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House of Representatives
Session of 2019 - 2020 Regular Session


Posted: May 7, 2019 01:18 PM
From: Representative James R. Roebuck, Jr.
To: All House members
Subject: School Nurse student to Staff Level Reduction Act
For many children, school is more than just a place to learn; it’s also a place to get and stay well. But a study by the National Association of School Nurses found that many children around the country do not have adequate access to the only health care provider they may encounter in their daily lives: a school nurse. And that means they are less likely to be healthy and less able to thrive in school, according to the association.

In Pennsylvania school districts are required to employ one certified school nurse for every 1,500 students. While some advocate lowering the ratio to 1:750 or below (to address special needs students), annually there are several Pennsylvania school districts that apply for waivers and emergency certifications because they are unable to meet the ratio. Furthermore, the increasing complexity of the health issues facing Pennsylvania’s school children is likely to make school nurses’ jobs more difficult with time.

The importance of school nurses became painfully evident in the school district of Philadelphia when in October of last year, a nine-year-old collapsed in a school cafeteria. He was rushed to the hospital where he was later pronounced dead of heart failure. There was no school nurse on duty that day. A Philadelphia school district official certified in CPR tried to revive him, but it’s unknown if a school nurse would have been there that day if they would have been able to save him.

DOH statistics show large numbers of school children afflicted with health conditions that require regular monitoring and sometimes daily care. For example, the increase in asthma cases in Pennsylvania schools, which mirrors the alarming escalation of cases nationwide, will probably not soon abate. Asthma care is only one example of the many conditions school nurses are responsible for resolving daily.

Federal laws, such as IDEA, have opened regular public classrooms to medically fragile children and have further increased school nurses’ daily responsibilities. Helping students cope with drug and alcohol abuse, teen pregnancy and school violence, while not traditionally thought of as part of the school nurse’s purview are now common to a job that has evolved dramatically over the past few decades.

The state-mandated continuing professional education program known as Act 48 will help ensure that school nurses are at the leading edge of professional nursing practice. There will be, however, no shortage of challenges presented to Pennsylvania’s certified school nurses now and in the years to come.

My proposal will reduce the student to nurse ratio in Pennsylvania to the recommended level of 1 school nurse to every 750 students. Having adequate nursing staff is critical with helping students manage chronic illness and stay healthy, this helps increase attendance rates, frees parents from having to take time off work to care for sick children, allows teachers to focus on their curriculum rather than on their students’ health needs. Please join me in ensuring our students have the care they need to be successful in school.

Introduced as HB1409