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August 11, 2013

Board members disagree on action items

Three contentious issues passed 4-1

MADISON COUNTY — Three action items on the Madison County School Board’s agenda Thursday, including how to meet a student’s special needs and the granting of a new title to a current employee, led to some heated exchanges.

The five-member board voted 4-1 on every action item in the agenda. But in the end, the board:

• Provided for federally mandated care for a student with serious health needs

• Ratified an agreement making the district eligible to receive grants in exchange for its continued efforts in energy efficiency, and

• Enabled the restoration of a historic home with connections to the Battle of Richmond.

Chief finance officer Debbie Frazier also delivered some good news about the 2012-13 budget’s ending balance. (See Saturday’s edition of the Richmond Register or visit

And new Superintendent Elmer Thomas and Chief Academic Officer David Gillium gave their first reports (see adjacent story).

Nurses for students with special-needs

The Individualized Education Program, commonly known as IEP, is mandated by the federal Individuals with Disabilities Education Act. The law is intended to identify children with disabilities and create an individualized plan to meet the student’s educational needs.

Several students in the Madison County School district have IEPs, and certain accommodations must be made to stay within the confines of the law.

On Thursday, the board voted 4-1 to approve a contract with Nurses Registry Inc. to provide a specialized nurse for a student who has specific doctor’s orders. Board member Mary Renfro was the only dissenting vote.

Thomas said the contract has been approved every year.

Renfro asked why the 11 nurses that were approved to staff the schools couldn’t care for this one student. 

“The professional nursing staff that we have right now is a general nursing staff that takes care of all the students. This student’s needs are so great, that by doctor's order, they must have someone with them because at any moment, they can have a life-threatening situation,” he replied. The nurse would stay with the student at all times.

Renfro asked why the student’s insurance would not pay for the special nurse.

Director of Special Education Debbie King said if the student was eligible for Medicaid, then Medicaid would pay for the services.

“But this particular student is not eligible for Medicaid,” King said, and the student’s health insurance will not cover the cost of the nurse.

Board chair Mona Isaacs called for a motion after a short discussion, but Renfro wanted to know if King had checked with other nursing companies.

King said she had checked with other nursing companies, but “this was the best offer we can get for this particular student.”

The nurses with this company also are already familiar with the student, she said.

Thomas said there have been other contracts with nursing companies in the past “because once the doctor puts it to orders – that you have to provide this for the student – then you have to provide this for the student.”

“This is what we get into with these unfunded mandates from Washington,” said board member John Lackey. “Maybe it’s valuable, but we need to be told, and the community too, how much it is costing.”

King said the cost was around $45,000 last year for this particular student.

“That’s one teacher job basically,” Renfro said. “We just had all of these extra nurses approved. To me, it seems like one of those nurses can provide those services.”

King reiterated that the student had “such intensive needs that they (school nurses) can’t meet her needs. She can’t safely attend school, based on doctor’s orders, without this nurse being with her.”

Lackey asked if other school districts are doing the same thing.

Yes, King said, “because that’s what we’re required to do, and that’s what we do for the kids.”

Renfro asked again why one of the school nurses couldn’t take care of the student.

Thomas reminded her that 11 was the same number of nurses in the district last year and that 11 nurses were approved to meet student needs. The team of 11 will staff high schools three times a week and alternate two times one week and three times the next at elementary and middle schools.

Renfro then asked if King could reach out to three or four nursing companies, instead of just two.

“We had trouble getting two to get back with us quite honestly,” said King, who conducts online searches and talks to other school districts and hospitals in search of these specialized nurses.

Board member Beth Brock, who is a nurse, said nurse agencies are pretty specialized and a home-health agency does not provide the service needed.  

Lackey said the district needs to be proactive in finding ways to hire a nurse who can attend to more than one student.

“We try to think outside the box,” King assured him.

There is another student who will need a specialized nurse, she said, but she had difficulty getting a contract together for Thursday night and could not tell the board how much it will cost.

Isaacs read the recommended motion to approve the contract and every member voted “aye,” except for Renfro, who still had more questions.

Renfro asked why the district could not hire a licensed practice nurse instead of a registered nurse, which she said would be cheaper.

But according to the contract, whether the Nurse’s Registry sends an LPN or an RN, the nurse would cost the same, Isaacs pointed out.

“I’ll oppose this because I don’t believe that LPNs get the same as RNs,” Renfro said

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