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School-Based Health Centers Seek to Solve School Nursing Lull

In the much-debated cover story of the December 13, 2005 issue of USA TODAY, reporters were quick to point out the growing dangers school children face during our nation’s ongoing nursing shortage. Financial restrictions and staffing availability has played a major part in what is becoming a dangerous epidemic. With the growing rates of children living with health issues such as asthma and diabetes, a school nurse must always be on staff for emergency situations that faculty may simply be unqualified to handle. But in a financial tight-hold, many schools have found that goal to be rather unattainable. School-based health centers are on the rise and may just be the answer many parents and school boards have been looking for.

Federally mandated guidelines require one nurse per every 750 students. Currently, 47% of schools fail to meet this guideline. Staffing levels are dangerously low because the financial compensations for school nurses fall far behind that of compensations other facilities are able to provide. For example, take a look at the differences between school nursing and any other nursing atmosphere. A newly graduated nurse with a BSN starts working with an average salary of $56,000, and the average salary for a seasoned school nurse is $36,000. In an industry that is already lacking in qualified employable nurses, schools cannot compete with other facilities when it comes to budgeting for a comparable full-time nursing employee. On the flip side, the yearly cost for running a school-based health clinic can range from $53,000 to $150,000 depending on the number of days in which the clinic will run per week. And, with much of the financial support coming from private donations, community support, local hospital involvement and government grants, the financial burden is often curved.

The primary barrier to healthcare is financial. School-based health centers offer the opportunity for uninsured children to receive the healthcare they may otherwise never see. Forty percent of children who visit school-based health centers are uninsured. And even when children do have health coverage the utilization is not as good as it should be, especially in preventative care. In addition, these centers provide the opportunity for parents to remain at work while children remain at school. When treatment is finished they simply return to the classroom. With fewer school days missed for minor ailments, children are more likely to receive a higher quality education. This is an important reason why 70% of parents approve their children to use the health centers through written consent forms and provided medical histories.

Nurses aren’t the only healthcare professionals being staffed by school-based health centers. On the $53,000 to $150,000 budget, schools also staff social workers and medical assistants. And just recently, health centers have begun participating in managed care networks because the managed care plans see the centers as opportunities to expand capacity to provide primary care to their school-age children. This is good news for children in need of the centers’ services, which include physical and mental health services. Care for psychosocial problems is becoming an increasingly important component. For many high schools, even more thorough services are provided, including family planning services and violence/drug abuse prevention programs. Some centers keep track of immunizations and conduct full physical exams. And whereas most centers are ale to prescribe medications, some are able to dispense medication too.

While most experts believe that school-based health clinics are not the only solution to providing healthcare for children, they do agree that it is a step in the right direction. Many organizations have become advocates for these centers and encourage involvement among parents and concerned citizens to inform government officials about the importance of the centers and their current lack of funding.

The National Assembly on School-Based Health Care (NASBHC) and The Center for Health and Health Care in Schools (CHHCS), are among the leaders in advocating the centers. NASBHC even offers leadership, resources and technical support to the centers, in order to enable them to deliver high quality services, become financially stable and play an active role in public policy. CHHCS works with institutional leaders, state officials and clinical providers to maximize outcomes for children for more effective health programming in schools.

If you are interested in supporting further government involvement in school-based health centers log on to the NASBHC website at www.nasbhc.org/APP/congress_zip.htm to find your congressional representative.