By LINDA CHION KENNEY
School board members approved a $7 million dip into the general fund to offset the “critical nursing shortage,” which this school year required contractual services from seven outside vendors.
In making the budget change request, superintendent Van Ayres said the amount projected for the year, and needed from the general fund, totals $10.5 million, “which is an increase of $7 million for the remainder of the 2023-24 school year.”
Overall, Ayres said, the district has 530 health services positions, including 158 nursing vacancies, of which 143 have been filled by outside agencies. That amounts to 31 registered nurses and 121 licensed practical nurses.
Calling it a “rather large conundrum,” board member Lynn Gray said the cost is necessary, given what she called the high incidence of chronic illnesses among today’s youth, including diabetes, asthma and obesity. The coronavirus pandemic shed further insight into the great need for medical attention for today’s youth, she added.
“The nurses were so valuable and needed, and we had them,” Gray said. “Well, fast forward,” she added, noting that surrounding interests pay their nurses more, “and now a lot of our nurses have left.”
She called it “the big rub” that nurses paid by the school district earn notably less than those paid for by outside agencies, “so why wasn’t this corrected when we started to see our nurses leave in droves?”
While Gray said she is a not a fan of outsourcing, she does understand that with supply down, demand increases, and, in turn, it costs more to employ nurses in short supply.
According to ZIP Recruiter, Florida ranks 49 out of 50 states nationwide for school nurse salaries. Arkansas ranks the lowest. As of April 15, the company reports the average hourly pay for a school nurse in Florida is $25.68 per hour.
Meanwhile, reports show the shortfall of nearly 18,000 doctors and 59,000 nurses for Florida by 2035, as the state’s population grows to more than 25 million people in 10 years.
School board member Nadia Combs said that while the school district has a nursing shortage, so, too, does the community at large, and, thus, pay has become competitive.
“You’re seeing nurses who were in schools now working at hospitals or in different locations and making probably 30 or 40 percent more,” Combs said. “We’re losing our nurses left and right.”
As the demand for nurses increases, so, too, do the demands of the job in the schoolhouse setting, a point raised by school board member Patti Rendon.
“We have so many students today taking psychiatry medications,” Rendon said, adding that nurses “have to know how to deal with behaviors and how to deal with multiple illnesses and multiple medications on a regular basis.”
In short, “we’re dealing with a very different field than we were 10, 15 years ago,” Rendon said. She advocated for a fresh look at Medicaid reimbursement rates in the next legislative session. According to Rendon, the rate differs greatly for nursing in schools versus nursing in a nursing home or hospital.
Rendon noted, as well, that salaries have likewise been affected for people working with intellectual and developmental disabilities in group homes and day programs.
School board member Jessica Vaughn agreed, saying, “We have been here several times before, again, with our ESE professionals.” Vaughn added, “It is really disheartening when our employees look through the classifieds, and they see that we are outsourcing and paying at a much higher rate.”
As a hospital social worker for 25 years, school board chair Karen Perez said she has seen a definite shift in the health care system since COVID, which has brought to light the higher pay for traveling nurses.
“I’m going to squash the myth it was just about pay,” Perez said. “What the [nurses] kept saying was that they needed that mental respite. They could work for a couple of weeks, go someplace else, relax, and it wasn’t so focused on eight- to 12-hour shifts and things like that.”
Karen Perez, school board chair, at the April 16 school board meeting
The worth of school nurses involves much more than medication management, Perez said, noting such things as helping families get access to health insurance, making sure families connect with their healthcare providers and the careful monitoring of health conditions. School nurses “are helping our students not just stay out of the hospitals but also stay in school,” Perez said.
As for the motion that passed unanimously to cover the costs for nursing through outside vendors, Perez said the vote was a no-brainer. As she put it, “We do need the supplemental nursing staff to keep our students here in school and out of the emergency rooms.”