What This Bill Does
This bill allows the Secretary of Education to create a grant program that gives money to local school districts and state education agencies to help ensure every elementary and secondary school has at least one full-time registered nurse on staff. The bill also aims to help these schools keep nurses employed and maintain recommended numbers of nurses compared to students.
Who It Affects
Local school districts, state education agencies, school nurses, elementary and secondary school students, families with uninsured children, and public health professionals seeking nursing positions in schools.
Key Provisions
- The Secretary of Education must establish a competitive grant program within 12 months, with grants lasting 5 years (Sec. 3(a))
- Schools applying for grants must submit a needs assessment showing they don't have enough nurses, describe student health needs, and create a plan to keep nurses after the grant ends (Sec. 3(b))
- The Secretary will prioritize grants going to high-need school districts and organizations that set specific goals to hire nurses from underrepresented groups in public health (Sec. 3(c))
- Grant money can be used to recruit and hire nurses, convert part-time nurse positions to full-time, increase nurse salaries to keep them employed, and maintain recommended nurse-to-student ratios (Sec. 3(d))
- Schools receiving grants must submit yearly reports showing how many full-time and part-time nurses they hired, breaking down information by race, ethnicity and gender, and describing progress on student health goals (Sec. 3(e))
What Changes
If this becomes law, school districts will have access to federal grant money specifically for hiring and keeping school nurses. The Secretary of Education will create new regulations defining what "full-time" means for school nurses, what the recommended number of nurses per student should be, and what counts as an "underrepresented population in public health professions."
Important Definitions
- Registered nurse: A nurse qualified under state law to provide assessment, diagnosis, counseling, educational, therapeutic and other health services to meet student needs (Sec. 3(g)(4))
- Local educational agency: Not specified in bill text (defined in another federal law referenced in the bill)
- High-need local educational agency: Not specified in bill text (defined in another federal law referenced in the bill)
- Full-time school nurse: Not specified in bill text (the Secretary must create this definition by regulation)
Effective Date
Not specified in bill text
I
118TH CONGRESS
1ST SESSION
H. R. 305
To authorize the Secretary of Education to carry out a grant program
to assist local educational agencies with ensuring that each elementary
and secondary school has at least one registered nurse on staff.
IN THE HOUSE OF REPRESENTATIVES
JANUARY 11, 2023
Ms. WILSON of Florida 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 de-
termined by the Speaker, in each case for consideration of such provisions
as fall within the jurisdiction of the committee concerned
A BILL
To authorize the Secretary of Education to carry out a
grant program to assist local educational agencies with
ensuring that each elementary and secondary school has
at least one registered nurse on staff.
Be it enacted by the Senate and House of Representa-
1
tives of the United States of America in Congress assembled,
2
SECTION 1. SHORT TITLE.
3
This Act may be cited as the ‘‘One School, One Nurse
4
Act of 2023’’.
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•HR 305 IH
SEC. 2. PURPOSE; FINDINGS.
1
(a) PURPOSE.—The purpose of this Act is to assist
2
States and local educational agencies with ensuring that
3
every elementary and secondary school has at least one
4
full-time registered nurse on staff, and to maintain rec-
5
ommended nurse-to-student ratios, including through the
6
recruitment, hiring, and retention of registered nurses.
7
(b) FINDINGS.—Congress finds the following:
8
(1) According to the American Academy of Pe-
9
diatrics, every elementary and secondary school
10
should have at least one full-time registered nurse
11
on staff.
12
(2) According to the National Center for Edu-
13
cation Statistics, during the 2015–2016 school year,
14
only about half of all public schools had a full-time
15
registered nurse and nearly 20 percent did not have
16
any nurse on staff. Schools with higher free or re-
17
duced-price lunch program eligibility rates had lower
18
rates of school nurses.
19
(3) According to the Georgetown University
20
Center for Children and Families, in 2019, roughly
21
6 percent of children in the United States were un-
22
insured.
23
(4) For children who lack health care coverage,
24
a school nurse is often a critical source of health
25
services.
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•HR 305 IH
(5) Studies suggest that schools with a full-time
1
registered nurse experience far-reaching benefits in-
2
cluding fewer student absences, students spending
3
more time in class, more accurate medical records,
4
higher immunization rates, fewer student preg-
5
nancies, and better health outcomes for students
6
with asthma or diabetes.
7
(6) School nurses play a critical role in helping
8
to manage the chronic physical, emotional, mental,
9
and social health needs of students, conduct health
10
screenings, facilitate vaccinations and immunization
11
compliance efforts, reduce burdens on educators and
12
other school staff, and support a positive and
13
healthy school climate.
14
SEC. 3. ONE SCHOOL, ONE NURSE GRANT PROGRAM.
15
(a) GRANT PROGRAM AUTHORIZED.—Not later than
16
12 months after the date of enactment of this section, the
17
Secretary shall establish a program to award grants, on
18
a competitive basis, to eligible entities to carry out the
19
activities under subsection (d). Grants awarded under this
20
section shall be for a period of 5 years.
