,,ii #aafth ,,congress #ast ,session ,s4 #acfb ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #h1 #bjai,mr4 ,tester 7for himself and ,mr4 ,merkley7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to make demonstration grants to eligible local educational agencies or consortia of eligible local educational agencies for the purpose of increasing the numbers of school nurses in public elementary schools and secondary schools4 #a4 ,short title ,this ,act may be cited as the ,nurses for ,under-,resourced ,schools ,everywhere ,act or the ,,nurse ,act4 #b4 ,findings ,congress finds the following3 7#a7 ,the ,national ,association of ,school ,nurses identifies schools as primary locations to address student health issues1 since a school nurse is the health care provider that many students see on the most regular basis4 7#b7 ,the ,american ,academy of ,pediatrics has recognized the crucial role that school nurses play in children's health and has called for having a full-time school nurse every day and in every school building4 7#c7 ,the school nurse functions as the leader and coordinator of the school health services team1 including by carrying out chronic disease management and health promotion as well as facilitating access to a medical home for each child and supporting academic achievement4 7#d7 ,school nurses promote wellness and disease prevention to improve health outcomes for our ,nation's children4 ,in addition1 school nurses perform early intervention services such as periodic assessments for vision1 hearing1 and dental problems1 in an effort to remove barriers to learning4 7#e7 ,the ,american ,federation of ,teachers has called for a nurse in every school1 as nurses are front-line workers that address an array of health needs and their presence in a school can help to improve student learning4 7#f7 ,according to #bjag data from the ,national ,association of ,school ,nurses1 only #ci4c percent of schools employ a full-time school nurse1 while #ce4e percent of schools employ a school nurse only part-time1 and #be4b percent do not have a school nurse at all4 7#g7 ,the ,national ,association of ,school ,nurses has reported that medication administration to students is one of the most common health-related activities performed in school4 ,as more chronically ill and medically unstable children enter the school system each year1 the medical factors that promote and support their academic success increase1 including the need for medications that enhance overall health or stabilize chronic conditions4 7#h7 ,national data indicate that between #ae and #bj percent of children who spend their day in school have a chronic health condition4 7#i7 ,according to the ,american ,academy of ,pediatrics1 students today face increased social and emotional issues1 which enhance the need for preventive services and interventions for acute and chronic health issues4 ,school nurses are actively engaged members of school-based mental health teams and spend nearly #cb percent of their time providing mental health services1 including universal and targeted interventions1 screenings to identify early warning signs and provide referrals to medical providers1 and crisis planning4 7#aj7 ,according to the ,department of ,education1 during the #bjac-bjad school year1 #a1cfj1gdg children enrolled in public schools experienced homelessness4 ,homeless children develop increased rates of acute and chronic health conditions1 and the stress of their living situation can negatively affect their development and ability to learn4 ,as a result1 schools have become the primary access to health care for many children and adolescents4 ,school nurses serve on the front lines as a safety net for the ,nation's most vulnerable children4 7#aa7 ,communicable and infectious diseases account for millions of school days lost each year4 ,data illustrate that when students have access to a registered nurse in school1 immunization rates increase4 #c4 ,increasing the number of school nurses 7a7 ,definitions ,in this section3 7#a7 ,,esea terms ,the terms elementary school1 local educational agency1 secondary school1 and ,state educational agency have the meanings given to the terms in section #haja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja74 7#b7 ,acuity ,the term acuity1 when used with respect to a level1 means the level of a patient's sickness1 such as a chronic condition1 which influences the need for nursing care4 7#c7 ,eligible entity ,the term eligible entity means-- 7,a7 a local educational agency in which not less than #bj percent of the children are eligible to participate in the school lunch program established under the ,richard ,b4 ,russell ,national ,school ,lunch ,act 7#db ,u4,s4,c4 #agea et seq472 7,b7 a consortium of local educational agencies described in subparagraph 7,a72 or 7,c7 a ,state educational agency in consortium with local educational agencies described in subparagraph 7,a74 7#d7 ,high-need local educational agency ,the term high-need local educational agency means a local educational agency described in paragraph 7#c77;,a7-- 7,a7 that serves not fewer than #ae1jjj children who are eligible to participate in the program described in such paragraph2 or 7,b7 for which not less than #dj percent of the children served by the agency are eligible to participate in the program described in such paragraph4 7#e7 ,nurse ,the term nurse means a registered nurse1 as defined under ,state law4 7#f7 ,secretary ,the term ,secretary means the ,secretary of ,education4 7#g7 ,workload ,the term workload1 when used with respect to a nurse1 means the amount of time the nurse takes to provide care and complete the other tasks for which the nurse is responsible4 7b7 ,demonstration grant program authorized 7#a7 ,in general ,from amounts appropriated to carry out this section1 the ,secretary of ,education shall award demonstration grants1 on a competitive basis1 to eligible entities to pay the ,federal share of the costs of increasing the number of school nurses in the public elementary schools and secondary schools served by the eligible entity1 which may include hiring a school nurse to serve schools in multiple school districts4 7#b7 ,s,e,as ,in the case of an eligible entity described in subsection 7a77#c77;,c7 that receives a grant under paragraph 7#a71 such entity shall use amounts received under the grant to award subgrants to the local educational agencies that are members of the entity1 and reserve not more than #aj percent of such grant funds to support statewide activities to meet a variety of health needs1 which may include hiring a nurse to provide training and technical assistance to schools statewide that meet the criteria established in subsection 7d77#b77;,a74 7c7 ,applications 7#a7 ,in general ,an eligible entity desiring a grant under this section shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,contents ,each application submitted under paragraph 7#a7 shall include information with respect to the current 7as of the date of application7 number of school nurses1 student health acuity levels1 and workload of school nurses in each of the public elementary schools and secondary schools served by the eligible entity4 7d7 ,priority ,in awarding grants under this section1 the ,secretary shall give priority to each application submitted by an eligible entity that-- 7#a7 is a high-need local educational agency1 a consortium composed of high-need local educational agencies1 or a ,state educational agency in consortium with high-need local educational agencies2 and 7#b7 demonstrates-- 7,a7 the greatest need for new or additional nursing services among students in the public elementary schools and secondary schools served by the agency or consortium2 or 7,b7 that the eligible entity does not have a school nurse in any of the public elementary schools and secondary schools served by the local educational agency or the consortium-member local educational agencies4 7e7 ,federal ,share2 non-,federal ,share 7#a7 ,federal ,share ,the ,federal share of a grant under this section-- 7,a7 shall not exceed #ge percent for each year of the grant2 and 7,b7 in the case of a multiyear grant1 shall decrease for each succeeding year of the grant1 in order to ensure the continuity of the increased hiring level of school nurses using ,state or local sources of funding following the conclusion of the grant4 7#b7 ,non-,federal ,share ,the non-,federal share of a grant under this section may be in cash or in kind1 and may be provided from ,state resources1 local resources1 contributions from private organizations1 or a combination thereof4 7#c7 ,waiver ,the ,secretary may waive or reduce the non-,federal share of an eligible entity receiving a grant under this section if the eligible entity demonstrates an economic hardship4 7f7 ,report ,not later than #b years after the date on which a grant is first made to a local educational agency under this section1 the ,secretary shall submit to ,congress a report on the results of the demonstration grant program carried out under this section1 including an evaluation of-- 7#a7 the effectiveness of the program in increasing the number of school nurses2 and 7#b7 the impact of any resulting enhanced health of students on learning1 such as academic achievement1 attendance1 and classroom time4 7g7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years #bjbj through #bjbd4