districts may contract with ESDs to ensure there is never less than one nurse for every 750 full-time equivalent students in the ESD.  School districts which currently have ratios that meet the terms of the legislation may not reduce their nurse/student ratio below 1 to 750.  For pay purposes, school districts must consider in-school and out-of-school experience to determine total years of service.

Appropriation:  None.

Fiscal Note:  Requested on January 19, 1998.

Effective Date:  Ninety days after adjournment of session in which bill is passed.

Testimony For:  There are not enough nurses in our schools to handle the complex health needs of students.  Non-licensed personnel are being forced to perform health-related services, which they feel ill-prepared to do.

Testimony Against:  Without adequate funding, this mandate will require school districts to hire fewer teachers to meet the nurse ratio requirements.  This will compromise education.

Testified:  Jean Ameluxen, Judy Maire, OSPI (con); Ann Simons, School Nurse Organization of Washington (pro); Doug Nelson, Public School Employees (pro).