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: 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: Passed House: 3/09/05, 75-21.

Committee Activity: Early Learning, K-12 & Higher Education: 3/23/05, 4/1/05 [DP, DNP].

SENATE COMMITTEE ON EARLY LEARNING, K-12 & HIGHER EDUCATION

Majority Report: Do pass.Signed by Senators McAuliffe, Chair; Pridemore, Vice Chair; Weinstein, Vice Chair; Berkey, Delvin, Eide, Kohl-Welles, Rasmussen, Rockefeller, Schoesler and Shin.

Minority Report: Do not pass.Signed by Senators Schmidt, Ranking Minority Member; Benton, Carrell, Mulliken and Pflug.

Staff: Ingrid Mungia (786-7423)

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 Bill: The Office of Superintendent of Public Instruction and the Department of Health 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: None.

Fiscal Note: Requested on March 15, 2005.

Committee/Commission/Task Force Created: No.

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

Testimony For: Instead of just looking at nurse-to-students ratios, we need to look at grade levels to see if we need different ratios for different grade levels. We also need to look and see if school nursing needs to be part of basic education. With this bill we can also look at school children served with managed care and see if we can coordinate something between schools and managed care. Every year there are more health concerns in schools. Some nurses have so many students they can't focus on prevention. The section of the bill dealing with OSPI is good because they can request districts to submit information regarding their schools nurse-to-student ratios. We need to look at the nursing situation in our schools. There is a worry about student privacy and safety with so few nurses in schools. The department of health is in support of this bill because the department recognizes school districts are inadequately staffed to serve the growing, diverse, and complex student population. This bill allows the work group to study various concepts of nurse staffing models. It is past time to do this type of study. OSPI is in support of this bill. It is important for OPSI to consider the health issues of students and how to support the health needs of student in order for them to be academically successful and safe. WSSDA supports the bill.

Testimony Against: None.

Who Testified: Representative Morrell, prime sponsor; Mary Myers, School Nurses Organization of Washington; Mary Kinfield, PTA; Paula Meyer, Department of Health; Lucinda Young, WEA; Gayle Thronson, OSPI; Dan Steele, WSSDA.