Pub. 4 2014-2015 Issue 1

18 Keep in mind Utah Law 53A-11- 204 (2007), nursing services in the public schools states: Collaborative efforts which encourage schools to provide nursing services equivalent to the services of one registered nurse for every 5,000 students or, in districts with fewer than 5,000 students, the level of services recommended by the Department of Health. On a national level, a 1:5,000 ratio is considered unsafe. The landscape of school nurs- ing has changed dramatically over the years. Children who were once institutionalized or kept home due to their medical conditions are now attending school, and are entitled to a free appropriate public education (FAPE) as defined by Section 504 and the Individuals with Disabilities Education Act (IDEA). In order to help provide a safe and appropri- ate environment for the increasing number of attending medically fragile students, national recommendations of school nurse to student is related to student acuity: 1:750 for students in the general population; 1:225 in the student populations requiring daily professional school nursing services or interventions; 1:125 in student populations with complex health care needs, and 1:1 may be necessary for individual students who require daily and continuous professional nurs- ing services (NASN, 2010). Consider what a safe school nurse to student ratio would be at your school, taking into account how the ratio changes when hiring a part-time position. Calculate number of students divided by school nurse FTE for your school nurse-to-student general ratio. School Nurse Qualifications There are various levels of nursing preparation, from Licensed Practical Nurse (LPN) to PhD. The National Association of School Nurses (NASN) and the Utah State Office of Educa- tion (USOE) both recommend the hiring of a registered nurse (RN) with baccalaureate preparation. School nursing is an independent practice requiring advanced training in organi- zational management, critical thinking skills, communication, child advocacy, and knowledge of the educational process. The school nurse may obtain national recognition by taking the Nationally Certified School Nurse Examination, which is equivalent to the achievement of a nationally certi- fied teacher. If considering hiring an LPN, be aware that the LPN requires supervision by a doctor or an RN and cannot delegate his or her license for medical management. Funding Resources for a School Nurse Position USOE has available matching School Nurse Incentive Program funds gener- ated from 2007 legislation. House Bill 160, section 7, lines 314-321 (2007 Session) state: “The State Board of Education shall distribute monies ap- propriated to award grants to LEAs that a) provide an equal amount of matching funds and b) do not sup- plant other monies used for school nurses.” Application for this grant is an acknowledgment of the importance of having workable ratios of licensed school nurses to students. Applications go out by late March, after legislative notification of avail- able funding and are due back to the state school nurse consultant by April 15th. A quick turnaround through an application approval process provides notification of grant awards by the end of May. Refusal of funds will not limit eligibility for any funds that may be available in the future. Over the years, funding has dropped from an original $1 million to $882,000. Efforts are underway to promote increasing funding through legislation. The funds are distributed according to a mathematical formula that secures a base funding for school districts, with remaining funds distributed evenly among districts and charter schools according to reported fall student enrollment. The March funding application requires the following assurances: • Monies provided through this grant shall continue to be used to increase the hours of current part-time school nurses or to hire new school nurses in order to lower school nurse-to-student ratios from the 2008 level. • A school nurse who is hired as one full FTE at a school LEA site can- not be counted as a partial FTE at a second school LEA site. • A physician consultant to provide oversight for school health services is required and physician name and license number is provided. • Matching funds may be provided through a match in kind, e. g., collaborative with local health department, using contracted hours or services with a licensed physician to oversee medical and nursing ac- tivities for district or charter school with documentation of a memo- randum of understanding (MOU) or with a signed contract, or with a contract guarantee to increase hours of current school nurses or new hire school nurses. • Districts and charter schools shall provide documentation ensuring that monies received are not used to supplant costs for nurses hired prior to July 1, 2008 by providing the following information: o List of schools participating in the funding program o Current school nurse FTEs with names and license numbers The decision on the number of hours a nurse will be on duty at your school should be determined by the acuity of the CONTINUED FROM PAGE 17