By Thomas Goldsmith

Students at North Carolina’s public schools would benefit from far greater access to school nurses who could treat injuries, dole out medicine, and monitor chronic illness, according to a report that legislative staff completed last May, based on a September 2016 request.

In January, the General Assembly’s Program Evaluation Oversight Committee heard a short version of the long-delayed report by the nonpartisan Program Evaluation Division. The report was next scheduled to be brought forward at a February meeting that was canceled.

Chairman Rep. Craig Horn, a Weddington Republican, previously said he “couldn’t comment” on the nurses report until the committee discussed it, but cited his “record of supporting school nurses in every school in North Carolina and recognizing its importance.” At the time of this quote, Horn said the committee would discuss the report this past Monday, but once again, the school nurses discussion was delayed.

Legislative staff said that the committee, who are charged with evaluating new and existing programs to determine whether they meet legislative intent, will consider the report at its next meeting on April 9.

That’s when staff are scheduled to present the full report, which calls for bringing the state up to a now-outdated standard of one school nurse for every 750 students, with an estimated cost of $45 million. The report also notes that meeting newer standards could require up to $79 million annually.

At a time when American argument centers on the best ways to promote student health, safety and well-being, the move to bring the state closer to national standards seemed like a natural progression.

“The need for school nurses is growing due to increased attendance by children with health issues as well as laws and policies expanding the health care responsibilities of schools,” state Program Evaluation Division staff wrote.

According to the staff report:

  • Forty-six percent of school systems, known as local education agencies or LEAs, meet the 1:750 nurse to student ratio once recommended by the National Association of School Nurses. More recent policies say nurses should be apportioned based on a weighted acuity scale of children’s health including increased risk among children from low-income families..
  • Two state programs designed to meet the need for more nurses — the Child and Family Support Teams and the School Nurse Funding Initiative — did not receive full funding and haven’t met their goals.
  • School employees who are not nurses perform about six of 10 medical procedures carried out in schools. That means less than expert care for students, as well as the siphoning off of non-nursing staff’s time without reimbursement for those tasks.

In a far-reaching recommendation, the staff report recommended the legislature should tell the state education board to create a goal and make a plan for higher levels of nurse staffing relative to student population. In addition to other goals, the report said new Medicaid regulations should provide for payments for qualified school-based nurse services.

According to numbers from the 2015-2016 school year, counties’ efforts toward meeting an optimum ratio vary widely across the state, even among the largest and more prosperous counties. Wake County employs one school nurse per 2,072 students, while in Mecklenburg the ratio is 1:889.

Twenty schools, mostly in smaller school districts, met the recommended allotment of nurses. For example, Weldon City schools had two full-time nurses for a student population of 883 and a rounded-off ratio of 1:442.

The town of about 1,575 people, where more than 90 percent of students in city schools are eligible for free or reduced-price meals, lies just across Interstate 95 from Roanoke Rapids. According to the report, Weldon was one nurse short of meeting an additional goal cited in the report, that each North Carolina public school should have a nurse to tend its students.

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Thomas Goldsmith worked in daily newspapers for 33 years before joining North Carolina Health News. Goldsmith is a native Tar Heel who attended the UNC-Chapel Hill, and worked at newspapers in Tennessee...