Title: An act relating to improving the delivery of health care services for school-aged children.

Brief Description: Requiring a work group to assess school nursing services in class I school districts.

Sponsors: By House Committee on Health Care (originally sponsored by Representatives Morrell, Clibborn, Green, Kessler, Cody, Appleton, Darneille, Williams, Campbell, Lovick, Simpson, Hunt, Chase, Wood, Sells, Roberts, Kenney, McIntire, Hasegawa, Santos, Moeller and Schual-Berke).

Brief History:

Health Care: 2/11/05, 2/24/05 [DPS].

Floor Activity:

Passed House: 3/9/05, 75-21.

HOUSE COMMITTEE ON HEALTH CARE

Majority Report: The substitute bill be substituted therefor and the substitute bill do pass. Signed by 14 members: Representatives Cody, Chair; Campbell, Vice Chair; Morrell, Vice Chair; Bailey, Ranking Minority Member; Curtis, Assistant Ranking Minority Member; Alexander, Appleton, Clibborn, Condotta, Green, Hinkle, Lantz, Moeller and Schual-Berke.

Staff: Molly Belozer (786-7104).

Background:

The U.S. Department of Health and Human Services includes, in "Healthy People 2010," a goal of a school nurse-to-student ratio of 1:750. A 1997 Joint Legislative Audit and Review Committee report found, in response to a survey, an average ratio of one full-time equivalent (FTE) registered nurse for every 1,713 FTE students among Washington school districts.   

In 2000, the Washington State Nursing Care Quality Assurance Commission and the Office of Superintendent of Public Instruction developed the "School District Model for Delivery of Health Services." The model for district-wide staffing for health services recommends one professional school nurse for every 1,500 regular education students.

In Washington, every school nurse must be certified as an educational staff associate (ESA). The State Board of Education certifies school nurses as ESAs. To attain initial certification as a school nurse under Board of Education rules, a candidate must:

   1.    hold a valid registered nurse license from Washington;
   2.    hold a baccalaureate degree or higher in nursing from an accredited program; and
   3.    complete 30 clock hours or three quarter hours of Board of Education-approved course work.

For continuing certification, school nurse candidates must provide documentation of 180 days of employment and have completed 45 quarter hours of post-baccalaureate course work.

Summary of Engrossed Substitute Bill:

The Office of Superintendent of Public Instruction must develop a work group to assess school nursing services in class I school districts. The work group must collaborate with representatives from groups including school nurses, schools, students, parents, teachers, health officials, and administrators. The work group must study the need for additional school nursing services by assessing the current school nurse-to-student ratio in each class I school district, assess the demand for school nursing services, and assess if funding for school nurses should continue as part of basic education. The work group must recommend best practices in school nursing services and make recommendations for school nursing services to the Legislature. The work group must also work with managed care plans to improve coordination of and access to health services for children on Medicaid or the State Children's Health Insurance Plan. The Office of Superintendent of Public Instruction must report the work group's findings and recommendations to the Legislature by February 1, 2006. This provision expires June 30, 2006.

School nurse is defined as a person who:
   1.    holds a bachelor of science degree in nursing, including training in public health nursing;
   2.   holds a valid license as a registered nurse in Washington; and
   3.   is certified as an educational staff associate.

A School Nurse Account (Account) is created to support an increase in school nursing services. The Account is funded with receipts from gifts, grants, or endowments received by the Office of Superintendent of Public Instruction from public or private sources. Schools with more than a 1:1,500 school nurse-to-student ratio must receive priority funding.

Appropriation: The sum of $45,000 to the Office of Superintendent of Public Instruction.

Fiscal Note: Available.

Effective Date: The bill takes effect 90 days after adjournment of session in which bill is passed. However, the bill is null and void unless funded in the budget.

Testimony For: School nurses are more important as children have more complex health services. Health and education are linked; studies have shown that attendance is improved with more sufficient school nurse staffing. Many school districts lack adequate school nurse staffing, some far below the minimum recommended 1500:1 school nurse-to-student ratio. Comprehensive health needs of schools need to be addressed.

Testimony Against: None.

Persons Testifying: Representative Morrell, prime sponsor; Lonnie Johns-Brown and Mary Myers, School Nurses Association of Washington; Paula Meyer, Department of Health, Nursing Care Quality Assurance Commission; Greg Williamson and Gayle Thronson, Office of Superintendent of Public Instruction; Lucinda Young, Washington Education Association; and Jani Greer, Tacoma Federation of Para-Educators, and American Federation of Teachers of Washington.

Persons Signed In To Testify But Not Testifying: None.