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(b) APPLICATION.—An eligible entity desiring a grant
22
under this section shall submit an application to the Sec-
23
retary at such time, in such manner, and containing such
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•HR 305 IH
information as the Secretary may require. Such applica-
1
tion shall include—
2
(1) a needs assessment of the eligible entity
3
that demonstrates the existence of persistent short-
4
ages of school nurses or persistent shortages of full-
5
time school nurses;
6
(2) a description of the health and wellness
7
needs of the student population served by the eligible
8
entity;
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(3) a comprehensive plan for the use of grant
10
funds to address persistent shortages described in
11
the needs assessment under paragraph (1), including
12
a description of how such activities shall address the
13
health and wellness needs described under paragraph
14
(2) and how such funds will be used to ensure that
15
the eligible entity will continue to employ and retain
16
school nurses after the completion of the grant pe-
17
riod; and
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(4) a description of how the eligible entity will
19
prioritize recruiting individuals from the commu-
20
nities served by the eligible entity and from under-
21
represented populations in public health professions
22
(as determined by the Secretary by regulation), and
23
how the eligible entity will track progress in meeting
24
any specified hiring goals.
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•HR 305 IH
(c) SELECTION AND PRIORITY.—In awarding grants
1
under this section, the Secretary shall give priority to eligi-
2
ble entities that—
3
(1) are a high-need local educational agency, or
4
are a partnership between a State educational agen-
5
cy and a consortium of high-need local educational
6
agencies; and
7
(2) describe and set specific hiring goals to-
8
wards increasing the share of school nurses who are
9
from underrepresented populations in public health
10
professions.
11
(d) ACTIVITIES.—Grant funds awarded under this
12
section shall be used by an eligible entity to carry out one
13
or more of the following activities:
14
(1) Recruit and hire school nurses.
15
(2) Provide resources necessary to convert part-
16
time school nurse positions at elementary or sec-
17
ondary schools served by the eligible entity into full-
18
time school nurse positions.
19
(3) Support the retention of school nurses, in-
20
cluding by increasing salaries.
21
(4) Maintain recommended nurse-to-student ra-
22
tios (as determined by the Secretary by regulation).
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(e) REPORTING.—Each eligible entity awarded a
24
grant under this section shall submit to the Secretary an
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•HR 305 IH
annual report for each year of the grant award. Such re-
1
port shall include—
2
(1) a summary of the eligible entity’s progress
3
in employing at least one full-time registered nurse
4
at each elementary and secondary school served by
5
the eligible entity and maintaining recommended
6
nurse-to-student ratios (as determined by the Sec-
7
retary by regulation);
8
(2) data on the number and percentage of full-
9
time and part-time school nurses, disaggregated by
10
major racial and ethnic groups and gender, em-
11
ployed at each elementary and secondary school
12
served by the eligible entity; and
13
(3) a summary of any progress made by the eli-
14
gible entity in addressing the health and wellness
15
needs identified in the needs assessment required
16
under subsection (b)(2) as a result of activities car-
17
ried out with a grant under this section.
18
(f) REGULATIONS REQUIRED.—Not later than 12
19
months after the date of enactment of this section, the
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Secretary shall—
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(1) in consultation with the Secretary of Health
22
and Human Services—
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•HR 305 IH
(A) specify in regulation the recommended
1
nurse-to-student ratios for elementary and sec-
2
ondary schools;
3
(B) provide for guidance and other tech-
4
nical assistance to eligible entities with respect
5
to achieving and maintaining such ratios; and
6
(C) specify in regulation the definition of
7
‘‘underrepresented populations in public health
8
professions’’ for the purposes of this section;
9
and
10
(2) in consultation with the Secretary of Health
11
and Human Services and the Secretary of Labor,
12
specify in regulation the definition of ‘‘full-time’’
13
with respect to school nurses for the purposes of this
14
section.
15
(g) DEFINITIONS.—In this section:
16
(1) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
17
ty’’ means—
18
(A) a local educational agency; or
19
(B) a partnership between a State edu-
20
cational agency and a consortium of local edu-
21
cational agencies in the State, entered into for
22
the purposes of a grant under this section.
23
(2) HIGH-NEED
LOCAL
EDUCATIONAL
AGEN-
24
CY.—The term ‘‘high-need local educational agency’’
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•HR 305 IH
has the meaning given such term in section 200 of
1
the Higher Education Act of 1965 (20 U.S.C.
2
1021).
3
(3) LOCAL EDUCATIONAL AGENCY; STATE EDU-
4
CATIONAL AGENCY.—The terms ‘‘local educational
5
agency’’ and ‘‘State educational agency’’ have the
6
meanings given such terms in section 8101 of the
7
Elementary and Secondary Education Act of 1965
8
(20 U.S.C. 7801).
9
(4) SCHOOL NURSE.—The term ‘‘school nurse’’
10
means a registered nurse who is employed by a
11
school or local educational agency or State or State
12
educational agency and is qualified under State law
13
to provide assessment, diagnosis, counseling, edu-
14
cational, therapeutic, and other health services to
15
meet student needs.
16
(5) SECRETARY.—The term ‘‘Secretary’’ means
17
the Secretary of Education.
18
Æ
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