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Health scare: So long, school nurses?

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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."

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