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Survey finds about half of Minnesota districts go without a school nurse

The state’s first comprehensive scan of school nurses shows many schools, particularly those with more low-income families, lack access to a school nurse.

The Minnesota School Nurse Workforce: A 2022 Snapshot report focused on the school nurse workforce in 2022 in response to the impact the COVID-19 pandemic had on the health and well-being of students, families, school nurses and educators. Through emails, calls, and website scans, the Minnesota departments of health and education and partners set about collecting school nurse and health services staffing data from 94% of public and charter schools in Minnesota.

“This is the first time we’ve had such a comprehensive data picture about school nurses and health services staff in Minnesota,” said Minnesota Commissioner of Health Dr. Brooke Cunningham. “What we’ve learned is students in smaller districts, charter schools, and schools that serve more families with lower incomes just aren’t getting that same access to a school nurse as other students in Minnesota.”

The survey found concerning differences between districts. For example, in the 162 school districts where 40% or more of students are eligible for free or reduced-price lunch, data showed students were three times less likely to have access to nursing or health services than other schools.

The report also found that students in the smallest school districts (less than 500 students), as well as charter schools, had lower access to a professional nurse. Approximately two-thirds of schools in this dataset were public school districts and one-third were charter schools. Almost half of public-school districts (150 of 322, or 47%) served more than 1,000 students whereas the vast majority (73%) of charter schools served fewer than 500 students. Overall, two in five school districts (public and charter) served 500 students or fewer.

Additional key findings:

• Overall, less than half (49%) of Minnesota school districts employed a licensed school nurse.

• Due to their enrollment of more than 1,000 students, only 34% of Minnesota school districts are required, per Minnesota Statute 121A.21, to employ a licensed school nurse. Of these large schools, 93% employed a licensed school nurse, but only 26% of districts below that threshold did.

• About one in four school districts (26%) did not provide any staff dedicated solely to the role of providing health services for students.

• Staffing levels and roles varied greatly by district size. Students in the smallest school districts had lower access to a professional nurse.

“Access to quality health care is critical for students in Minnesota, no matter their ZIP code,” said Minnesota Commissioner of Education Willie Jett. “School nurses play an important role in the overall health and well-being of our young people.”

Research has shown that school nurses are a critical bridge between health and learning within and beyond the walls of schools. School nurses empower students to be well through teaching, treating, counseling, and supporting students to increase classroom seat time and decrease trips to the health office and absences from school, according to a 2021 study by University of Washington researchers in The Journal of School Nursing.

During the past two legislative sessions, Governor Tim Walz and the Minnesota Legislature made significant investments in school support personnel – including school nurses. Investments included $74 million in the 24-25 biennium and $127 million in the 26-27 biennium to support hiring new or increasing current school counselors, psychologists, social workers and licensed school nurses.

The school nurse workforce report also included recommendations for next steps. These recommendations included examining the impact of the current state statue, exploring how school health services are funded and considering new, creative funding strategies for smaller schools or those with higher school needs.

The report was a collaboration between the Minnesota Department of Health (MDH) Adolescent and School Health Unit, University of Minnesota Prevention Research Center, Minnesota Service Cooperatives, BrightWorks Educational Cooperative, the School Nurse Organization of Minnesota and the Minnesota Department of Education. It was made possible through COVID-19 Public Health Workforce supplemental funding from the Centers for Disease Control and Prevention, administered by MDH.

For the full report, visit the MDH School Health Data and Reports webpage.



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