HR305-119

What This Bill Does

The One School, One Nurse Act of 2025 responds to shortages of full-time school nurses. It states a purpose of helping states and local educational agencies ensure every elementary and secondary school has at least one full-time registered nurse and maintain recommended nurse-to-student ratios through recruitment, hiring, and retention. Within 12 months, the Education Secretary must create a competitive five-year grant program for local educational agencies or state-agency partnerships with consortia of local educational agencies. Applications must include a needs assessment showing persistent shortages, student health and wellness needs, a plan to recruit, hire, retain, and continue employing school nurses after the grant, and a plan to recruit from local communities and underrepresented public-health populations. Priority goes to high-need local educational agencies and applicants with specific hiring goals for underrepresented populations. Funds may recruit and hire nurses, convert part-time positions to full time, raise salaries or otherwise support retention, and maintain nurse-to-student ratios. Grantees must report annually on full-time nurse coverage, nurse demographics by school, and progress on identified health needs. Education, consulting HHS and Labor, must define nurse-to-student ratios, underrepresented populations, and full-time status.

Who Benefits and How

Public school students benefit from a goal of at least one full-time registered nurse in every elementary and secondary school. High-need local educational agencies benefit from grant priority when they face persistent school nurse shortages. School nurses benefit from hiring, salary, retention, and conversion of part-time positions to full-time jobs. Students with asthma or diabetes benefit from more consistent health management during the school day. Uninsured children benefit because school nurses can be an important access point for health services. Underrepresented public-health professionals benefit from applicant hiring goals tied to community recruitment.

Who Bears the Burden and How

The Education Department must create the grant program, define ratios, issue guidance, and review annual grantee reports. Local educational agencies must complete needs assessments, submit sustainability plans, track nurse demographics, and report school-level progress. State educational agencies in partnerships must coordinate consortia and grant implementation. HHS and Labor must consult on ratios, public-health workforce definitions, and full-time school nurse definitions. Federal appropriators must fund the grant program if the staffing goal is to scale nationally.

Key Provisions

• Creates a competitive five-year One School, One Nurse grant program.
• Requires applications to document nurse shortages, student health needs, sustainability plans, and community hiring goals.
• Prioritizes high-need local educational agencies and underrepresented public-health hiring goals.
• Authorizes funds for recruitment, hiring, salary-supported retention, full-time conversion, and nurse-to-student ratios.
• Requires annual grantee reports and federal regulations defining ratios, underrepresented populations, and full-time status.