Philadelphia Considering Outsourcing School Health Services


Much to the chagrin of unionized school nurses, the School District of Philadelphia is discussing the outsourcing of its school health services.

Ayana Jones of The Philadelphia Tribune writes that proposals have been issued and must be returned by June 10 for those private providers who are interested.

“We face a number of cuts in our schools regarding health care services, primarily the number of nurses which have declined from 283 to 183 this school year. This means that we have a number of schools that do not have a full-time nurse,” said district spokesperson Fernando Gallard.

The proposals must not cost more than the current district expenditures to provide students medical services, which is about $23.7 million. Gallard said the main issue is providing more services to students. To that end, proposals must provide “evidence-based, bold and innovative ideas.”

Offerings which were suggested in the document given to vendors included: school-based health centers, mental and behavioral care, substance health care, dental health, nutrition and health education, comprehensive primary care, oversight of staffing services, and billing management.

Philadelphia Federation of Teachers’ officials are not pleased with the change.

 PFT President Jerry Jordan said, “The move to privatize school nursing services is a shortsighted, Band-Aid solution. To be a certified school nurse requires very specific training and qualifications that you cannot simply ‘contract out.’ Worse the RFP [request for proposals] is an insult to Philadelphia’s certified school nurses, many of whom work in more than one school and do a heroic job of attending to the health needs of thousands of school children.

Jordan continued by stating the union would do everything in its power to stop the privatization of the city’s public schools.

On the other hand, Donna Cooper, Executive Director of Public Citizens for Children and Youth, thinks expanding health care services to students is a good idea. She added that there might be more creative ways to organize health care services and outside ideas are much-needed.

Health care services in schools have been critically reduced because of shrinking budgets, so already many schools are without a full-time school nurse. The Philadelphia Daily News’ Solomon Leach writes the move does not mean that the district is going to get rid of the 183 nurses employed in the city’s schools, according to Superintendent William Hite. However, contract language pertaining to school nurses is already in dispute between the district and the union.

Within the district, health care is provided to 218 public schools and 95 private and parochial schools. Since 2010-2011, 100 nurses have been laid off. Now there is only one nurse for every 930 students, which federal and state guidelines allow, but which is significantly higher than the recommended one to 750 students.

Privatized school health centers are becoming more popular nationwide, with about 1,930 schools with health centers or programs in 2010-11, according to School-Based Health Alliance, a nonprofit devoted to improving health for kids. Some charter schools in Philadelphia have health centers staffed with nurse practitioners who are certified to write prescriptions, give vaccinations, and provide physicals.

The district’s request for proposals explained that providers could serve one or several schools, or slowly roll out services over time. The vendor’s staff could work with district nurses or make the school nurses their own employees.

“School nurses have been doing extraordinary work,” Hite said. “This is an attempt to also provide them with what hopefully could be more resources, [so] more children have access to quality care.”

Dale Mezzacappa, blogging for the Philadelphia Public School Notebook, writes that most schools share a nurse, which, says Hite, does not provide what is necessary to respond to students’ needs. A few schools with students who have multiple disabilities have more than one nurse.

Jordan counters by saying more than 26% of the city’s families live in poverty and sometimes the school nurse is their only source for health care. He believes the district should be hiring more school nurses.

The School Reform Commission, however, believes that outside vendors may be able to provide more school services because they can be reimbursed for many of them by federal and state medical assistance programs or insurance companies.