March 31, 2014: A study of health services in California schools, funded by the Lucile Packard Foundation for Children's Health, and headed by Dian Baker, at left, a pediatric nurse practitioner and associate professor of nursing at CSU-Sacramento, was presented Friday at the California School Nurses Association in Sacramento.
The study, which analyzed 2011-2012 state education data, interviewed school education experts, and conducted a large-scale survey of certified school nurses who are members of the California School Nurses Association, found that school health services for California students with special health care needs vary greatly by school district, are provided by a variety of school staff, operate under a confusing patchwork of regulations, and are often underfunded.
There are 1.4 million children in the state with chronic health issues, ranging from mild to life-threatening. About 16% of 6-to-11 year-olds and 20% of 12-to-17 year-olds have a special health care need that may require additional health services at school to allow for their full participation.
Among the study’s findings:
- 57% of California public school districts report having no school nurse personnel. These districts serve about 1.2 million students, about 20 percent of all public school students in the state.
- School nurse responsibilities have become more complex, including inserting urinary catheters, helping children with their feeding tubes, changing ostomy bags, monitoring oxygen tubes, testing blood sugar, and administering anti-seizure medication.
- Unlicensed school staffers provide sometimes complex medical care in the absence of school nurses. While many staffers are trained by nurses, there is little statewide regulation or monitoring of their training.
- Children with special health care needs aren’t always identified by school staff and may not receive services that could help them stay and succeed in school.
The study’s authors recommend:
- Require systematic data collection and reporting systems in school districts to identify and serve children with special health care needs, and to monitor their health and educational outcomes.
- Require that all personnel delivering health services in schools receive mandatory training, including first aid, CPR and procedures needed to serve specific children in each school.
- Require that funds generated through Medi-Cal Administrative Claiming be earmarked to support school health services in the same manner as are Local Education Agency funds.