Healthcare and Ohio's Public Schools: Trends in Personnel Service Delivery Systems

Ohio's 612 public school systems are not required by state law to have a school nurse on staff. However, Ohio law does define a school nurse and specifies requirements for licensure should a school employ school nurses. Personnel structures in place to provide health care services to Ohio's school children have been circumventing existing regulation in the name of fiscal necessity with increasing frequency. Telephone surveys were conducted to 612 schools in Ohio to determine who is providing healthcare services in Ohio's public schools. Personnel credentials (e.g. licensed school nurse), employer of health care personnel (e.g. school district) as well as poverty levels (% of students on free or reduced lunch) in school districts were explored. Approximately 61.8% of school districts utilize licensed school nurses to provide health care services in schools. Less than 7.4 % of Ohio's public schools meet the Healthy People 2010 goal for a ratio of 1 school nurse to 750 school students. Nearly 12.1% of school districts have ratios greater than 1:3000. Twenty percent of school districts contract with local health departments for school health services. When public health nurses (PHN) are used to provide services, the school district's nurse to student ratios worsen, due to less than 5% of school districts using PHN's provide full time services. As the poverty level of a school district increases, ratios of registered nurses to students were not shown to have any strong correlation either negatively or positively, with a Pearson coefficient of -0.067.