COMMITTEE SUBSTITUTE
FOR
H. B. 4398
(By Delegates Campbell, Williams, Perry, Beach, Leggett,
Tansill, Wysong, Poling, Paxton and Canterbury)
(Originating in the Committee on Finance)
[February 23, 2006]
A BILL to amend and reenact §18-5-22 of the Code of West Virginia,
1931, as amended; and to amend said code by adding thereto a
new section, designated §18-9A-10a, all relating to improving
the capacity of county boards of education to provide school
health services; authorizing contracting with health care
agencies generally; providing for distribution to counties of
appropriations to support service needs that exceed the
established capacity; and changing the authorization for rule
promulgation on the training and standards for specialized
health procedures performed by school personnel from the
Public Health Commissioner to the West Virginia Board of
Education and increasing the number of nurses to meet the one
to fifteen hundred ratio established in code.
Be it enacted by the Legislature of West Virginia:
That §18-5-22 of the Code of West Virginia, 1931, as amended,
be amended and reenacted; and that said code be amended by adding
thereto a new section, designated §18-9A-10a, all to read as follows:
ARTICLE 5. COUNTY BOARD OF EDUCATION.
§18-5-22. Medical and dental inspection; school nurses;
specialized health procedures; establishment of
council of school nurses.
(a) County boards shall provide proper medical and dental
inspections for all pupils attending the schools of their county
and have the authority to take any other action necessary to
protect the pupils from infectious diseases, including the
authority to require from all school personnel employed in their
county, certificates of good health and of physical fitness.
(b) Each county board shall employ full time at least one
school nurse for every one thousand five hundred kindergarten
through seventh grade pupils in net enrollment or major fraction
thereof:
Provided, That each county shall employ full time at
least one school nurse:
Provided, however, That a county board may
contract with a
public health department health care agencies for
services considered equivalent to those required by this section in
accordance with a plan to be approved by the state board:
Provided
further, That the state board shall promulgate rules requiring the
employment of school nurses in excess of the number required by
this section to ensure adequate provision of services to severely
handicapped pupils.
An appropriation may be made to the state
department to be distributed to county boards to support school
health service needs that exceed the capacity of staff as mandated in this section. Each county board shall apply to the State
Superintendent for receipt of this funding in a manner set forth by
the State Superintendent that assesses and takes into account
varying acuity levels of students with specialized health care
needs.
(c) Any person employed as a school nurse must be a registered
professional nurse properly licensed by the West Virginia Board of
Examiners for Registered Professional Nurses in accordance with
article seven, chapter thirty of this code.
(d) Specialized health procedures that require the skill,
knowledge and judgment of a licensed health professional, may be
performed only by school nurses, other licensed school health care
providers as provided
for in this section, or school employees who
have been trained and retrained every two years who are subject to
the supervision and approval by school nurses. After assessing the
health status of the individual student, a school nurse, in
collaboration with the student's physician, parents and in some
instances an individualized education program team, may delegate
certain health care procedures to a school employee who shall be
trained pursuant to this section, considered competent, have
consultation with, and be monitored or supervised by the school
nurse:
Provided, That nothing in this section prohibits any school
employee from providing specialized health procedures or any other
prudent action to aid any person who is in acute physical distress
or requires emergency assistance. For the purposes of this section
"specialized health procedures" means, but is not limited to, catheterization, suctioning of tracheostomy, naso-gastric tube
feeding or gastrostomy tube feeding. "School employee" means
"teachers", as defined in section one, article one of this chapter
and "aides", as defined in section eight, article four, chapter
eighteen-a of this code. Commencing with the school year beginning
on the first day of July, two thousand two, "school employee" also
means "secretary I", "secretary II" and "secretary III", as defined
in section eight, article four, chapter eighteen-a of this code:
Provided, however, That a "secretary I", "secretary II" and
"secretary III" shall be limited to the dispensing of medications.
(e) Any school service employee who elects, or is required by
this section, to undergo training or retraining to provide, in the
manner specified in this section, the specialized health care
procedures for those students for which the selection has been
approved by both the principal and the county board, shall receive
additional pay of at least one pay grade higher than the highest
pay grade for which the employee is paid:
Provided, That any
training required in this section may be considered in lieu of
required in-service training of the school employee and a school
employee may not be required to elect to undergo the training or
retraining:
Provided, however, That commencing with the first day
of July, one thousand nine hundred eighty-nine any newly employed
school employee in the field of special education is required to
undergo the training and retraining as provided
for in this
section:
Provided further, That if an employee who holds a class
title of an aide is employed in a school and the aide has received the training, pursuant to this section, then an employee in the
field of special education is not required to perform the
specialized health care procedures.
(f) Each county school nurse, as designated and defined by
this section, shall perform a needs assessment. These nurses shall
meet on the basis of the area served by their regional educational
service agency, prepare recommendations and elect a representative
to serve on the council of school nurses established under this
section.
(g) There shall be a council of school nurses which shall be
convened by the State Board of Education. This council shall
prepare a procedural manual and shall provide recommendations
regarding a training course to the Commissioner of the Bureau for
Public Health who shall consult with the State Department of
Education. The
commissioner state board then has the authority to
promulgate a rule in accordance with the provisions of article
three three-b, chapter twenty-nine-a of this code, to implement the
training and to create standards used by those school nurses and
school employees performing specialized health procedures. The
council shall meet every two years to review the certification and
training program regarding school employees.
(h) The State Board of Education shall work in conjunction
with county boards to provide training and retraining every two
years as recommended by the council of school nurses and
implemented by the rule promulgated by the
commissioner state
board.
ARTICLE 9a. PUBLIC SCHOOL SUPPORT.
§18-9A-10a. Allowance for student health services.
(a) The Legislature finds that the need for heath services has
grown over the years in the public schools, particularly with
respect to serving special needs students and regulations on the
administration of medications, and the existing statutorily
required ratio of one nurse for each one thousand five hundred
students in net enrollment in grades kindergarten through seven is
no longer adequate. The Legislature further finds that limits on
state funded professional personnel, required ratios for
instructional personnel and declining student population and
population density require county boards to make increasingly
difficult decisions with respect to the instructional personnel
employed in the classroom and those that provide health and other
services to students. Therefore, the intent of this section is to
augment the funding of instructional personnel and to assure
improved health services for students by partially funding nurse
positions for certain counties as an intermediate step toward
improving instructional personnel staffing. The Legislature
intends to further examine the state basic foundation program in
context with the changing educational environment and address the
staffing and other needs of the public schools as may be indicated
through that examination.
(b) Commencing with the school year beginning on the first day
of July, two thousand six, notwithstanding any other provision of
this code to the contrary and not subject to nor counted toward the respective ratios of professional and instructional personnel per
students in adjusted and net enrollment set forth in sections four
and five-a of this article, counties shall receive funding at the
state average contracted salary for nurses plus fixed charges,
retirement and the public employee insurance employer premium for
nurse positions as determined by applying a ratio of one nurse per
each one thousand five hundred students in net enrollment, or major
fraction thereof, in grades pre-kindergarten through twelve, less
existing nurses employed, to extent funds are available.