Brief Description: Improving children's health services.

Sponsors: Representatives Schual-Berke, Cody, Green, Morrell, Roberts, Appleton, Moeller, Simpson, Williams, Murray, Chase, Dickerson, Darneille, Haigh, Kagi and Santos.

Hearing Date: 2/11/05

Staff: Molly Belozer (786-7104).

Background:

Registered nurses may delegate specific limited health care tasks to non-medically licensed personnel, including teachers, paraprofessionals, and office staff, if adequate training and supervision are provided. By law, the only tasks that can be delegated to non-medically licensed personnel include the administration of oral medications and clean intermittent bladder catheterizations.

A 2001 Department of Health Sunrise Review of School Health Aides (Sunrise Review) recommended the state regulation of registered school health aides through the Department of Health according to established nursing practice standards and the state's uniform professional accountability processes. The Sunrise Review found that having school health aides would alleviate public harm, protect the public, and establish a cost-effective means of reducing the risk of legal actions.

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 3 quarter hours of Board of Education-approved course           work.

Summary of Bill:

A new profession of "school health aide" is created. The Department of Health (Department) must establish rules and set fees for this new profession. Conduct by members of this new profession is regulated under the Uniform Disciplinary Act. A school health aide must be registered with the Department to perform health care tasks applicable to school districts, such as administration of oral medication and catheterization under the training and supervision of a licensed registered nurse. The Office of Superintendent of Public Instruction must work with the Nursing Care Quality Assurance Commission to establish standards and procedures for educational and alternative training program approval.

A Joint Legislative Task Force for Student Health (Task Force) is created to consult with the Department of Health and the Office of Superintendent of Public Instruction on student health. The Task Force will investigate the need for additional school nursing services, assess the demand for school nursing services, and recommend best practices in school nursing services. Members of the Task Force will be appointed by the Senate President and the Speaker of the House, and will include members of the committees with jurisdictions over health, education, and budgetary matters. The Task Force must report its findings and recommendations to the appropriate legislative committees by December 1, 2005. The Task Force expires on July 1, 2006.   

A School Nurse Account (Account) is created to support an increase in certified educational staff associate (ESA) school nurses (but not nurses from the School Nurse Corps) in class I school districts. Schools with more than a 1:1,500 school nurse-to-student ratio must receive priority funding.

The duties of the State Board of Education are amended to require that the teacher, administrator, and school specialized personnel certification program include training requirements in first-aid and cardiopulmonary resuscitation (CPR). Furthermore, school building administrators and school district boards of directors should provide opportunities for all school employees to receive emergency first aid and CPR training, as well as periodic refresher courses.

Registered nurses are included in the distribution formula that is used to determine the basic education allocation for each annual average full-time equivalent (FTE) student. The minimum ratio for school nurse personnel under this formula is 1.33 registered school nurse personnel to 1,000 annual average FTE K-12 enrolled students (or a 1:750 school nurse-to-student ratio).

Appropriation: The sum of $45,000 from the General Fund-State to the Office of Superintendent of Public Instruction.

Fiscal Note: Requested on February 2, 2005.

Effective Date: The bill contains an emergency clause and takes effect immediately.