1. A Comprehensive Study of School Nursing Services April, 2015

3. Number of RN School Nurses practicing in Montana public schools: 90 Number of RN/PHN School Nurses providing at least 1 hour per week of services in Montana public schools: 17 Total number of school nurses: 107 Total number of school nurse FTE: 83.4 Total number of students in Montana public schools: 144,034

4. Montana School Nurse to Student Ratio 2015 Montana School Nurse to Student Ratio 2015 1:1,728 2012 1:1,985 2009 1:2,300

5. School Nurse Reported Prevalence of Chronic Health Conditions Among Students in Districts with a School Nurse ConditionN Nurse Reported Prevalence Population Prevalence Estimate Asthma59195.65%6.90% Diabetes3700.32%0.29% Type 1 Diabetes3420.35%0.24% Type 2 Diabetes280.02%0.05% Seizure Disorder6930.66%0.63% Life Threatening Allergy15121.44%3.10%

6. Table 4. RN School Nurse to Student Ratio: Largest Montana Counties (>2500 Students), 2015 County# Students RN School Nurse FTE Nurse to Student Ratio Yellowstone2307018.81 to 1229 Flathead137497.11 to 1941 Missoula134567.41 to 1821 Gallatin120814.21 to 2887 Cascade116033.41 to 3424 Lewis & Clark95137.71 to 1232 Ravalli55663.31 to 1670 Lake44425.21 to 851 Silver Bow44363.61 to 1228 Hill31300.00 to 3130 Glacier28114.41 to 632 Roosevelt24800.00 to 2480 Lincoln2391 0.6 1 to 4304 Big Horn23872.21 to 1074

7. Table 5. RN School Nurse to Student Ratios : Largest Montana School Districts (>2000 Students), 2015 District# Students RN School Nurse FTE Nurse to Student Ratio Billings Public Schools1638813.61 to 1202 Great Falls Public Schools10237 3.41 to 3021 Missoula County Public Schools 8648 4.21 to 2076 Helena Public Schools8080 6.71 to 1202 Bozeman Public Schools6205 1.91 to 3191 Kalispell Public Schools5830 2.11 to 2762 Butte Public Schools4296 3.61 to 1190 Belgrade Public Schools3175 1.71 to 1905 Columbia Falls Public Schools 2097 2.21 to 944 Laurel Public Schools2043 0.61 to 3198 Browning Public Schools2018 3.31 to 605

8. Students with Chronic Conditions in Counties with No School Nurse: Extrapolation from Districts with a School Nurse Condition Prevalence Estimate Speculated # of Students in Counties with with Condition in Counties a School Nurse with No School Nurse Asthma 5.65% 1123 Diabetes 0.32% 74 Type 1 Diabetes 0.35% 70 Type 2 Diabetes 0.02% 4 Seizure Disorder 0.66% 131 Life Threatening Allergy 1.44% 286

9. Health Risk Factor Statewide Prevalence Speculated # of HS Estimate among High Students with Health Risk School (HS) Students Factor in Counties with No School Nurse (N=5803) Felt Sad/Hopeless 26.4% 1532 Suicide Attempt in Past Year 7.9% 458 Current Alcohol User 37.1% 2153 Currently Sexually Active 34.1% 956 Not Taught About HIV/AIDS 16.2% 940 Current Physical Inactivity 10.7% 621 Special Needs 12.4% 720 Hunger 3.3% 191

10. Step Up and Be Counted Survey Results Montana, 2014-2015 Standardized Data Set for School Health Services: A Joint Project of the National Association of School Nurses (NASN) and the National Association of State School Nurse Consultants (NASSNC)

11. Median nurse-reported student encounters per day, Montana Step Up survey, 2014-15 school year.

12. Boxplots of the distribution of reported frequencies of student encounters by Montana school nurses, Step Up survey, 2014-15 school year.

13. Outcomes of student encounters with school nurses, Montana Step Up survey, 2014-15 school year.

14.  New data points for 2015-16 year: Workforce ◦ RNs, LPNs, aides with administrative duties ◦ LPNs and aides who supplemental/float ◦ LPNs and aides with special assignments Health Office Disposition ◦ LPNs disposition ◦ Non-RN, non-LPN disposition

17. How can a school nurse help your child with mental illness? Mental health is as critical to a student ’ s academic success as is their physical health. School nurses serve as a key role in the school setting by promoting positive mental health in all students. School nurses provide empathy, compassion and develop positive relationships with all students and especially those with mental illness. School nurses collaborate with administrators, teachers, parents, families, and health care professionals in identifying those students at risk for mental illness. The school nurse health room is often identified by many students with mental illness as a “ safe zone ” or a place where there is little pressure or stress. It is often in the health room where students with mental illness feel most comfortable talking about their triggers and stressors.

18. Frequently Asked Questions about School Health Screening Who can do school health screenings? What health conditions will be screened for and at what grade levels? How will I know if my child’s screening indicates a need for further testing? Will my child’s school health screening results be kept confidential? My child has special needs. Will my child still receive school health screenings?

19. dphhs.mt.gov/schoolhealth