Philly schools to outsource nurses?

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Specializes in Vents, Telemetry, Home Care, Home infusion.

Philadelphia Inquirer

May 13, 2015

Philly schools to outsource nurses?

...In 2011, the district employed 283 nurses. Now, it has 183, with most schools unable to afford the services of a full-time certified healthcare worker and many city children requiring care for medical conditions, especially asthma.

The school system on Wednesday issued a request for proposals asking for companies to suggest bold and innovative” ideas for reinventing school-based health care. The document said a vendor could, for instance, propose full-blown centers with primary care, mental and dental services; handle staffing services only; manage billing services to maximize reimbursements; or a combination of those things....

Idea is intriguing to have full blown health centers, especially in high schools...

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Specializes in Maternal - Child Health.

I would be very curious to see how a model like that would be financed, given that nursing services alone are too expensive for the district to fund.

Is it feasible to offer in-school services to insured or self-pay students and adults and have that income offset the cost of non-reimbursed care? Do we want primary and secondary schools to become healthcare providers with all the liability and bureaucracy that entails, including 3rd party billing, accreditation, health department inspections, etc.?

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Specializes in Pediatrics, Emergency, Trauma.

Wait in for the other show to drop on this one. :yes:

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Specializes in school nursing, ortho, trauma.

This idea has been tossed around in other places before and always looks so good on paper - not so good in practice. I've said it before, I'll say it again: School Nurses are probably the most vital commodity in the building but the lowest priority.

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Specializes in kids.

They should be careful what they wish for!

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Specializes in Complex pedi to LTC/SA & now a manager.
This idea has been tossed around in other places before and always looks so good on paper - not so good in practice. I've said it before, I'll say it again: School Nurses are probably the most vital commodity in the building but the lowest priority.

I wholeheartedly agree. If it weren't for the inter district communication of my son's school nurses he would not be in school right now. Rightfully they leave administration out of confidential medical issues and go straight to me. We brainstorm how to keep my son in school and safe, he knows her office is a safe haven, and after testing to see if that was true he does not abuse it. Outsourcing would remove the personal care, knowledge and expertise. I do think school RNs could be supplemented with a qualified LPN (large schools, RN in charge with LPN to help whether with record QA in the beginning/end of the year, student check in, assist with medication administration, under direction of school nurse accompany students with medical needs on field trips along with a first aid kit) in lieu of a random non licensed individual as a "health care assistant" as in my experience the UAPs are more likely to overstep boundaries. Bringing too much of non school healthcare (urgent care, medical or dental clinics, etcetera) blurs too many lines. I've seen school nurses help an uninsured family connect with a qualified social worker to expedite the state children's insurance application and subsequently expedite acceptance into the local FQHC via referral for a definitive need that shouldn't wait 6+ months for intake. The school nurse was able to provide the intake & medical screening and reducing the need for a long intake appointment.

Nursing is under appreciated in many venues but I think more so in schools than other areas.

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