House Bill 0703
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 2000 HB 703
By Representative Murman
1 A bill to be entitled
2 An act relating to school health care; creating
3 s. 381.0058, F.S.; providing for funding to
4 improve school nurse-to-student ratios;
5 requiring local match for state funds;
6 providing duties of the Secretary of Health and
7 Commissioner of Education; providing for
8 program proposals; specifying criteria for
9 receipt of funding; establishing a pilot
10 project in Hillsborough County to provide
11 comprehensive health and wellness services to
12 public school students and staff members;
13 providing legislative findings and declaration;
14 providing project goals; providing student
15 achievement objectives; providing staff
16 productivity objectives; providing anticipated
17 outcomes; providing for funding; providing
18 staffing criteria; providing an effective date.
19
20 Be It Enacted by the Legislature of the State of Florida:
21
22 Section 1. Section 381.0058, Florida Statutes, is
23 created to read:
24 381.0058 Funding to improve school nurse-to-student
25 ratios.--
26 (1) It is the intent of the Legislature to provide
27 matching funds, in addition to those provided under s.
28 381.0056 for the School Health Services Act and s. 381.0057
29 for school health funding, to counties for the purpose of
30 increasing nurse-to-student ratios and to provide staffing for
31 school health services. The purpose of this funding is to
1
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 2000 HB 703
583-189A-00
1 encourage further development of programs that offer the
2 greatest potential for promoting the health of students and
3 increasing the availability of and access to nurses in the
4 delivery of school nurse services. State funds shall require a
5 local match of at least 25 percent, cash or in-kind,
6 specifically for implementation of programs that provide a
7 nurse for no more than five schools staffed with a health
8 support aide. Schools are to be within reasonable proximity to
9 each other, so as to maximize nurse availability to each
10 school's aides or volunteers should an emergency occur while
11 the nurse is at another school. Local projects that utilize
12 volunteer services specifically for provision of school health
13 services may consider the value of these services as match.
14 (2) The Secretary of Health, or a designee, in
15 cooperation with the Commissioner of Education, or a designee,
16 shall publicize the availability of funds, targeting counties
17 that have entered into formal agreements with public and
18 private entities committed to enhancing the availability of
19 school nurse services, as reflected in the school health plan.
20 (3) The Secretary of Health, or a designee, in
21 cooperation with the Commissioner of Education, or a designee,
22 shall form a joint committee with equal representation to
23 evaluate and select the sites to receive funding.
24 (4) Any county that desires to receive state funding
25 under this section shall submit a proposal to the joint
26 committee established in subsection (3). The proposal shall
27 state the goals of the program, provide specific plans for
28 enhancing local resources available for school health nurse
29 services, and describe all of the health services to be
30 available to students with funds provided pursuant to this
31 section. Funding allocated to a county under this provision
2
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 2000 HB 703
583-189A-00
1 shall not be used to supplant the existing contributions to
2 school health services funding.
3 (5) Selection shall be based on the merits of each
4 proposal, and, in addition, priority shall be given to those
5 county health departments and school districts that most
6 closely meet the following criteria:
7 (a) Have evidence of an inservice staff development
8 plan to ensure staff and volunteer capability to provide
9 school health services.
10 (b) Have evidence of a cooperative working
11 relationship between the county health department and the
12 school district and the community, as well as parental
13 support.
14 (c) Provide high numbers or higher than state average
15 numbers of subsidized school lunches.
16 (d) Have high numbers or higher than state average
17 numbers of medically underserved high-risk children,
18 low-birthweight babies, infant mortality, or teenage
19 pregnancy.
20 (e) Have high numbers or higher than state average
21 numbers of children with chronic health conditions or
22 high-risk behavioral problems.
23 (f) Have documented in the local school health
24 services plan a commitment from counties to fund or provide
25 other resources for the enhanced availability of school health
26 services.
27 (g) Have a plan to ensure billing for Medicaid funding
28 for services rendered under the certified school match program
29 or the county health department certified match program as
30 specified in s. 409.9122.
31
3
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 2000 HB 703
583-189A-00
1 (h) Have evidence of a plan for promoting parent
2 involvement in school health services.
3 (i) Have written commitments from public and private
4 entities for local contributions to the school health services
5 program.
6 (j) Have levels of academic achievement that place the
7 schools at peril for failing status under the A+ plan.
8 Section 2. Hillsborough County public schools pilot
9 project; integrated health services program.--There is
10 established in Hillsborough County, to be phased into public
11 schools over portions of the county, a pilot project to
12 provide comprehensive health and wellness services to school
13 students and staff members.
14 (1) LEGISLATIVE FINDINGS AND DECLARATION.--
15 (a) The Legislature finds that a full-time health
16 component at school sites provides the following benefits to
17 the student population:
18 1. Medical procedures that must be performed during
19 the school day are safely and professionally performed by
20 trained medical personnel; many school sites dispense over 50
21 different medications a day to hundreds of students.
22 2. Children are better evaluated when ill or injured,
23 and children with chronic illnesses, such as asthma and
24 diabetes, are better managed during the school day.
25 3. Steps can be taken to obtain parent permission to
26 provide certain medications to treat minor complaints, and
27 this would significantly decrease the numbers of children
28 going home for minor illnesses, resulting in better services
29 at school, less interruption of the educational process, and
30 less disruption of the parents' workday.
31
4
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 2000 HB 703
583-189A-00
1 (b) The Legislature further finds that having the
2 health care professionals who are assigned to meet student
3 needs also provide limited medical services to employees at
4 school sites, to the extent allowed by Florida Workers'
5 Compensation laws, can be cost effective and increase employee
6 productivity, for the following reasons:
7 1. Nurses are trained to deal with crisis intervention
8 and prevention; and training staff members about blood-borne
9 pathogens, dealing with human immunodeficiency virus (HIV),
10 and reinforcing good practices to minimize these health
11 concerns is an ongoing process.
