Health scare: So long, school nurses?

It
seems exactly backwards: guaranteed medical care for suburban school kids, but
none for city kids, where the need is greatest.

            “Sometimes, they’re [school nurses]
the primary health-care provider for our kids,” says city schools spokesperson
Barbara Jarzyniecki.

            The county health department
administers the city’s school-nurse program. It has done so since it took over
the city health department in the mid 1950s.

            More than 14 percent of city
students suffer from asthma — one in 20 from severe asthma. Nearly 20 percent
of entering kindergartners have never visited a dentist. One in 11 comes to
school taking prescription medication. Rochester, as defined by the Needs
Resource Index developed by the State Education Department, is the neediest of
New York’s Big Five school districts. More than 14 percent of the student body
is classified as students with disabilities.

            Health, Jarzyniecki says, affects
students’ attendance, which, in turn, impacts student achievement.

            Does it make sense, then, to cut the
school nurse program?

            “It’s unthinkable,” says Stephanie
Aldersley, Democratic minority leader in the Monroe County Legislature. “I
simply can’t imagine the schools functioning.”

            But that’s exactly what could
happen. The Monroe County budget proposal, as compiled by Jack Doyle, funds
city school nurses only through the end of the current school year. And that’s
it.

Doyle blames
county Democrats for the elimination of the nursing program, as well as
other agency cuts. The Democrats’ refusal to go along with $26.2 million in
bonding for county retirement and pension costs, he says, necessitated
stripping an additional $4.8 million from the budget.

            “Those cuts were totally
unnecessary,” says Bill Smith, Republican majority leader in the lej. “In all
my years in the legislature, that, to me, is the most baffling. My jaw has not
come back up from dropping.”

            The Democrats aren’t buying it. They
believe Doyle intended to make the cuts all along, and Democrats’ stand on the
bonding issue made them a convenient scapegoat.

            “Whether or not we ever vote for
that bond, it’s not clear to me those programs will be reinstated,” Aldersley
says.

            To reconsider the bonding,
two-thirds of the legislature must vote to suspend its own rules, which state
that a motion can only be revisited once. The lej has considered the bonding
twice, and twice Democrats rejected it.

            Republicans say Democrats are being
stubborn: trying to get maximum political mileage from the fact that Doyle
released the budget a week late.

            “They’ve had their fun,” says
Republican Ray Santirocco, who believes Democrats will eventually support the
bonding. “They don’t want to punish those agencies. They’ve had their
opportunity to jab at Jack.”

            But asked if her caucus will reverse
its position on the bonding, Aldersley says, “not at this point.”

            It’s unwise to push costs into the
future, Aldersley says, and Democrats are dubious about the savings Doyle
claims the bonding will achieve. The other option is to borrow the money from
the state comptroller — which is what Aldersley believes the county will
eventually do, because it doesn’t need the lej’s permission to do it.

Democrats,
Aldersley says, will propose amendments to restore some of the cuts in the
budget. Funding for city school nurses, she says, will likely be among them.

            But at the same time, Aldersley says
Democrats have “no appetite” for either a sales tax increase — as proposed by
Doyle — or a property tax increase, which some Republicans have said they
might support to close an estimated $42 million budget gap.

            Sales tax increases punish middle-
and low-income people the most and make the county noncompetitive, Democrats
say. And any property tax increase would “have to be at least 15 percent,”
Aldersley says, to plug the deficit.

            Cuts then, Aldersley concedes, are
the only option left. There are no sacred cows, but Aldersley says she’s sure
both sides will want to safeguard public health, safety, and other basic
functions people expect from government.

            “Beyond that, where do you go?” she
asks. “Then it becomes political.”

Rochester is
one of three cities in the state — the others are Buffalo and New York
— not required to have a “medical inspector” on staff in the schools.

            The county always funded city school
nurses, says state Assemblywoman Susan John, so there was no need to make it a
mandate.

            John began reconsidering the idea
after last year’s county budget cuts, which resulted in nursing staff
reductions in city schools. She’s also facing pressure from parents.

            “It’s something I would like to try
to do in the next legislative year, but it’s very difficult,” John says.

            Nurses need funding, John says, “and
the state’s resources are limited.” Plus, she adds, would it be fair to fund
nurses in Rochester and not in other cities?

            Another possibility is to fund the
nurses through a 50/50 match between state and county, John says.

            If John does make a proposal and the
assembly goes along, the motion has at least one probable supporter in the
state senate — Republican Jim Alesi.

            “I’d like to see all of the details
of it, but I would say, conceptually, I would support anything that keeps
health-care professionals on school grounds,” he says.

            Ideally, Alesi says, the state
should fund any such mandate. But, he says, he would likely support an unfunded
mandate for the school nurses, as well.

            “The more things we tell the local
governments to do without giving them money, we’re putting more pressure on
them and their budgets,” he says. “[But] there are essentials that we can’t do
without, especially when you’re talking about young people. Their health is of
prime importance to me.”

This article appears in Nov 5-11, 2003.