Audit Response
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Ancillary Services: Use All Appropriate Local Health Services Available to Reduce Duplication and Costs

Amend West Virginia Code to allow counties to use nurses and other appropriate health professionals in all health care agencies such as Federally Qualified Health Centers (FQHC) to serve as school nurses.

Estimated cost savings
$1.8 million per year from eliminating school nurses and using those from FQHC.
Policy change(s) required
Code §18-5-22.
Actions already underway
Currently, if counties post for a school nurse, but are unable to attract qualified applicants, they are still restricted and cannot use their school-based health staff to provide services.

The Office of Healthy Schools provided technical assistance to school systems and communities to expand school-based health centers resulting in a rapid increase of the opening of new centers. This will increase the advantages that could come from legislation to expand contracting ability for school nursing services to health care providers.
WVBOE response
The WVBOE agrees with the recommendation of flexibility for counties to use appropriate health care professionals, such as a nurse practitioner or physician's assistant, in order to (a) allow school-based health centers to write the health care plans; and (b) train aides to free up nurses to provide other services.

The WVBOE calls upon the Legislature to modify Code to allow flexibility for counties to use appropriate health care professionals.

The Board supports exploring ways for expanding needed services without dramatically increasing costs.

Amend West Virginia Code to require these health care centers to perform the duties of a school nurse, free of charge, as payment for the use of school facilities.

Estimated cost savings
N/A
Policy change(s) required
W.Va. Code §18-5-22(b) would have to be amended with new language.
Actions already underway
Current ratio of 1 school nurse to every 1,500 students in Grades K-7 is already severely limited by W.Va. Code 18-5-22 (b). The current high acuity health care needs of students go beyond a simple ratio.
WVBOE response
The WVBOE does not support this recommendation to amend Code to require these health centers to perform the duties of a school nurse, free of charge. Many of these health centers would be willing to negotiate with local schools regarding the costs of their services and payment for facilities. The Board believes mandating this in state law would be restrictive and perhaps counter-productive to agreements with health care centers.