New Hanover County Health Department 2029 South 17 th Street Wilmington, NC Phone (910) FAX (910)
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1 New Hanover County Health Department 2029 South 17 th Street Wilmington, NC Phone (910) FAX (910) To: From: Dr. Tim Markley Superintendent, New Hanover County Schools David E. Rice Health Director Subject: School Health Contract Date: March 25, 2011 We have maintained a strong working relationship with New Hanover County Schools for many years, with contracts for services such as School Health, Mobile Dental Unit, and School Mental Health. It is our mission to assure a safe and healthy community. We are responding to Dr. Rick Holiday s request for information on how a ten percent budget reduction would impact School Health Services. We have realized budget cuts from New Hanover County Schools (NHCS) during the last three years with new schools opening. We have been asked to do more with less, putting our children s health in jeopardy. The following list captures some of the impacts of those cuts: We reduced operating expenses, nursing hours (nine nurses have been cut from 40 hours to 32), and nursing positions (three full-time). We eliminated funds for a temporary substitute nurse to cover long-term absences. In 2010, we lost $117,000 in the School Health budget. Nursing services provided to NHCS have been reduced in a number of schools, 17 schools reduced from 40 hours per week to 32 or 20. We went from providing a nurse in every school to four of our nurses sharing two schools each. We prioritized the health needs of each school and student population when appropriating hours of service. This also leaves no time for follow-up to parents with children having serious chronic medical conditions. Follow up often must be done after school dismisses for the day. The attached chart shows the current allocation of nursing hours and the many factors involved in determining greatest need. All of these reductions have increased the work on school staff, as they must handle the health issues when a school nurse is not present. Three years ago, our contract funds also covered one full-time administrative position for support of school health nurses (human resources, program support, information technology, and fiscal support). We eliminated this position and the health department now provides all support as in-kind for 35 School Health staff. The two nursing supervisors are also funded by our department.
2 The numbers of children with serious chronic medical conditions is increasing each year. The attached list of chronic serious medical conditions is an indication of the potential for daily medical emergencies. To consider more reductions (10%) would mean a loss of three additional nurse positions, 120 nursing hours per week (5,280 nursing hours per school year). This will cause more schools to experience a decrease in nursing hours, and set the stage for additional medical emergencies occurring with medically fragile children. We are requesting that the health and safety of our children be a priority in the new budget year. We cannot assure a safe and healthy level of services with an additional ten percent reduction. School Health Report Totals for July 2010-February 2011: Student/Staff Visits to Health Room: 84,268 Records Assessed by School Nurse: 23,506 Students Referred for Care: 2,171 Medications Administered/Special Procedures Performed: 31,678 Number of Contacts (contacting parents, staff, health care providers, etc.): 57,710 Emergency Action Plans Developed: 2,053 Health Fairs: 19 Health Education Sessions (classroom presentations, presentations on School News, etc.): 431 Health Education Session Participants: 25,572 Media Events: 165 Displays: 437
