[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3197 Introduced in House (IH)]
<DOC>
118th CONGRESS
1st Session
H. R. 3197
To make demonstration grants to eligible local educational agencies or
consortia of eligible local educational agencies for the purpose of
increasing the numbers of school nurses in public elementary schools
and secondary schools.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 10, 2023
Ms. Titus introduced the following bill; which was referred to the
Committee on Education and the Workforce, and in addition to the
Committee on Energy and Commerce, for a period to be subsequently
determined by the Speaker, in each case for consideration of such
provisions as fall within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To make demonstration grants to eligible local educational agencies or
consortia of eligible local educational agencies for the purpose of
increasing the numbers of school nurses in public elementary schools
and secondary schools.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Nurses for Under-Resourced Schools
Everywhere Act'' or the ``NURSE Act''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) The National Association of School Nurses identifies
schools as primary locations to address student health issues,
since a school nurse is the health care provider that many
students see on the most regular basis.
(2) The American Academy of Pediatrics has recognized the
crucial role that school nurses play in children's health and
has called for having a full-time school nurse every day and in
every school building.
(3) The school nurse functions as the leader and
coordinator of the school health services team, including by
carrying out chronic disease management and health promotion as
well as facilitating access to a medical home for each child
and supporting academic achievement.
(4) School nurses promote wellness and disease prevention
to improve health outcomes for our Nation's children. In
addition, school nurses perform early intervention services
such as periodic assessments for vision, hearing, and dental
problems, in an effort to remove barriers to learning.
(5) The American Federation of Teachers has called for a
nurse in every school, as nurses are front-line workers that
address an array of health needs and their presence in a school
can help to improve student learning.
(6) According to 2017 data from the National Association of
School Nurses, only 39.3 percent of schools employ a full-time
school nurse, while 35.5 percent of schools employ a school
nurse only part-time, and 25.2 percent do not have a school
nurse at all.
(7) The National Association of School Nurses has reported
that medication administration to students is one of the most
common health-related activities performed in school. As more
chronically ill and medically unstable children enter the
school system each year, the medical factors that promote and
support their academic success increase, including the need for
medications that enhance overall health or stabilize chronic
conditions.
(8) National data indicate that between 15 and 20 percent
of children who spend their day in school have a chronic health
condition.
(9) According to the American Academy of Pediatrics,
students today face increased social and emotional issues,
which enhance the need for preventive services and
interventions for acute and chronic health issues. School
nurses are actively engaged members of school-based mental
health teams and spend nearly 32 percent of their time
providing mental health services, including universal and
targeted interventions, screenings to identify early warning
signs and provide referrals to medical providers, and crisis
planning.
(10) According to the Department of Education, during the
2013-2014 school year, 1,360,747 children enrolled in public
schools experienced homelessness. Homeless children develop
increased rates of acute and chronic health conditions, and the
stress of their living situation can negatively affect their
development and ability to learn. As a result, schools have
become the primary access to health care for many children and
adolescents. School nurses serve on the front lines as a safety
net for the Nation's most vulnerable children.
(11) Communicable and infectious diseases account for
millions of school days lost each year. Data illustrate that
when students have access to a registered nurse in school,
immunization rates increase.
(12) Throughout the COVID-19 pandemic, school nurses have
played an important role helping students and coordinating
activities such as contact tracing and symptom screening.
SEC. 3. INCREASING THE NUMBER OF SCHOOL NURSES.
(a) Definitions.--In this section:
(1) ESEA terms.--The terms ``elementary school'', ``local
educational agency'', ``secondary school'', and ``State
educational agency'' have the meanings given to the terms in
section 8101 of the Elementary and Secondary Education Act of
1965 (20 U.S.C. 7801).
(2) Acuity.--The term ``acuity'', when used with respect to
a level, means the level of a patient's sickness, such as a
chronic condition, which influences the need for nursing care.
