School safety has garnered much attention in recent years. The passage of Senate Bill 1, the "School Safety Bill," in our state demonstrates the type of positive legislation that can occur when parties work together. Increased training for school resource officers, a greater emphasis on trauma-informed approaches and more mental health providers in schools are all steps toward improved security and support for children.
To address this issue comprehensively, the conversation must expand to embrace physical health as well. "School health and safety" is terminology more inclusive of appropriately addressing safety at school.
According to the Kentucky Department of Education, nearly 651,000 children attended school in 173 public school districts across Kentucky in 2017-18. More than 120,000 of these children had chronic health conditions such as asthma, diabetes, seizures or life-threatening allergies. These numbers were higher than the estimated 13-18% reported nationally. Despite the significant number of children with medical concerns, there is no state requirement for Kentucky schools to employ nurses.
The National Association of School Nurses recommends that, "to optimize student health, safety and learning, a registered school nurse be present in every school all day, every day."
The American Academy of Pediatrics echoes this by saying that nurses are in a "critical position to address unmet health needs" and supports placement of a professional nurse in every school.
Sadly, Kentucky has no reported data on the number of nurses in our schools; nor are there requirements for school districts to employ nurses. As schools have faced budget shortfalls, nursing positions have been cut leaving vulnerable children to receive care from unlicensed staff such as school clerks or secretaries who have multiple additional responsibilities.
Often teachers spend time caring for sick or injured students or addressing chronic conditions that take time away from teaching. Recently, California teachers went on strike, and among their demands was the inclusion of funding for a nurse in every school.
Educators across the country are recognizing that the expectations placed on them are greater than is reasonable or in the best interest of children.
Care for the mental health of children was recognized in SB 1, and to help fund the mental health requirements of the bill, the Cabinet for Health and Family Services submitted a state plan amendment to the federal Medicaid program. If approved, it will expand the scope of reimbursable health services that schools can provide.
While this revenue will help support properly credentialed mental health providers, it is also an occasion for schools to increase access to school nursing services. The Kentucky Department of Medicaid can decide how these funds will be used for nursing, and they must support measures which will allow nurses to practice to the full scope of their licensure. States such as Massachusetts, Louisiana and South Carolina have developed such models, and Kentucky should do the same. Keeping children safe at school is much broader than just securing the perimeter and increasing training.
Parents send their children to school expecting that they will be in a safe and caring environment. To provide such a setting effectively, we need nurses in every Kentucky school - children across the Commonwealth are depending on it.