School nurses do a lot more than dispense medication and take temperatures these days, which is why the state Legislature four years ago passed a bill raising their education requirement from a two-year to a four-year degree.
Whether that decision was a good move in the interest of student well-being or an unnecessary and unfunded mandate on school districts has been debated every year since the new requirements were signed into law by Gov. Maggie Hassan in 2016.
In 2017, a legislative rules committee decided to extend the deadline for complying with the new rules by six years. Lawmakers tried and failed to reverse the law last year, when a repeal measure passed the House, 233-107, only to fail in the Senate, 14-8.
This is one of those issues that does not break on partisan lines. The 14 senators who voted to keep the tougher requirements last year included eight Republicans and six Democrats.
Opponents of the four-year requirement are back again this year, with another repeal attempt that will soon head to the House floor without a recommendation from the House Education Committee.
A recent 10-10 committee vote on the bill, HB 275, shows how deeply divided the Legislature has been on this issue as the state tries to upgrade credentials for school nursing while districts like Manchester are struggling to fill the positions.
“The bill goes forward with no recommendation from the committee,” said House Education Committee Chair Mel Myler, D-Merrimack, after the Feb. 5 vote. “It’s a rarity, but it happens.”
Republican Rick Ladd of Haverhill, former chair of education and a longtime teacher and school administrator, says the verdict is in from school districts across the state, and they are almost universally opposed to the new requirement.
“The school districts and superintendents we’ve heard from are grappling with funding disparities in their schools; advanced placement courses are not being taught; schools are being closed; foreign languages disappear, and now we are mandating this level of nursing,” he said. “The school nurse is a vital element … knows the community, knows the staff, knows the parents … and that’s something you can do with a two-year degree. We are raising the bar so high, it’s going to start working the wrong way on us.”
School nurses hired before the new law took effect are grandfathered, but those hired after July 1, 2016, have to obtain a bachelors degree within six years of their hire date. While an associate degree is sufficient for a state nursing license, it no longer qualifies for school nursing certification after the six-year period. Candidates also need three years of experience in pediatric nursing or related areas, and have to commit to continuing education. Like teachers, they have to be recertified every three years by the Department of Education, at a cost of $75, in addition to what they pay for their nursing licenses.
The new certification requirements are endorsed by the New Hampshire Nurses Association and the Children’s Behavioral Health Collaborative at New Futures.
“We’ve heard from the New Hampshire Nurses Association that, in fact, there is not a school nurse shortage,” said Rep. Tamara Le, D-North Hampton. “There are a lot of medically frail children in our school system who require the advanced skill set that such a nurse can provide, and quite often they come with Medicaid dollars, so I do not see a great impact there financially.”
Andrew Cline, chairman of the state Board of Education, is hoping the repeal of the new requirements succeeds, although the board has not taken an official position. He believes the feedback lawmakers have been getting from constituents could turn the tide.
“We have received quite a bit of feedback from districts indicating they are having real problems hiring nurses because of the bachelor’s requirement,” he said. “My thinking was that over time legislators would start hearing from their districts what a problem this is, and that appears to be the case.”
The bill will most likely come to a floor vote in the House on Feb. 27 or 28.