School nurses or athletic trainers? Iowa House bill would let districts hire either one

School districts would be able to employ either a nurse or an athletic trainer to provide health care to students under a bill moving forward in the Iowa House.

Currently, school districts are required to employ a nurse, with the goal of having one nurse for every 750 students in the district.

House Study Bill 10 would add athletic trainers as an option for districts.

The bill's author, Rep. Shannon Lundgren, R-Peosta, said the bill is in response to districts in her area that are struggling to find school nurses and need more options.

"What I would like to do is work towards that middle ground," she said. "Not replacing our school nurses. That was never my intent. But giving the flexibility to our schools to have somebody with some degree of medical training that can do a little bit more than a teacher with maybe medication training or something of that sort."

House lawmakers voted 2-1 on Wednesday morning to pass the bill out of subcommittee, sending it to the full Health and Human Services Committee for consideration.

Several groups representing Iowans with disabilities, school nurses and other school groups spoke against the proposal at a subcommittee meeting Wednesday morning.

Carlyn Crowe, a lobbyist for the Iowa Developmental Disabilities Council, which opposes the bill, said nurses perform a variety of tasks, such as changing catheters and administering medication for conditions like epilepsy, that allow students with special health care needs to stay in school.

"And we feel like having this either/or situation in a school district — not just in a school building but a whole school district — could have devastating effects on kids with special health care needs," she said.

Melissa Peterson, a lobbyist for the Iowa State Education Association, which opposes the bill, said school nurses perform tasks such as writing health plans for students with special health care needs that she doubts athletic trainers could handle.

"We have school nurses that serve folks that are as young as 3 and as old as 18," she said. "That again is not something that traditionally has been under the purview of an athletic trainer. We appreciate we have shortages, but we shouldn’t be putting students at risk."

Dave Daughton, a lobbyist representing the School Administrators of Iowa, which is undecided on the bill, said he appreciates the flexibility it would provide to schools but has concerns.

"I’m just not sure that the scope of practice and other things like that would fit in this," he said.

Nate Newman, president of the Iowa Athletic Trainers Society, which supports the bill, said athletic trainers are trained for things such as administering medication, treating seizures, responding to behavioral health issues, giving immunizations and helping students with asthma.

"All of these things are required to be taught within our programs and for our students to know and be tested on and be ready to practice when they start," he said. "We feel that many of these things are covered within our practice set and look forward to answering any questions that may be asked."

Rep. Josh Turek, D-Council Bluffs, who is a former paralympian, said "I've got a lot of love for athletic trainers," but said he isn't in support of the bill.

"I’ve probably been under the supervision of athletic trainers far more than nurses," he said. "But this does, to me, seem to be a clear issue of scope of practice."

Rep. Carter Nordman, R-Panora, said he supports moving the bill forward and allowing Lundgren to work on the details.

"I think flexibility is important, especially in our rural areas in Iowa where there are some schools that are really struggling to find a school nurse," he said. "So I think it would be wise for us to at least move this forward and continue to have the conversation."

Stephen Gruber-Miller covers the Iowa Statehouse and politics for the Register. He can be reached by email at sgrubermil@registermedia.com or by phone at 515-284-8169. Follow him on X at @sgrubermiller.