Publicservicebuilding, 255 Capitol Street NE, Salem, Oregon97310

Oregon Department of Education

PublicServiceBuilding, 255 Capitol Street NE, Salem, Oregon97310

Phone (503) 378-3569 • Fax (503) 378-5156 •

REPORT TO THE STATE BOARD OF EDUCATION AND THE INTERIM LEGISLATIVE COMMITTEES RELATED TO EDUCATION

ANNUAL REPORT REQUIRED BY THE 75TH OREGON LEGISLATIVE ASSEMBLY HOUSE BILL 2693 (ENROLLED)

BASED ON DATA FROM SCHOOL YEAR 2010-2011

Providing information on school nurse services in Oregon public schools, and the presence of medically impaired students in those schools

Background:

In 2009, House Bill 2693was passed by the Oregon State Legislature, and enrolled.This Legislation (see attachment) requires the Oregon Department of Education to submit to the State Board of Education and the interim legislative committees related to education, an annual report no later than October 1 of each year that is based on the previous school year and that provides information on the availability of nurses in Oregon public schools, and delineates the number of certain medically impaired students in Oregon public schools

The information required is presented in this document.

The Oregon Department of Education set up and administered this data collection, and the 2010-2011 schoolyear is the first year that school districts have been required to submit this data. Out of 198 Oregon school districts, data was received from117districts as of September 27, 2011. The data listed below, therefore, is based on participation by 57% of Oregon public school districts.

Past experience with new data collections shows that the participation rate improves as school districts become more familiar with the collection requirements.The following information is based upon the data received by the 117 participating school districts.

This report consists of two sections which are:

• Part One: School Nurse Data
• Part Two: Medically Impaired Student Data

Part One: School Nurse Data

As indicated above, there are 198 school districts in Oregon. Of these, 117 submitted data on school nurses employed.

Because of the way this data collection was set up, nurse datacollected for school year 2010-11 can only be expressed in whole numbers. Thus,while this data collection indicates that Oregon schools employ 340 full time nurses, the actual number of full time school nurse positions is estimated to be closer to 230 for Oregon’s 198 school districts.

Since Oregon had a total student enrollment of 531,238 for this time period, the ratio (based on 340 nurses) of school nurses to students is:

One school nurse to 1,500 students.

This ratio, based on the estimated (but more accurate) number of 230 nurses is:

One school nurse to 2,300 students.

In Section 5 of House Bill 2693 (see hyperlink) school districts are encouraged to provide:

1. One Registered nurse or school nurse for every 3,500 students by July 1, 2014
2. One Registered Nurse or school nurse for every 2,500 students by July 1, 2016
3. One registered nurse or school nurse for every 1,500 students by July 1, 2018
4. One registered nurse or school nurse for every 750 students by July 1, 2020

Using either the number of 340 nurses, or the estimate of 230 nurses, Oregon school districts appear to be on track with the recommendations put forth in Section 5 of House Bill 2693.

For future collections, the data parameters will be changed to make it possible for school districts to indicate part-time school nurse positions. Once this information is available to the Oregon Department of Education, the accuracy of the collected data will be enhanced, since numbers of nurses will reflect full time positions, rather than physical bodies.

Part Two: Medically Impaired Student Data

The second set of data collected concerns reflects the numbers of students who require somepredictableamount of school nurse timeduring their hours of participation in their school program. As described in Section I of this document, the numbers collected in this section reflect information from the 117 school districts who submitted data, and not the 198 total Oregon school districts. Again, these numbers are about 57% of the total Oregon districts for School Year 2010-2011.

It is worth noting thisdata represents student needs which are not reflected in the Health Impairment Data collected as part of the Special Education Data Collection. Some examples of such health impairments include students with insulin dependent diabetes, and asthma. Special Education Data Collection for the school-age population includes the following categories:

• Intellectual Disability
• Hearing Impairment
• Vision Impairment
• Deaf-Blindness
• Speech/Language Impairment
• Emotional Disturbance
• Orthopedic Impairment
• Traumatic Brain Injury
• Other Health Impairment
• Autism
• Specific Learning Disability

An examination of this list makes it evident that many non-special education students with health impairments are being served and accommodated in Oregon schools. Some of these students have serious health problems, and require intricate professional management, in order to be safe in the school setting, and to be able to access their educational program in an optimum manner. Some examples of such health problems include students with insulin-dependent diabetes, asthma, and severe food allergies.

One example that might be worthy of closer examination is the incidence of insulin dependent diabetes in Oregon school students.

Statistically, the National Diabetes Association estimates that about one in 10 Americans suffers from diabetes.

In Oregon schools, while exact numbers are not available, it is evident to all who work with these student populations that there has been a very large increase in the number of Oregon students who have insulin dependent diabetes. It is difficult to find even a small school district in Oregon which does not have an insulin-dependent diabetic student. The age of these students varies from 6 years old, to 18 years old.

Management of insulin dependent diabetes includes careful dietary intervention, blood tests during the school day, administration of injections of insulin, and incorporation of disease incident prevention into all the student’s activities. Some students, especially those who are older, and/or who are more experienced in caring for themselves, are able to be independent at school with their diabetes management. Others are not, and the task of evaluating the student’s school day, determining steps of care, and teaching non-licensed school staff to perform these tasks, falls to the nurse employed by the school district.

The number of diabetic students, and the number of nurse and staff hours spent in schools teaching and providing proper care for them, is not reflected in any statistical data base—yet just this one aspect of student health has a large impact on school resources.

In House Bill 2693 three categories of student needare identified for collection in HB 2693.

• Medically Complex Students - students who have an unstable health condition, and who may require daily professional nursing services
• Medically Fragile students - students who may have a life-threatening health condition and who may require immediate professional nursing services
• Nursing Dependent students - students who may have an unstable or life-threatening health condition and who may require daily, direct and continuous professional nursing services

The student numbers are as follows:

The relationship of these categories to the whole is reflected in this chart.

Numbers reflected in this report are new to the state of Oregon and reflect medical needs of students, and numbers of available school nurses. As has been stated above, data was only captured for 57% of Oregon school districts. It is expected that this percentage will improve as school districts become aware of and practiced at submissions for this data collection.

Intensive analysis of this data will be more useful when trend data becomes is available. It is expected that this improvement in data collected will be reflected in the report submitted October 1, 2012 to the Oregon State Board of Education and the legislative education subcommittees. In the meantime, this report represents a valuable first step in the creation of a clear picture of the medically needy student in the Oregon school system, and nursing resources available for care of that student.

Information and data used for this report may be obtained from Leslie Currin RN, School Health Specialist,Oregon Department of Education.

This report is respectfully submitted by,

Leslie Currin RN

School Health Specialist

Oregon Department of Education

503-947-5812

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