Student-to-School Nurse Ratio Improvement Act of 2013 - Authorizes the Secretary of Education to make matching demonstration grants to local educational agencies (LEAs) in which the student-to-school nurse ratio in each of their public elementary and secondary schools is 750 or more students to every school nurse for the purpose of reducing such ratio.
Gives grant priority to LEAs: (1) for which not fewer than 10,000 or not less than 20% of the children served are from families with incomes below the poverty line, and (2) that demonstrate the greatest need for new or additional nursing services for their students.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1857 Introduced in House (IH)]
113th CONGRESS
1st Session
H. R. 1857
To make demonstration grants to eligible local educational agencies for
the purpose of reducing the student-to-school nurse ratio in public
elementary schools and secondary schools.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 7, 2013
Mrs. McCarthy of New York introduced the following bill; which was
referred to the Committee on Education and the Workforce, and in
addition to the Committee on Energy and Commerce, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To make demonstration grants to eligible local educational agencies for
the purpose of reducing the student-to-school nurse ratio in public
elementary schools and secondary schools.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Student-to-School Nurse Ratio
Improvement Act of 2013''.
SEC. 2. FINDINGS.
The Congress finds the following:
(1) The American Academy of Pediatrics emphasizes the
crucial role of school nurses in the seamless provision of
comprehensive health services to children and youth, as well as
in the development of a coordinated school health program.
(2) The school nurse functions as a leader and the
coordinator of the school health services team, facilitating
access to a medical home for each child and supporting academic
achievement.
(3) School nurses promote wellness and disease prevention
to improve health outcomes for our Nation's children. In
addition, school nurses perform early intervention services
such as periodic assessments for vision, hearing, and dental
problems, in an effort to remove barriers to learning.
(4) Recent national data indicates 45 percent of public
schools have a school nurse all day, every day, while another
30 percent of schools have a school nurse who works part time
in one or more schools.
(5) The American Nurses Association has reported that when
there is no registered nurse on the school premises, the
responsibility to administer the necessary medications and
treatments, and appropriate monitoring of the children falls on
the shoulders of administrators, educators, and staff who are
ill-prepared to perform these tasks.
(6) Statistics from the National Center for Educational
Statistics indicate that of the 52,000,000 students who
currently spend their day in schools, 15 to 18 percent of
children and adolescents have a chronic health condition.
(7) A recent study indicated that from 2002 to 2008, the
percentage of children in special education with health
impairments, due to chronic or acute health problems, increased
60 percent. School nurses use their specialized knowledge,
assessment skills, and judgment to manage children's
increasingly complex medical conditions and chronic health
illnesses.
(8) Among adolescents aged 12 to 19 years old, the
prevalence of pre-diabetes and diabetes increased from 9
percent to 23 percent between 1999 and 2008. More than 30
percent of children aged 2 to 19 years old are obese or
overweight (>85th percentile). In 2008, more than 10 million
children in the United States had asthma. The prevalence of
food allergies among children under the age of 18 increased 19
percent from 1997 to 2007.
(9) According to the American Academy of Pediatrics,
students today face increased social and emotional issues,
which enhance the need for preventive services and
interventions for acute and chronic health issues. School
nurses are actively engaged members of school-based mental
health teams and spend nearly 32 percent of their time
providing mental health services, including universal and
targeted interventions, screenings to identify early warning
signs and referrals to medical providers, and crisis planning.
(10) In 2011, the Bureau of the Census reported 9.7 percent
of children under the age of 19, which equals 7.6 million
children under the age of 19, were without health insurance.
Data shows that uninsured children achieve lower educational
outcomes than those with health coverage. Children who cannot
afford to see a medical provider miss more days of school,
experience increased severity of illness, and suffer from
disparities in health.
(11) More than 1.6 million children experience homelessness
each year in the United States. Homeless children develop
increased rates of acute and chronic health conditions, and the
stress of their living situation can negatively affect their
development and ability to learn. As a result, schools have
become the primary access to health care for many children and
adolescents. School nurses serve on the frontlines as a safety
net for the Nation's most vulnerable children.