(3) Eligible entity.--The term ``eligible entity'' means--
(A) a local educational agency in which not less
than 20 percent of the children are eligible to
participate in the school lunch program established
under the Richard B. Russell National School Lunch Act
(42 U.S.C. 1751 et seq.);
(B) a consortium of local educational agencies
described in subparagraph (A); or
(C) a State educational agency in consortium with
local educational agencies described in subparagraph
(A).
(4) High-need local educational agency.--The term ``high-
need local educational agency'' means a local educational
agency described in paragraph (3)(A)--
(A) that serves not fewer than 15,000 children who
are eligible to participate in the program described in
such paragraph; or
(B) for which not less than 40 percent of the
children served by the agency are eligible to
participate in the program described in such paragraph.
(5) Nurse.--The term ``nurse'' means a registered nurse, as
defined under State law.
(6) Secretary.--The term ``Secretary'' means the Secretary
of Education.
(7) Workload.--The term ``workload'', when used with
respect to a nurse, means the amount of time the nurse takes to
provide care and complete the other tasks for which the nurse
is responsible.
(b) Demonstration Grant Program Authorized.--
(1) In general.--From amounts appropriated to carry out
this section, the Secretary of Education shall award
demonstration grants, on a competitive basis, to eligible
entities to pay the Federal share of the costs of increasing
the number of school nurses in the public elementary schools
and secondary schools served by the eligible entity, which may
include hiring a school nurse to serve schools in multiple
school districts.
(2) SEAs.--In the case of an eligible entity described in
subsection (a)(3)(C) that receives a grant under paragraph (1),
such entity shall use amounts received under the grant to award
subgrants to the local educational agencies that are members of
the entity, and reserve not more than 10 percent of such grant
funds to support statewide activities to meet a variety of
health needs, which may include hiring a nurse to provide
training and technical assistance to schools statewide that
meet the criteria established in subsection (d)(2)(A).
(c) Applications.--
(1) In general.--An eligible entity desiring a grant under
this section shall submit to the Secretary an application at
such time, in such manner, and containing such information as
the Secretary may require.
(2) Contents.--Each application submitted under paragraph
(1) shall include information with respect to the current (as
of the date of application) number of school nurses, student
health acuity levels, and workload of school nurses in each of
the public elementary schools and secondary schools served by
the eligible entity.
(d) Priority.--In awarding grants under this section, the Secretary
shall give priority to each application submitted by an eligible entity
that--
(1) is a high-need local educational agency, a consortium
composed of high-need local education agencies, or a State
educational agency in consortium with high-need local education
agencies; and
(2) demonstrates--
(A) the greatest need for new or additional nursing
services among students in the public elementary
schools and secondary schools served by the agency or
consortium; or
(B) that the eligible entity does not have a school
nurse in any of the public elementary schools and
secondary schools served by the local educational
agency or the consortium-member local educational
agencies.
(e) Federal Share; Non-Federal Share.--
(1) Federal share.--The Federal share of a grant under this
section--
(A) shall not exceed 75 percent for each year of
the grant; and
(B) in the case of a multiyear grant, shall
decrease for each succeeding year of the grant, in
order to ensure the continuity of the increased hiring
level of school nurses using State or local sources of
funding following the conclusion of the grant.
(2) Non-federal share.--The non-Federal share of a grant
under this section may be in cash or in-kind, and may be
provided from State resources, local resources, contributions
from private organizations, or a combination thereof.
(3) Waiver.--The Secretary may waive or reduce the non-
Federal share of an eligible entity receiving a grant under
this section if the eligible entity demonstrates an economic
hardship.
(f) Report.--Not later than 2 years after the date on which a grant
is first made to a local educational agency under this section, the
Secretary shall submit to Congress a report on the results of the
demonstration grant program carried out under this section, including
an evaluation of--
(1) the effectiveness of the program in increasing the
number of school nurses; and
(2) the impact of any resulting enhanced health of students
on learning, such as academic achievement, attendance, and
classroom time.
(g) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each of fiscal years 2024 through 2028.
<all>