A threat to school nurses
2/24/2004
THREE CHILDHOOD disorders -- asthma, diabetes, and obesity -- are on the upswing in Massachusetts, yet Governor Romney is still proposing to drop state funding for the health care professionals who deal with children suffering from these conditions day in and day out: school nurses. Romney's plan to end the $8.4 million school nurses grant program will not mean layoffs for all school nurses, since most of them are paid out of local funds by the communities in which they work. But his cut will mean fewer nurses in the very districts where they are often the only health care providers the students can take their problems to.
Of all the budget cuts Romney is making to stick to his no-new-taxes pledge, this is one that will be particularly harmful to a vulnerable population: the children of the poor and working poor with little access to the health care system. Time and again, it is school nurses who first identify a health problem -- from hearing loss to a sexually transmitted disease -- and then make sure the student is referred to a clinic or doctor.
Nurses have to be ready to use nebulizers with asthmatics' medication, treat severe allergy reactions with adrenaline shots, and test the blood sugar of students with diabetes. They are a primary source of information for children about the hazards of smoking, drinking, substance abuse, and risky sexual activity.
In the mid-1990s, the state recognized the crucial and growing role of school nurses and used tobacco tax money to set up the Enhanced Health Services grant program, which at one time was budgeted for more than $15 million. More than 100 districts used grants to hire nurses, train staff, and buy such basic equipment as modern hearing- and vision-testing machines. Romney raided the program's money substantially last year and wants to end it in his new budget.
The administration's response to critics is to propose beefing up efforts to get federal government reimbursement under Medicaid for funds the school districts pay for the health care of special education students. But when that money comes back, it goes into municipal general funds, so it is not clear that districts would use it for school nurses. After two years of sharp decreases in state aid for schools, districts would have to weigh using any new reimbursement money for nurses against the need for teachers to keep class enrollments from reaching unmanageable levels.
As long as the health grant program is in place and adequately funded, districts do not have to make such agonizing choices. Through the grant program, the state acknowledged a responsibility to help schools fulfill a role that has fallen on their shoulders: that of front-line health providers. Legislators should restore the program to at least its current level.
© Copyright 2004 Globe Newspaper Company.
