BILL ANALYSIS
AB 2454
Page 1
Date of Hearing: May 12, 2010
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 2454 (Torlakson) - As Amended: April 28, 2010
Policy Committee: Education
Vote:5-4
Urgency: No State Mandated Local Program:
Yes Reimbursable: Yes
SUMMARY
This bill, commencing July 1, 2020, requires the governing board
of a school district to employ at least one school nurse,
registered nurse, or licensed vocational nurse for every 750
pupils. Specifically, this bill:
1)Authorizes the governing board of a school district to bill a
pupil's health insurer for the cost of health care services
provided to the pupil.
2)Requires a registered nurse (RN) or licensed vocational nurse
(LVN) to provide health care services to pupils under the
supervision of a school nurse. This measure also prohibits a
school nurse from supervising more than a combined total of
five RNs and LVNs.
3)Authorizes a school district to contract with a county office
of education (COE) for the services of a school nurse employed
by the COE.
4)Prohibits the number of pupils enrolled at a school served by
a school health center to be included in a school district
nurse-to-pupil ratio established pursuant to this measure.
5)Specifies that schools with more than 750 enrolled pupils need
not employ more than one nurse.
6)Defines "RN" as a registered nurse currently licensed by the
California State Board of Registered nursing.
7)Defines "LVN" as a licensed vocational nurse currently
AB 2454
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licensed by the California Board of Vocational Nursing and
Psychiatric Technicians.
FISCAL EFFECT
1)Beginning in the 2020-21 fiscal year (FY), annual GF/98 state
reimbursable mandated costs between $630 million and $670
million to school districts to employ at least one school
nurse per every 750 pupils, as specified.
2)Beginning in the 2020-21 FY, increased GF cost and pressures,
of at least $3.8 million, to the extent this bill increases
reimbursements under Medi-Cal and the Healthy Families Program
for school health services provided to low-income children.
3)Beginning in the 2020-21 FY, annual GF/98 cost pressure, of
approximately $473,000, to school districts to develop a
process for billing health insurers for health care services
provided to pupils, as specified.
COMMENTS
1)Purpose . In 2008-09, there were 6.3 million pupils enrolled
in California schools. According to the State Department of
Education, there was one nurse for every 2,249 pupils in
2008-09.
According to the author, "Studies over the past 15 years
consistently document the connection between health and
academic failure, with poor health affecting student's
attendance, grades and ability to learn in school. Chronic
diseases such as asthma, diabetes, obesity and tooth decay
affect about 20% to 30% of students in California, which lead
to more absenteeism and lower school performance. One way to
combat absenteeism due to chronic diseases is the return of
the school nurse. School nurses help students monitor and
manage their chronic diseases. Management of chronic disease
is necessary to improve students' health and thereby improve a
student's attendance and performance at schools."
This bill, commencing July 1, 2020, requires the governing
board of a school district to employ at least one school
nurse, registered nurse, or licensed vocational nurse for
every 750 pupils.
AB 2454
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2)Existing law requires the governing board of a school district
to give diligent care to the health and physical development
of pupils, and may employ properly certified persons for the
work.
Current law requires a school nurse to have the following: (a)
Bachelor of Science (BS) in nursing, (b) RN license, and (c) a
school nurse credential. An individual is issued a
preliminary school nurse credential for five years. After
completing two years as a school nurse and completing a school
nursing program, the individual qualifies for a clear
credential. According to the Commission on Teacher
Credentialing, an average of 247 school nurse credentials was
issued annually between 2002 and 2009. The committee may wish
to consider whether or not there is an adequate supply of
school nurses to meet the 1:750 ratio in 2020.
Statute also authorizes local education agencies to bill
Medi-cal for health services, including nursing services.
Analysis Prepared by : Kimberly Rodriguez / APPR. / (916)
319-2081