Hardin County Schools is looking for a way to continue its school nurse program after the Lincoln Trail Board of Health voted in February to end the health department’s involvement with school health.
Sara Jo Best, public health director of the Lincoln Trail District Health Department, said the decision was based on potential budget cuts. Rising pension costs could mean an additional $3 million the department would be responsible for over the next two years.
Hardin County Schools, LaRue County Schools and Marion County Schools have contracted with the health department for medical oversight and billing of Medicaid for school nursing services.
School officials from Hardin and LaRue counties said they want to continue to have nurses in their schools. Contracting with the health department is a model districts can use to provide school health services.
“Our vision is no interruption in student health services,” said Janay Sutton, director of health and family resource services for HCS.
The districts employ the nurses, but work with the health department to bill Medicaid and receive reimbursement. The reimbursement helps to cover the costs of the program.
Best said the health department provides the infrastructure for the district to receive the reimbursement. It orders supplies, has a courier deliver paperwork and covers unbudgeted expenses that come up.
Best said the potential budget cuts have led department staff to evaluate all programs. She previously said the priority is on mandated programs and services such as communicable disease control. School health services are non-mandated.
“I need all the staff I can get to work mandated services,” she said. “One person out can cause a domino effect.”
The health department has been involved with school health since 1991, Best said.
The department’s board of health voted Feb. 19 to not continue current school health contracts next fiscal year or explore any additional contracts next year, according to a fact sheet from the health department.
Best said the vote doesn’t mean schools should not have nurses.
“We only have so much in the budget and can only do so much,” she said.
She said the board voted before the state budget is passed because of the school budget schedule. The next board meeting would be in May when the districts are close to finalizing their budgets.
“It’s the right thing to do,” she said. “It gives them enough time.”
School district officials were critical of the health department’s handling of the decision. Many said they heard the program was ending through a letter from Best informing them of the decision.
“We were very concerned like Hardin County and Marion County that there wasn’t any dialogue with us prior to the board making its decision,” said Rip Collins, who oversees school health for LaRue County Schools.
Sutton said she would have liked to have a conversation and brainstorm solutions before the board voted.
“It’s sad they didn’t bring us to the table,” Sutton said.
Officials from Hardin and LaRue counties have met with health department officials and board members since the vote.
“Basically, it’s a done deal,” Collins said. “We are going to need to make arrangements.”
Sutton said the district is looking into other ways to continue to have nurses in each school.
“We will have school nurses,” she said.
She said the district is in talks with several companies.
“Medicaid reimbursement is a key piece,” Sutton said.
She said she plans to have a solution much sooner than the summer.
“It’s a process,” she said. “We’re looking for the right fit.”
For a registered nurse to be able to bill Medicaid, they have to be a public health nurse or part of a federally qualified health center, Sutton said.
She said she wants to give school health employees stability and security.
“So they don’t feel like it’s a year-to-year process,” Sutton said. “We’re going to fix this and fix it for longevity. ... They are way too valuable and irreplaceable, in my opinion.”
Collins said LaRue County Schools has contracted with the health department for the last two years to have a nurse at its middle school and two elementary schools.
At LaRue County High School, he said the model is different and through Cumberland Family Medical Centers.
Collins said he’s working with Cumberland to see if the provider can expand to the other schools. He expects to have a deal by the end of April for next school year.
Marion County Schools Superintendent Taylora Schlosser did not return an interview request.
Collins and Sutton said school nurses are important for their students. They can identify medical problems early on and help prevent issues.
“Our nurses, they stay extremely busy,” Collins said.
In Hardin County, school nurses saw a record number of students last year. The district and health department expanded the school nursing program in 2014 to have a nurse in each school.
In 2016, the program changed hands when the health department wasn’t able to continue contributing. The school district became the nurses’ employer and paid for the program.