Want more school nurses? Listen in. . . . Becky Bowers-Lanier, EdD, MSN, MPH, RN Principal, B2L Consulting VASN Advocacy Consultant

Disclosure statement Rebecca Bowers-Lanier I disclose the absence of personal financial relationships with commercial interests relevant to this educational activity within the past 12 months.

Objectives Discuss how local school divisions are structured and funded; Identify the key decision makers for resource allocation within local school divisions; Describe attributes of a politically savvy player in the game of politics and policymaking; Outline a personal plan to continue to make the case for school nurses and school nursing.

First, school governance and funding School boards are policymaking bodies for local school divisions Virginia Department of Education, under the direction of the Virginia Board of Education, sets the standards. Public K-12 schools operated by counties and cities, not the Commonwealth Article VIII of the Virginia Constitution states that the General Assembly provides for a system of free public elementary and secondary schools for all children of school age. The state budget funds 55% of school operations. The Commonwealth Institute estimates that Virginia is short-changing school divisions by $800M. Poor districts disproportionately suffer the most because the state funds them at higher rates than richer districts (so they suffer the most with state cuts)

How are school nurse positions currently funded? School nurses are considered support services, along with school psychologists and social workers. Local school boards have discretion to fill these positions as they deem necessary. School health data from 2015: 1128.3 FTE RN Positions providing direct care 377.3 FTE LPN Positions providing direct care 494 UAPs 55.8 RNs with special assignments Ratio of 1:1107.2 RN only Ratio with Fairfax & Chesterfield RNs,1:1012.9 (1:900, 2014) Ratio of 1:829.7 RN & LPN Ratio with Fairfax & Chesterfield RNs, 1:775.6 (1:764, 2014)

Proposal approved by the Virginia Board of Education October 2016 That school nurses be included in the Standards of Quality (Standard 2) According to the BOE: “School nurses help to ensure that schools are safe learning environments for all students. Their role has grown as more students are enrolled with complex medical conditions that require skilled medical care. In addition, schools in recent years have been mandated to administer certain medications for students with acute diabetic and allergic conditions.” That the ratio of school nurse to student be 1:550.

The dilemmas There are two. The first: The second: The SOQ proposal does not threaten state funding. It is currently how the state funds school nurse support positions. That is the good news. NASN position is that there be access to a school nurse for all students without a ratio. The second: The proposal does not define who a school nurse is.

Our charge One Accommodate the reality that in order for Virginia to recognize the importance of the school nurse to the education of students, the SOQ inclusion is vital. Two We must help policymakers to understand who the school nurse is.

Who needs to be convinced? The General Assembly in the 2017 session Your job is to convince your state senator and delegate of the need to approve the proposed SOQ revision for school nurses. Your job is to help your state senator and delegate understand what school nurses do. Quoting the AAP: . . . school nurses understand and educate about normal development; promote health and safety, including a healthy environment; intervene with actual and potential health problems; provide case-management services; and actively collaborate with physicians... Your local school board Your job is to convince the school board of the value of a registered nurse for the SOQs. The school board will have to fully fund the SOQs that the state does not.

What is Advocacy? Advocacy is the deliberate process of influencing those who make decisions

Why is Advocacy an Integral Part of School Nurse Practice? School nurses are the school health subject matter experts serving in an educational setting Included in our responsibilities School Nursing: Scope & Standards of Practice, 2nd Edition (ANA & NASN), Standard 12. Leadership Included in our role as a school nurse Keep your eye on the prize! Your students!

Why is Advocacy an Integral Part of School Nurse Practice? School nurses are well positioned and empowered to advocate for the needs of their students and families, as well as for every school to have a school nurse every day, all day.

Become a School Nurse Advocate How? Give a voice to what you do Keep a log of stories that show how YOU interceded to help children at your school. Share your stories to demonstrate your efforts on behalf of students to improve their health and have a positive impact on their academic achievement. “Slide” your stories into conversations every chance you get— with “moms,” principals, teachers, influential community members, and most importantly, school board members

What Else Works? Be involved in the PTA Go to school board meetings—regularly and often Work with your SHAB Be an active member of IEP teams Proactively address health concerns in your school What communication vehicles do you have access to?

What Else Works? Be involved with other school colleagues working on activities to improve children’s health and well-being Be involved in community events that focus on health and well-being Demonstrate your value as a school nurse School nurses are the subject matter expert on children’s health in the school setting!

Legislative Logistics… Legislative Logistics…. It’s a matter of timing… when is the best time to advocate?

Advocating: Best months? January February March OR April May June July August Sept. Oct. Nov. Dec.

How do we advocate? Part 1 Very personally. You have one state senator and one representative. The bedrock of advocacy is personal relationships—getting to know them before you need them. That means right now—between November 9 and December 24 Meet your delegate and state senator in their district offices. Talk about the proposed SOQ revision and why this is a big deal for students. Talk about what you do in your job every day to keep students healthy and in school.

How do we advocate? Part 2 Have regular contact, exchanging information, touching bases. Keep your meetings with your legislator non-partisan, politics aside. Attend town hall meetings. Help them to remember who you are and what you do. If you think they’re doing good jobs, help them get re-elected. You know you’re a “key contact” with your legislator when: You call them and get a call back within 30 minutes OR you have a cell phone number OR you’re on a first-name basis. 

Personal characteristics for effective grassroots advocates Sense of humor Excellent communication skills (verbal and nonverbal) Thick skin Systems perspective Honesty Good manners Patience Willingness to compromise Knowing the limits of compromise

Advocacy at the Local, State, and National Levels What Can Be Improved? Silence is not golden Value advocacy Develop and maintain relationships Prepare for the 2017 General Assembly

Questions? Thank you! Becky Bowers-Lanier bowerslanier@gmail.com Contact Information- Becky Bowers-Lanier bowerslanier@gmail.com