The Richmond Register

Education

February 25, 2013

Health department will cease to provide nursing services to schools

Reimbursement shortfalls, rising costs cited as reasons

MADISON COUNTY — In May, the Madison County Health Department will end the public-health nursing services its has provided for Madison County schools for nearly 22 years.


The health department’s school-nurse contracts with both the Madison County School District and Berea Independent School District expire then and are not likely to be renewed, according an announcement today from the health department.


The funding from the school districts was not covering the health department’s costs of providing nurses and care, according to the news release.


Including the current school year, the health department will have incurred estimated losses of $830,000 in the school health program since 2010, the release stated.


Despite efforts to contain costs, including a staff reduction in 2011, the health department continued to lose money providing the service when it needed to break even, health department officials have warned for several months.


Also, rising personnel costs, in the form of increased employer contributions to health insurance and the Kentucky Retirement System, have contributed to higher operating expenses overall for local health departments in recent years, the news release pointed out.


Dramatic reductions in Medicaid reimbursements will cause the local health department to lose more than $300,000 on school-nurse services for the current year, the release stated.

The shortfall required the department to negotiate for “significant increases” in contract amounts for nursing services to Berea and Madison County if the school-nurse program was to continue in the 2013-14 school year.


“I am delivering this news with great sadness,” said Nancy Crewe, public health director. “This is not a decision we’ve made lightly. Our school health program is of the highest quality and has served as a model for other programs statewide.”


Meanwhile, new negotiations have begun as the Madison County School District seeks a new partner to retain a school-nurse program, according to spokesperson Erin Stewart.


The school district paid $303,000 for the school nurse program in 2011-12, said Debbie Frazier, the district’s chief finance officer.


The charge for those services during the 2012-13 school year was $453,000, but the Chemical Stockpile Emergency Preparedness Program, or CSEPP, contributed $150,000, bringing the school district’s cost back down to the previous year’s amount, Frazier said.


Baptist Health in Richmond donated $50,000 to the school health program to help offset costs for both Madison County and Berea schools. Berea Independent’s contract for the current school year is $23,000, according to the health department’s budget.


The Madison County School District’s 2013-14 draft budget anticipated maintaining the same financial commitment for school nurses, she said. However, if negotiations for new services result in any differences compared to the draft budget, it will be addressed in a future budget draft.


The district has two goals in establishing a new partnership for the school nurse program, Stewart said.

The new provider will:


• Offer comparable health services as are currently offered to students


• Make every effort to retain as many of the current nursing staff as possible so that service will seem uninterrupted for students


“The district is hopeful that this transition will not affect quality in any way as we begin school next fall,” said Superintendent Tommy Floyd. “We are hopeful that many of the faces our students see in the nurses’ offices across the district will be the same faces next school year.”


The number of school nurses the health department will lay off is undetermined, according to its news release. But, the department will offer resources to employees of the school-nurse program to help identify possible job opportunities inside and outside the health department, it stated.


“We chose to make this announcement early so that staff can have time to explore and apply for other opportunities,” said Crewe. “Some staff may choose to apply for internal positions at MCHD, while others may find employment with the Madison County School District.”


The health department first began operating school-based health clinics in 1991. Services included school physicals, well-child exams, hearing and vision screenings, sick visits, immunizations and development of emergency action plans for children with special health needs.


Nurses also provided insulin injections for students with diabetes and assisted with referrals.


The health department will continue to provide mandatory environmental health and communicable disease services and optional dental services in all schools as it has in the past.


Providing school-based health clinics are optional for health departments, according to the release.


“We have long valued Madison County Schools as a willing partner in this program,” Crewe said. “They have in no way cut the funding they have always committed to the school nurse program.  In fact, the district is working diligently, as it has been over the last two years, to find ways to continue to provide health services for students.”


Sarah Hogsed contributed to this story.

Crystal Wylie can be reached at cwylie@richmondregister.com or 623-1669, Ext. 6696.


 

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