Political wrangling has thwarted plans to expand the patchwork-funded school nurse program in Mississippi to an acceptable level. For now, Mississippi has one school nurse per 1,500 students, including special needs children mainstreamed into the public school system mandated by 1975 federal legislation.
The Legislature doesn’t fund the state’s 330 school nurses serving 499,000 children in education appropriation bills, which Gov. Haley Barbour has said should be done. The Bower Foundation appropriates some funds specifically for school nurses. The Partnership for a Healthy Mississippi payrolls annually $2.5 million for “tobacco nurses” in 52 districts. That fund is no longer available.
“Schools have to find their own money for nurses,” said Joyce Vaughn, director for School Nurse and Health Services for the Mississippi Department of Education. “Right now, there’s not a nurse for every school. Some districts have one nurse for nine schools.”
In February, Barbour, a former tobacco lobbyist, said there hasn’t been a proper accounting of The Partnership multi-million funds, awarded after Attorney General Mike Moore successfully sued and won the nation’s first state-instigated tobacco lawsuit. (In May, the ruling judge said it was not constitutional for The Partnership to receive the money in the manner it was routed, and that it should go through the legislative process.) The governor would like to see the $20-million annual supplement diverted to four areas, including $5 million to expand the school nurse program to all school districts through his “Healthy Kids” initiative.
“I’ve advocated the $20 million be appropriated for Medicaid, since the federal government would then match the $20 million on a more than three-to-one basis, generating a total of more than $80 million of healthcare spending for Mississippi’s children,” said Barbour. “Currently, more than 60 school nurses who implement tobacco prevention programs serve more than 50 school districts. Appropriating $5 million to the Mississippi Department of Health will double this program’s capabilities for education and outreach.”
Sharon Garrison, spokesperson for The Partnership, said House Bill 1115 was passed in the last session to fund The Partnership with state requirements, but the governor vetoed the legislation. “We’ve filed a notice of appeal with the state Supreme Court on the judge’s ruling in May, but we don’t have a court date yet,” she said. “Meanwhile, we’ve made funding for school nurses a priority this year.”
What happens if the governor and Legislature can’t agree on funding for The Partnership, or the Legislature rejects the governor’s $5-million proposal for the Department of Health to fund school nurses? “That’s a very good question,” said Vaughn. “We’re just waiting to see. We have a large number of children in the state with healthcare needs that should be addressed on a daily basis, and many of those needs would not be met if they weren’t in a school setting, or it weren’t for school nurses.”
State lawmakers passed legislation a decade ago that favored one nurse per 750 students, but it was not funded, pointed out Emily Ashworth, president of the Mississippi School Nurses Association. “There was a promise that by 1998, they would start funding them, but that was delayed to 2000, and all of a sudden, you didn’t hear about it anymore,” she said. “They dropped the ball.”
According to the National Association of School Nurses, the Healthy People 2010 Objective calls for one school nurse for every 750 students because of an increasing number of students with chronic health problems, such as asthma, diabetes and epilepsy; children who require nursing care in school must have access to a school nurse; school nurses are first responders in case of emergencies or disasters at school; and school nurses are the primary healthcare providers for the many students who lack healthcare coverage.
For students with special needs, the recommendation is one nurse per 250 students; for those with severe needs, one nurse is needed per 175 children.
Ricki Garrett, executive director of the Mississippi Nurses Association, said absenteeism and poor quality schoolwork would be greatly diminished if there were a nurse for every school in the state.
“There’s a squeeze with more and more chronically ill children attending school with fewer nurses available,” she said.
School nurses are busy stomping out fires, not preventing them, said Ashworth.
“The Legislature should mandate this funding for the simple reason that it costs 25¢ a day to cover each child, when you take into account a nurse’s annual salary of $35,000 divided by 187 days, then divided by 750 children,” she said. “That’s a lot cheaper than an emergency room visit. Are legislators really going to tell parents they’re not going to put a nurse in their child’s school because their child isn’t worth 25¢ a day? Or tell the teacher who has to deal with a sick child how to make up for lost instructional time? It’ll show up later in standardized tests.”
Contact MBJ contributing writer Lynne W. Jeter at Lynne.Jeter@gmail.com.