Fayette schools taking more time to consider scaled-back nursing plan

Fayette County School Superintendent Tom Shelton.
Fayette County School Superintendent Tom Shelton. Herald-Leader

Fayette County Public Schools officials will reconsider some of the spending cuts they have proposed for the district's school-nurse program before bringing the issue to a vote.

The Fayette Board of Education was to have voted Monday night on a contract with the Lexington-Fayette County Health Department to provide school nurses for the district in 2013-2014, but Superintendent Tom Shelton said Monday morning that the item was being pulled from the agenda.

Shelton said the delay will allow time to consider cutting fewer nurses, and to answer questions that some residents have raised about the program.

About 30 registered nurses provided care in the Fayette Schools last year. Under the proposed new contract, there would be 13 RNs, plus 14 lesser-trained licensed practical nurses, backed up by some clerical workers. In some instances, school staffers would dispense some medicines.

"It's not a matter of changing the model, because we wouldn't have time to do that," Shelton said Monday about possible changes to the proposed plan. "It's a matter of do we want the board to add some resources on a one-time basis to expand the model a little bit, while making sure that we answer all the questions people have raised."

The board is now expected to vote on the nursing contract in July. Shelton said that's the latest that the contract can be approved and still be implemented when schools open in August.

The proposed nursing plan has drawn fire from some parents and caregivers.

June Boggs, a Lexington mother who has a son with congenital health problems, has peppered Shelton and school board members with calls and emails arguing that the proposed cuts would shortchange students.

Carol Komara, a registered nurse and a former school board member, wrote an essay in Friday's Herald-Leader questioning various parts of the plan, and urging district officials to find a better way.

Komara said in her essay that the number of nurses proposed for next year falls well below the ratio of one nurse to 750 children that is recommended by the National Association for School Nurses.

The nursing cutback is a result of an expected $500,000 reduction in federal funding to the county health department, which employs nurses for the school program.

In the past, the health department and the school system essentially split the cost of the nursing program. Next year, the school district will provide about $1.4 million, and the health department's contribution is expected to fall to about $275,000.

School officials said the scaled-back nursing plan is a one-year stopgap measure designed to get the schools through next year. After that, the district intends to seek a permanent nursing solution, they said.

Boggs contends that the school board should reject the plan and start over.

"The number of nurses is too small; they could barely manage last year, they were spread so thin," Boggs said. "You are talking about delegating responsibilities for things like administering medications to school personnel with zero medical training."

Boggs and Komara suggested that the school system should consider directly employing nurses, rather than going through the health department.

Shelton said hiring nurses is something the district will evaluate for 2014-15. He said there isn't enough time to do that now, with schools opening in about two months.

"We will do a request for proposals next year to see if we should hire nurses and do the services ourselves, or work with one of the local hospitals or some other agency," he said.

As for improving the program in the coming year, Shelton said adding back some nurses is a possibility. But the district would have to dip into its cash reserves to do that, he said.

"I'm asking my staff to look at what additional resources we could use on a one-time basis to expand the model," he said. "Effectively, it would be a matter of saying we want more support at the RN level or the LPN level or whatever."

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