Agenda Item
a. RFP 20-476 Nursing Services for Medically Fragile Students with Disabilities Contract Extension (Year 3 of 4) – (School Health and School Nursing Services for more than $50,000.00 per vendor but not to exceed a total contracted amount of 3,000,000)
Summary: Presented by: Ms. Stacy E. Stepney, Chief Academic Officer, Division of Curriculum & Instruction
Request: It is requested that the Board of Education approve the contract extensions with Pediatric Services of America, Inc. dba Aveanna Healthcare; Cobb Pediatric/The Stepping Stones Group; Delta T Group; and Maxim Healthcare as the most responsive and responsible bidders to provide school health and school nursing services for more than $50,000.00 per vendor but not to exceed a total contracted amount of $3,000,000.00.
Why: Under the individuals with Disabilities Education Act (IDEA), school health services and school nurse services are defined as related services. Section 504 works together with IDEA to protect children and adults with disabilities from exclusion and unequal treatment in schools, jobs, and the community. These services are required, according to IDEA and Section 504 guidelines and physician’s orders, for students with significant medical needs to access their education.
Currently, there are 24 special education nurses that are district employees. The District is currently contracting with ten (10) nurses anticipating an additional sixteen (16) nurses for one-to-one services for students with significant medical needs who are eligible for special education services, and two (2) nurses anticipating an additional six (6) to support students with significant medical needs who are eligible for Section 504 services. Additional resources are needed to address the school-based nursing requirements and to provide IDEA and Section 504 mandated services to students with disabilities. Therefore, the DeKalb County School District (DCSD) has contracted with nursing vendors to provide registered nurses (RNs) and licensed practical nurses (LPNs) with specialized knowledge when the District is unable to hire them directly.
The request for an increase in the contracted amount from $1,500,000 to $3,000,000 is a result of contracted vendors requesting a rate increase to maintain the District’s ability to compete with other local school districts seeking contracted nursing support for medically fragile students.
Details: The Request for Proposals (RFP) was issued on November 14, 2019, and approved February 10, 2020. The approved DCSD RFP process was followed. Five (5) of the twelve (12) vendors who responded were selected based on the following criteria: ability to provide needed staff, hourly rates, and experience with school-based settings. The five (5) selected vendors were Aveanna Healthcare, ATC Healthcare, Cobb Pediatric, Delta T Group, and Maxim Healthcare.
Financial impact: The total contract amount will not exceed $3,000,000.00.
The general budget charge codes are as follows: $1,500,000 (100.2100.530000.00011.7340.2021.8010.035.0000)
$500,000 (100.2100.530000.22711.7320.9990.8010.035.0000)
The IDEA federal budget charge code is:
$1,000,000 (404.2100.530000.05021.7340.2824.8010.035.2023)
The financial impact is contingent upon the number of registered nurses (RNs) and licensed practical nurses (LPNs) provided through contracted services. The rates for these services are as follows: RNs $39.00 - $60.00 per hour and LPNs $32.00 - $45.00 per hour. The total contracted amount will not exceed $3,000,000.00.
Contact: Ms. Stacy E. Stepney, Chief Academic Officer, Division of Curriculum & Instruction, 678.676.0731
Ms. Michele Summerlin, Executive Director Exceptional Education, Division of Curriculum and Instruction, 678.676.2163
Effective: May 1, 2023 - April 30, 2024
Status: Attorney approval not required
CHRONOLOGY OF THE AGENDA ITEM RFP 20-476 (Nursing Services for Medically
Fragile Special Education Students)
Extension – continuation; extend the period of time
Vacancies of appropriately trained nurses have increased over the last few years. No single
company has been able to provide a sufficient number of nurses to cover DeKalb’s needs.
DCSD has been unable to fill all vacancies when employees resign or retire. Currently, there are
24 special education nurses that are district employees. The District is currently contracting with
eight (8) nurses anticipating an additional 15 nurses for one-to-one services for students with
significant medical needs who are eligible for special education services, and one (1) nurse
anticipating an additional six (6) to support students with significant medical needs who are
eligible for Section 504 services. The cost incurred by these vendors, due to the hourly rate and
number of nurses needed, exceeded $100,000 for the 2021-2022 school year.
The chart below provides a historical perspective of the nursing expenses in the District.
Year Nursing Services Amount
July 1, 2017 – 18, 1:1 nurses needed based on Total Nursing Services Expenditures
June 30, 2018 doctor’s orders for medically fragile = $684,886.76
students
Contracted nurses to substitute for
extended absences for DCSD nurses
July 1, 2018 - 21, 1:1 nurses needed based on Hourly rate:
June 30, 2019 doctor’s orders for medically fragile LPN’s $33.50 – $38.00
students RN’s $40.00 – $43.50
Yearly amount for 1 nurse@
Contracted nurses to substitute for $38.00 an hour 8 hours a day for
extended absences for DCSD nurses 180 days =
$54, 720.00
$54,720.00 x 21 nurses =
$1,149.120.00
Total Nursing Service Expenditures =
$880,753.50
July 1, 2019 - Special Education Students- Hourly rate:
June 30, 2020 24 - 1:1 nurses needed based on LPN’s $33.50 – $38.00
physician orders RN’s $40.00 – $43.50
Yearly amount for 1 nurse@
Section 504 Students Only - $38.00 an hour 8 hours a day for
4- 1:1 nurses needed based on 180 days =
doctor’s orders for medically fragile $54, 720.00
students
Total Nursing Service Expenditures
= $871,968.10 (reduced due to
school closures as of March 2020
due to the COVID-19 pandemic)
July 1, 2020 – Special Education Students- Hourly rate:
June , 30 2021 12 - 1:1 nurses projected based on LPN’s $33.50 – $38.00
parent intent to return to in-person RN’s $40.00 – $43.50
instruction (when available) Yearly amount for 1 nurse@
$38.00 an hour 8 hours a day for
Section 504 Students Only - 180 days =
5- 1:1 nurses needed based on $54, 720.00
doctor’s orders for medically fragile
students
Total Nursing Service Expenditures
to date: $32,476.85 (reduced due to
school closures as of March 2020
due to the COVID-19 pandemic);
Expected expenditure TBD per
District confirmed in-person
student return date.
July 1, 2021 – June Special Education Students- Hourly rate:
30, 2022 12- 1:1 nurses currently supporting LPN’s $33.50 – $38.00
students attending in-person RN’s $40.00 – $43.50
instruction. The department Yearly amount for 1 nurse@
anticipates an increase in 1:1 nurse $38.00 an hour 8 hours a day for
support as additional students return 180 days =
to in-person instruction. $54, 720.00
Section 504 Students Only - Special Education
1- 1:1 nurse needed based on Delta-T- $178,437.57
doctor’s orders for medically fragile Aveanna-$82,898.35
students Stepping Stones-$142,600.95
Maxim-$0
504
Delta-T- $40,914.99
July 2022- Present Special Education Students- Hourly rate:
Eight (8)- 1:1 nurses currently LPN’s $33.50 – $38.00
supporting students attending in- RN’s $40.00 – $43.50
person instruction. The department Yearly amount for 1 nurse@
anticipates an increase of 15 nurses $38.00 an hour 8 hours a day for
upon receipt of pending physician 180 days =
orders, students return from Hospital $54, 720.00
Homebound (HHB), and
identification of specially Special Education
skilled/trained contract nurses. Total- $69,312.17
Section 504 Students Only - 504
One (1)- 1:1 nurse currently, Total $6,540.28
anticipating an increase of six (6)
based on doctor’s orders for
medically fragile students