School nurses in Pa. they are pushing for more staff support and funding

Natalie Javitt is an intern with the Pennsylvania Legislative Correspondents Association.

Middle school nurse Kacie Blum said she had nearly 12,000 visitors to her office last academic year, seeing 60 to 75 students a day.

She said Blum’s local urgent care facility sees about 35 patients a day and employs multiple physicians.

Caring for students with diabetes, cystic fibrosis and cerebral palsy, as well as working on individualized health plans and clinics, are just some of the tasks Blum deals with every day. But she said she can only provide consistent and reliable care if she has the time and ability to do so.

“There’s not a lot of room for a bathroom break, a lunch break, or planning for the administrative responsibilities that I’m supposed to have during the day,” said Blum, who received the 2025-2026 School Nurse Excellence Award for the south-central region of Pennsylvania.

Blum, who works at York Suburban Middle School in York County, was one of 20 school nurses who went to the Capitol on Tuesday to demand an update to Pennsylvania’s 75-year-old public school code, which governs nurse-to-student ratios and state funding for medical needs.

AND House bill proposed by Rep. Lisa Borowski (D-Delaware) would augment reimbursement rates and the required number of nurses per student in schools.

Currently, the code provides for one school nurse for every 1,500 students. Under Borowski’s House Bill 2285, that ratio would be cut in half, to one nurse for every 750 students, bringing it into line with CDC recommendations.

Pennsylvania reimburses public schools for health care costs through a flat-rate funding structure. The bill also seeks to augment the reimbursement rate by 30% on an average student basis to offset rising medical and service costs.

It also proposes limiting school reimbursement for providing care.

Borowski proposed the bill after meeting with Leigh Ann Coary, a school nurse in the Tredyffrin/Easttown school district, tthe hat made her concerned that the nurses were stretched too lean. Coary said on average she sometimes sees more than 100 students, making it tough to meet their individual needs and multitask.

“If I’m dealing with a medically sensitive student, I can’t be in another hallway and have an allergic reaction,” Coary said. “If I’m on the phone with a parent about a student in crisis, I can’t be running into an emergency situation at the same time. When we’re short-staffed, the question becomes, ‘Who else is waiting?’

Coary said school nurse regulations need to be updated to better reflect the unpredictability and variety of health crises students are currently experiencing.

The bill modernizes the reimbursement system instead of relying on an dated financing system, but the policy will be meaningless if staff shortages are not addressed, she added.

Coary continued that nurses need to be recruited and retained by school districts so they don’t have to employ so many students.

The shortage of nurses is a national problem felt across the country questionnaire finding a 19% vacancy rate for registered nurses in Pennsylvania hospitals.

Borowski said she expects these shortcomings will be addressed in lawmakers’ deliberations on the bill. But she said staffing rates ensure children have access to care even in the face of shortages, and increasing funding would improve care by actually covering costs.

“I don’t know how one person can meet the needs of so many students in one day,” Borowski said.

Blum said increasing reimbursement rates was more cost-effective than paying the costs of litigation if something went wrong and there weren’t enough nurses to support in an emergency.

She said Pennsylvania’s school code is archaic and written for a different era because the last update to the school health care reimbursement structure was in 1991.

“The work I do within the walls of my school spills into my students’ homes and onto the streets of their neighborhoods,” said Whitney Roach, a nurse in Philadelphia County. “School nurses are uniquely qualified and trusted to improve the health and well-being of not only schools, but entire communities.”

The House of Representatives Education Committee passed the bill party line vote in March.