(12) Communicable and infectious diseases account for
millions of school days lost each year. Data illustrate that
when students have access to a registered nurse in school,
immunization rates increase.
(13) A 2011 study showed that a school nurse in the
building saves principals, teachers, and clerical staff a
considerable amount of time that they would have spent
addressing health concerns of students, including saving
principals almost an hour a day; saving teachers almost 20
minutes a day; and saving clerical staff more than 45 minutes a
day. This would amount to a savings of about 13 hours per day
in the aggregate for such school personnel.
(14) Using a formula-based approach, taking into
consideration the overall health acuity of the student body and
the workload of school nurses, for determining a balanced
student-to-school nurse ratio offers a reasonable means for
achieving better student outcomes.
SEC. 3. REDUCING STUDENT-TO-SCHOOL NURSE RATIOS.
(a) Demonstration Grants.--
(1) In general.--The Secretary of Education, in
consultation with the Secretary of Health and Human Services
and the Director of the Centers for Disease Control and
Prevention, may make demonstration grants to eligible local
educational agencies for the purpose of reducing the student-
to-school nurse ratio in public elementary schools and
secondary schools.
(2) Application.--To receive a grant under this section, an
eligible local educational agency shall submit to the Secretary
of Education an application at such time, in such manner, and
containing such information as the Secretary may require, which
shall include information with respect to the current ratios of
students-to-school nurses, student health acuity levels, and
workloads of school nurses in each of the public elementary
schools and secondary schools served by the agency.
(3) Priority.--In awarding grants under this section, the
Secretary of Education shall give priority to applications
submitted by high-need local educational agencies that
demonstrate the greatest need for new or additional nursing
services among students in the public elementary secondary and
secondary schools served by the agency.
(4) Matching funds.--The Secretary of Education may require
recipients of grants under this section to provide matching
funds from non-Federal sources, and shall permit the recipients
to match funds in whole or in part with in-kind contributions.
(b) Report.--Not later than 24 months after the date on which a
grant is first made to a local educational agency under this section,
the Secretary of Education shall submit to the Congress a report on the
results of the demonstration grant program carried out under this
section, including an evaluation--
(1) of the effectiveness of the program in reducing the
student-to-school nurse ratios described in subsection (a)(1);
and
(2) of the impact of any resulting enhanced health of
students on learning, such as academic achievement, attendance,
and classroom time.
(c) Definitions.--For purposes of this section:
(1) ESEA terms.--The terms ``elementary school'', ``local
educational agency'', ``poverty line'', and ``secondary
school'' have the meanings given to those terms in section 9101
of the Elementary and Secondary Education Act of 1965 (20
U.S.C. 7801).
(2) Acuity.--The term ``acuity'', when used with respect to
a level, means the level of a patient's sickness, such as a
chronic condition, which influences the need for nursing care.
(3) Workload.--The term ``workload'', when used with
respect to a nurse, means the amount of time the nurse takes to
provide care and complete the other tasks for which the nurse
may be responsible.
(4) Eligible local educational agency.--The term ``eligible
local educational agency'' means a local educational agency in
which the student-to-school nurse ratio in each public
elementary and secondary school served by the agency is 750 or
more students to 1 school nurse.
(5) High-need local educational agency.--The term ``high-
need local educational agency'' means a local educational
agency--
(A) that serves not fewer than 10,000 children from
families with incomes below the poverty line; or
(B) for which not less than 20 percent of the
children served by the agency are from families with
incomes below the poverty line.
(6) Nurse.--The term ``nurse'' means a licensed nurse, as
defined under State law.
(d) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary to carry out this section
for each of the fiscal years 2014 through 2018.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Education and the Workforce, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Education and the Workforce, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Early Childhood, Elementary, and Secondary Education.
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