Schools Seek Funds For More Nurses
D.C. Officials Cite Growing Student Need

By Nikita Stewart
Washington Post Staff Writer
Tuesday, September 19, 2006

D.C. officials, working with Children's Hospital, are seeking $7 million in federal funding so city schools can hire additional nurses to care for students with special health needs.

The city has applied for a grant through the federal Centers for Medicare & Medicaid Services and should know by the end of November whether the request is approved, officials said. The grant would increase the annual budget for school health services to nearly $21 million and add full- and part-time nursing positions, officials said.

The goal is to place full-time health care staffs at 75 percent of the city's public and charter schools by early next year. Currently, 63 schools have full-time nurses. The other 107 schools have part-time visiting nurses.

When the hospital took over a contract to provide nurses for the District's public schools five years ago, 58 students were identified as needing life or health support during the school day. But hospital officials were certain that far more students required care for chronic illnesses and special needs, said Jacqueline Bowens, vice president and chief government and external affairs officer at the hospital.

The hospital began an extensive study and now lists 2,010 students in traditional and charter schools who need special care.

"We're trying to bring some consistency, so that every child, regardless of what school they are in, will have full-time health coverage," Bowens said.

Full-time coverage does not necessarily mean full-time nurses, Bowens said. The federal funds would be used to create a system of registered nurses and licensed practical nurses so the schools would have qualified personnel inside their buildings every day, she said.

In July, Children's reported that 124 schools have one or more students with health problems classified as "medically fragile," including sickle cell disease, brain tumors, cystic fibrosis and lupus, asthma, allergies and eczema.

Jennifer Ragins, school health policy officer for District schools, welcomed the assessment. "That's the kind of analysis we need. It makes the case for more nurses," she said. "The prevailing needs of our students have changed throughout the years."

The funding project combines efforts by Children's, the city Health Department and the D.C. Council, led by member David A. Catania (I-At Large).

If the federal funds are granted, hiring the nurses could be difficult, Catania said. "It's hard to find nurses overnight," he said.

Because the city expects to fill the positions slowly, the money not used for salaries would be applied to one-time purchases, such as refrigerators to store prescription medications, Catania said.

A portion of the money would go toward buying computers, cots, scales, vision screening machines and other equipment. Many school systems across the country have abandoned the tradition of school nurses as funding sources have decreased, said Amy Garcia, executive director of the National Association of School Nurses.

Nationally, there's an average of less than one nurse for every three schools, and nurses travel between schools on a "case management basis," Garcia said. "We do not believe that's the best model."

"There's been a tremendous increase in the number of children with chronic illnesses and who receive medication," Garcia said.

According to the association, 12 percent of children have a history of asthma and 13 percent had to take prescription medication for at least three months.

"The reality of children is very different than the reality of when our policymakers were in school," she said. "We have children in schools with tube feedings. . . . In the past, children just didn't come to school."