12 2. Sorting through events to determine exposure risks
13 in a timely manner can significantly reduce parent and
14 community concerns and fears and school district liability.
15 3. Onsite treatment of an employee's minor injuries or
16 illness, and onsite evaluation of injuries or illnesses to
17 determine if further professional medical attention is needed,
18 can be cost effective and reduce liability; and onsite
19 followup after an injury or illness reduces loss of employee
20 work time.
21 (c) The Legislature declares that providing
22 comprehensive health and wellness services to both the adult
23 and student populations at a school site will provide
24 significant benefits to both groups.
25 (2) GOALS.--The goals of the pilot project shall be as
26 follows:
27 (a) Improve the academic performance of students and
28 schools in Hillsborough County.
29 (b) Improve the health of both students and employees,
30 thus reducing absenteeism and disruption of educational
31
5
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 2000 HB 703
583-189A-00
1 activities and supporting Florida's Coordinated School Health
2 Program.
3 (c) Improve the delivery of health care services to
4 the public school children of Hillsborough County, thus
5 benefiting the students and their families.
6 (3) OBJECTIVES.--
7 (a) Operation of the pilot project shall achieve the
8 following health care objectives intended to improve student
9 academic performance:
10 1. Improved referral completions following mandated
11 health screenings.
12 2. Earlier identification of physical and mental
13 health problems.
14 3. Improved handling of chronic health problems,
15 including legally mandated monitoring of medications and
16 health care procedures.
17 4. Improved and earlier compliance with immunization
18 and other public health requirements, the enforcement of which
19 by school districts is required by statute.
20 5. A healthier, safer school environment.
21 6. Reduction in staff absences, resulting in increased
22 consistency in instructional programs.
23 (b) Operation of the pilot project shall achieve the
24 following health care objectives intended to increase staff
25 productivity:
26 1. Immediate and comprehensive assessment of
27 work-related injuries and illnesses.
28 2. Ability to monitor the health of persons returning
29 to work following injury or illness.
30 3. A healthier, safer school environment.
31
6
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 2000 HB 703
583-189A-00
1 4. Onsite assistance with followup or monitoring of
2 chronic health conditions, resulting in reduced absences.
3 (4) OUTCOMES.--The following measurable outcomes of
4 the pilot project are anticipated:
5 (a) Improved attendance by students, resulting in
6 improved "student daily attendance" and academic performance.
7 (b) Improved attendance by staff, resulting in more
8 consistency in the instructional program.
9 (c) Reduced need and expense for substitute personnel.
10 (d) Fewer students and employees leaving school during
11 the school day due to illness or injury.
12 (e) Earlier and more successful return of employees
13 from work-related injuries.
14 (f) Improved compliance by students with
15 physician-ordered medication and procedures, due to the
16 school's responsibility for such compliance.
17 (g) Positive responses by students, staff members, and
18 parents to the program.
19 (h) Improvement of school performance results as
20 measured by the A+ Plan.
21 (5) FUNDING.--The pilot project is authorized to seek
22 funding from categorical, grant, and full-service moneys of
23 the Department of Health; through individual programs,
24 including early childhood, Title I, alternative education, and
25 exceptional education programs; through community partners,
26 such as hospitals and hospital foundations; and through
27 Medicaid, the Florida KidCare Program, and the indigent health
28 care plan, and shall receive $2.5 million in seed moneys from
29 state funding sources. Indirect financial gains or cost
30 savings shall be attained through lowered health insurance
31
7
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 2000 HB 703
583-189A-00
1 premiums and workers' compensation costs and through reduced
2 sick leave and better student attendance.
3 (6) STAFFING.--Staffing provided to schools to
4 implement the pilot project shall be based on the following
5 criteria:
6 (a) Student population.
7 1. For elementary schools, one health technician per
8 site. In addition, one registered nurse shall be responsible
9 for approximately 1,500 students or from one to three
10 elementary schools.
11 2. For middle schools, one registered nurse per site
12 up to 1,000 students; one registered nurse and one health
13 assistant per site over 1,000 students.
14 3. For high schools, one registered nurse per site up
15 to 1,500 students; one registered nurse and one health
16 assistant per site over 1,500 students.
17 4. In addition, advanced registered nurse
18 practitioners shall be assigned responsibility within
19 specified geographic areas of the school district.
20
21 The medical protocols shall be under the supervision of one
22 full-time equivalent licensed physician; however, this
23 position shall be shared by physicians from appropriate
24 specialty areas such as pediatrics, family practice, and
25 occupational health.
26 (b) Special needs of the student population, which may
27 include the number of students in exceptional education
28 programs, the number of students requiring technical medical
29 procedures during the school day, and the number of students
30 identified as at high medical or socio-economic risk.
31 Section 3. This act shall take effect July 1, 2000.
8
CODING: Words stricken are deletions; words underlined are additions.
Florida House of Representatives - 2000 HB 703
583-189A-00
1 *****************************************
2 HOUSE SUMMARY
3
Establishes a program using local matching funds to fund
4 proposals to improve school nurse-to-student ratios.
Provides duties of the Secretary of Health and the
5 Commissioner of Education in promoting the program and
selecting funding sites. Specifies proposal requirements
6 and site criteria.
7
Establishes a pilot project in Hillsborough County to
8 provide comprehensive health and wellness services to
public school students and staff. Provides legislative
9 intent, goals, objectives, and anticipated outcomes of
the pilot project. Authorizes the pilot project to seek
10 funding from specified sources, and provides for $2.5
million in seed money from the state. Provides criteria
11 for school staffing to implement the pilot project.
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
9