3 New Hanover County Health Department 2029 South 17 th Street Wilmington, NC Phone (910) FAX (910) Serious Chronic Medical Conditions Students in New Hanover County System Services are provided by School Nurses Asthma Diabetes Seizures Severe Allergies ALAADD: Aromatic L-amino acid Decarboxylase deficiency (paralyzed) Alport Syndrome (kidney disease) Aortic Stenosis AV nodal re-entrant tachycardia Blind, Diabetic child with chromosomal abnormality Blood Disorders Brachial Plexis Disorder Brain Stem Glioma (takes chemo at home and comes to school during this time) Brain tumor with shunt Bronchodysplasia Carbohydrate calculation for diabetic students Cardiac Conditions many and varied Cerebral Palsy (multiple students) Cerebral shunts Christmas Disease (clotting disorder) Chrohn s Disease (multiple students) Chromosome-15 abnormality Chronic Encopresis (multiple students) Chronic Low Platelet Count /Anemia/clotting disorder Cirrhosis of liver with splenomegaly Cochlear Implant Colostomy Care (multiple students) Complex fusion of anomaly of cervical spine Congenital Adrenal Hyperplasia (multiple students) Cystic Fibrosis (multiple students) Esophogeal spasms Factor 7 bleeding disorder Fibromuscular Dysplasia Fistula care Gastrostomy Tube Feedings (multiple students) Guillain-Barre syndrome Hemophilia
4 Hydrocephalus with shunt Hypertrophic Cardiomyopathy (sudden death) Hypoglycemia (multiple students) Idiopathic Thrombocytopenia Purpura (multiple students) Ileostomy care Immunocompromised while receiving Chemotherapy (multiple students) Insulin Calculation and administration Insulin pumps and Omni Pods and changing sites of pumps when necessary Internal defibrillators Juvenile Rheumatoid Arthritis (multiple students) Kidney Disease with diet orders Leukemia/chemo Lupus Lymphedema Lymphoma Migraines Muscular Dystrophy Myasthenia Gravis Nephrotic Syndrome (multiple students) Nissen fundoplication Optic Pathway Glioma Pacemakers (multiple students) Perthes Disease Porphyria Acute Intermittent Post bone marrow transplants Post tracheotomy: Pulmonary obstructive disease Post-Stroke left body weakness Prader Willie Syndrome Pregnancy (multiple students) PVC s with syncope/ablation procedure Right Coronary Fistula Right Ventricular Shunt Scheurmanns Kyphosis SDS - sudden death syndrome (multiple students) Sensory Processing Disorder (multiple students) Sickle Cell Disease (multiple students) Spina Bifida with shunt Student without sweat glands Students with Internal Cardiac Defibrillators Supraventricular Ventricular Tachycardia Tourettes (multiple students) Urinary Catheterizations Vagal Nerve Stimulator
5 Vasovagal Syncope (multiple students) Vasovagal syncope with seizures Vaters Syndrome Ventricular Tachycardia Vesicoureteral Reflux Wolf-Parkinson-White Syndrome Cardiac- (multiple students)
6 New Hanover County Health Department School Health Program Hours of Service Elementary Enrollment F&R Lunch % EAP's Chronic Medical Conditions Sp.Proc's* Meds Current Nursing Hrs S&P Class EC Class Alderman A:14; Sz:1; SA: N N Anderson A:40 ;D:2; Sz:6; SA: N Y Bellamy A:30; D:2; Sz:5; SA: N Y Blair A 42 D 1 Sz 1 SA N N Bradley Creek A 16 D 1 Sz 3 SA N N Carolina Beach A:21; Sz:1; SA: N Y Castle Hayne A:21; SZ:6; SA: N Y Codington A:17; Sz:3; SA: Y Y College Park A:35; D:1; Sz:4; SA: Y Y Eaton A 26 Sz 2 SA N Y Forest Hills A 40 D 1 Sz 4 SA N N Freeman A 39 D 1 Sz 5 SA Y Y Gregory A:61; D:1; Sz:2; SA: N Y Holly Tree A 19 D 1 Sz 1 SA N N MC Wm's A:28; D:2;Sz:1;SA: N Y Murrayville A:60; D:2; Sz:9; SA: N N Ogden A 21 Sz 7 SA Y Y Parsley A 25 Sz 8 SA Y Y
7 New Hanover County Health Department School Health Program Hours of Service Elementary Enrollment F&R Lunch % EAP's Chronic Medical Conditions Sp.Proc's* Meds Current Nursing Hrs S&P Class EC Class Pine Valley A 46 D 1 Sz 4 SA N N Snipes A 46 Sz 5 SA N N Sunset A: 27; D:3; Sz:2; SA: Y Y Winter Park A 22 Sz 1 SA N Y Wrightsboro A:34; Sz:3; SA: N Y Wrightsville Beach A 9 D 2 SA N N Middle Schools Holly Shelter A:23; D:7; Sz:8; SA: Y Y Murray A:31; D:7; Sz:4; SA: Y N Myrtle Grove A:31; D:7; Sz:3; SA: N Y Noble A 28 D 3 Sz 2 SA N Y Roland Grise A 31 D 3 Sz 5 SA N Y Trask A:40; D:2; Sz:5; SA: N Y Virgo A:21; D:1; Sz:2; SA: N N Williston A:26; Sz:3; SA: Y N High Schools Ashley A 15 D 8 Sz 11 SA Y Y Hoggard A 55 Sz 21 SA Y Y
8 New Hanover County Health Department School Health Program Hours of Service Elementary Enrollment F&R Lunch % EAP's Chronic Medical Conditions Sp.Proc's* Meds Current Nursing Hrs S&P Class EC Class Laney A:57; D:5; Sz:16;SA: Y Y New Hanover A 29 D 6 Sz 12 SA Y Y Pre K's Howe A N Y Johnson] Sz 1 SA N Y Roe A 18 D N Y CHRONIC DISEASE KEY: A= Asthma D= Diabetes Sz= Seizures SA= Severe Allergies *= Daily
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