Pa. School Nurses Demand Ratio Reform, More Funding at Capitol
Twenty school nurses stormed the Pennsylvania Capitol demanding a cut to the state’s 75-year-old nurse-to-student ratio — one nurse per 1,500 students — calling it dangerously outdated.
HARRISBURG, PENNSYLVANIA — Twenty school nurses traveled to the Pennsylvania State Capitol on June 16, 2026, urging lawmakers to revise a 75-year-old public school code governing nurse-to-student ratios and state funding for medical needs in schools.
The nurses supported House Bill 2285, legislation sponsored by Rep. Lisa Borowski (D-Delaware County) that aims to cut the current required nurse-to-student ratio in half and increase reimbursement rates for school-based medical services.
A 75-Year-Old Standard Under Pressure
Pennsylvania’s school code currently requires one nurse for every 1,500 students — a standard that school nurses argue has not kept up with the growing complexity of student health needs. Under Borowski’s bill, that ratio would change to one nurse per 750 students.
Pennsylvania is one of only 12 states with a school nurse staffing mandate. States like Alabama and Vermont require one school nurse for every 500 students, a stricter standard than Pennsylvania currently enforces.
The existing one-per-1,500 ratio is also twice as lenient as the federal recommendation, according to the Pennsylvania Capital-Star.
Nurses Describe Overwhelming Patient Loads
Kacie Blum, a middle school nurse who received the 2025-2026 School Nurse Excellence Award for Pennsylvania’s South Central Region, reported her office logged nearly 12,000 visits during the past academic year — an average of 60 to 75 students per day.
Blum, who works at York Suburban Middle School in York County, noted that a local urgent care clinic sees roughly 35 patients a day with multiple providers on staff. She handles cases involving students with diabetes, cystic fibrosis, and cerebral palsy, while also managing individualized health plans and clinics.
“There’s little room for a bathroom break, a lunch break, or the planning periods I’m supposed to have for the administrative side of my day,” Blum said.
Blum mentioned that the volume of care she provides is only manageable if she has adequate time and capacity — something the current staffing standard does not allow.
Legislation Seeks Higher Reimbursements and Better Ratios
House Bill 2285 addresses two issues: the nurse-to-student ratio and the reimbursement rates the state provides to schools for nurse-related medical services. Rep. Borowski advocated for the changes at the Capitol event on June 16, 2026, according to the Pennsylvania Capital-Star.
School nurses at the Capitol gathering argued that without updated funding and staffing standards, many schools — particularly those in lower-income districts — will continue to struggle to provide basic health care to students. The bill has not yet been voted on by the full House.
