Thread: Bill 'requires' a nurse for every school

Tucson Region
Bill 'requires' a nurse for every school
Proposed legislation has opt-out clause; many districts cry no cash
By Daniel Scarpinato
arizona daily star
Tucson, Arizona | Published: 03.03.2008
advertisementPHOENIX — The continuing influx of immigrants and refugees. A rising tide of child diabetes, allergic reactions and asthma. One school district with 62 percent of students lacking health care.
Social evolution has turned schools into the health-care provider of last resort for many Tucson children — a role most districts are ill-equipped to fill.
Recognizing the building crisis, some state lawmakers are ready to ride to the rescue, at least sort of.
Legislation sponsored by Rep. David Lujan, D-Phoenix, would "require" school districts to have a registered nurse at every school site, but only if they agree to follow the law.
The proposal includes no money to pay for more nurses and includes an opt-out clause saying schools don't have to if they don't want to.
Advocates say they are doing what's politically feasible. With an estimated $2 billion state budget shortfall next year, the Legislature is unlikely to pay for more school nurses. But they believe this effort will prompt public discussion and put pressure on school districts without costing the state a dime.
"It gives nurses and others an opportunity to go to a public meeting and have a forum to advocate the reason we should have an RN at every school," Lujan said.
School districts say that while they'd like to hire more nurses, their budgets are too strapped as is.
The bill is "very bad public policy" that turns the school district into a "villain," said Alex Rodriguez, president of the Tucson Unified School District Governing Board.
"I would love a school nurse to be available in every school; however, this sounds like the same old story coming out of Phoenix," Rodriguez said. "We are in a $15 million budget deficit, so the bill sponsor will have to tell me how we're supposed to implement such a program under these conditions."
Flowing Wells Superintendent Nicholas Clement agrees it would be nice to have more nurses, but with no extra state funds he questions how the district would pay for them.
"Increasing the requirement on our end would have an impact on our budget," he said.
Other critics say the whole philosophy of the bill is out of line. For example, Matthew Ladner, vice president of research for the Goldwater Institute, contends that schools should resist the push to become de-facto urgent-care centers.
"This is a classic example of people trying to take the eyes of the schools off the ball," Ladner said. "The purpose of schools is to get students educated, and we already have plenty of problems with that."
Health care for low-income students is the responsibility of the Arizona Health Care Cost Containment System, or AHCCCS, he said.
If approved, the bill requires the Department of Education to publish a list of schools and nurses. Supporters hope that will be enough to trigger parent discussion and pressure on school boards that don't step up.
For TUSD, with more than 100 schools and just 50 registered nurses, the bill would require it to double its nursing staff. The only large school district in Pima County meeting the mandate is Sunnyside Unified, which has a registered nurse in each of its 23 schools.
"We're very fortunate Sunnyside's administration and board has supported the nurses," said Joy Schaefer, school nurse manager for Sunnyside and nurse at Ocotillo special education preschool.
"We've been in the schools for years," Schaefer said. "For some of these kids, this is their only source of health care."
Pat Moore, health coordinator for the Catalina Foothills School District, also supports the proposed legislation, citing the increasing level of responsibility for school nurses.
"I think we have an increasing number of fragile students with chronic illnesses and disabilities like we never we had before," Moore said.
Lujan, who is also president of the Phoenix Union High School District Governing Board, acknowledged that the bill gives schools an easy out but said he's doing what's politically feasible and leaving it to school districts to decide.
Last year, he pushed a bill with $12 million for more school nurses. That bill swiftly died. This year's bill has already advanced out of the House Education Committee with bipartisan support.
Kathy Rucker, TUSD's director of student health services, said that while the bill may seem only symbolic, it's an "incremental" step toward mandating nurses.
"We are the primary care providers for those kids," Rucker said. "You visit any middle school or high school, and it runs like an urgent care."
Suzanne Boyd a nurse at Fort Lowell Elementary School, said nurses are increasingly feeling that pressure.
"It's not enough to keep pace," Boyd said of staffing levels that require most nurses to oversee health assistants at four schools.
And while the state has health coverage for low-income children, Mary Hallett, a retired school nurse who has coordinated the bill for the Arizona School Nurse Consortium, said, "The reality is many of the parents who could apply for AHCCCS do not apply for AHCCCS. There are a lot of immigrants here in the state that can't apply for those services."
And Rucker said there are some parents "who will actually get upset with us when we refer kids out to urgent care. They'll say, 'Oh no, you just do it. You do it much quicker.' "
Lujan hopes by leaving the decision to local school districts his bill will win support in the Republican Legislature, even if it lacks the funded mandates of his previous effort.
http://www.azstarnet.com/sn/metro/227863.php

BACK IN THE DAY .....THERE WERE NURSES IN EACH SCHOOL. EVERY SINGLE ONE. IT WAS REQUIRED. BUT IT WAS NOT USED AS A REPLACEMENT FOR MEDICAL CARE. THE NURSE WAS THERE IF SOMEONE WAS INJURED ON THE PLAYGROUND OR GOT FOOD POISONING OR SOMETHING ELSE. AND SHE (FOR SOME REASON THEY WERE ALL WOMEN) WAS JUST THE FIRST CONTACT FOR THE CHILD TILL THE PARENT GOT THERE TO TAKE THE CHILD TO THE DOCTOR.

THE SCHOOL NURSE WAS NEVER MEANT TO BE THE SOLE OR MAJOR PROVIDER OF HEALTH CARE FOR SCHOOL CHILDREN. THIS IS ANOTHER MISUSE OF OUR SYSTEM THAT TAKES SERVICES AWAY FROM AMERICAN CHILDREN. NOW BECAUSE THIS SERVICE IS MISUSED BY ILLEGALS, THAT BENEFIT IS NO LONGER AVAILABLE TO AMERICAN CHILDREN.