Agenda Item
b. RFP 20-476 Nursing Services for Medically Fragile Students with Disabilities Contract Extension (Year 4 of 4) – School Health and School Nursing Services for more than $50,000.00 Per Vendor (Total contracted not to exceed $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 per vendor, but not to exceed a total contracted amount of $3,000,000.
Why: Under the individuals with Disabilities Education Act (IDEA), school health services and school nursing 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. Per IDEA and Section 504 guidelines and physician’s orders, these services are required 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 fifteen (15) nurses for one-to-one services for students with significant medical needs who are eligible for special education services and two (2) nurses 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.
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 Pediatric Services of America, Inc. dba Aveanna Healthcare, ATC Healthcare, Cobb Pediatric, Delta T Group, and Maxim Healthcare.
Financial impact: The total contract amount will not exceed $3,000,000.
The general budget charge codes are as follows:
$1,500,000 (G/L Account:100.2100.530000.00011.7340.2021.8010.035.0000)
$500,000 (G/L Account: 100.2100.530000.22711.7320.9990.8010.035.0000)
The IDEA federal budget charge code is:
$1,000,000 (G/L Account: 404.2100.530000.05021.7340.2824.8010.035.2024).
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 - $55.00 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
Mrs. Kiana King, Director, Special Education, Division of Curriculum & Instruction, 678-676-1885
Effective: February 13, 2024 - February 11, 2025
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 fifteen (15) nurses for special education and two (2) nurses,
anticipating an additional four (4) 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 2022-2023 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
June 30, 2018 doctor’s orders for medically Expenditures = $684,886.76
fragile 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 LPN’s $33.50 – $38.00
fragile students RN’s $40.00 – $43.50
Yearly amount for 1 nurse@
Contracted nurses to substitute $38.00 an hour 8 hours a day for
for extended absences for DCSD 180 days =
nurses $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 $54, 720.00
fragile 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:
Present 12 - 1:1 nurses projected based LPN’s $33.50 – $38.00
on parent intent to return to in- RN’s $40.00 – $43.50
person instruction (when Yearly amount for 1 nurse@
available) $38.00 an hour 8 hours a day for
180 days =
Section 504 Students Only - $54, 720.00
5- 1:1 nurses needed based on
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 – Special Education Students- Hourly rate:
June 30, 2022 12- 1:1 nurses currently LPN’s $33.50 – $38.00
supporting students attending in- RN’s $40.00 – $43.50
person instruction. The Yearly amount for 1 nurse@
department anticipates an $38.00 an hour 8 hours a day for
increase in 1:1 nurse support as 180 days =
additional students return to in- $54, 720.00
person instruction.
Special Education
Section 504 Students Only - Delta-T- $178,437.57
1- 1:1 nurse needed based on Aveanna-$82,898.35
doctor’s orders for medically Stepping Stones-$142,600.95
fragile students Maxim-$0
504
Delta-T- $40,914.99
July 1, 2022- Special Education Students- Hourly rate:
June 30, 2023 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 Yearly amount for 1 nurse@
department anticipates an $38.00 an hour 8 hours a day for
increase of 15 nurses upon 180 days =
receipt of pending physician $54, 720.00
orders, students return from
Hospital Homebound (HHB), and
identification of specially Delta-T- $938.00
skilled/trained contract nurses.
Section 504 Students Only -
One (1)- 1:1 nurse currently,
anticipating an increase of six (6)
based on doctor’s orders for
medically fragile students
July 1, 2023- Special Education Students- Hourly rate:
present Fifteen (15)- 1:1 nurses currently LPN’s $33.50 – $38.00
supporting students attending in- RN’s $40.00 – $43.50
person instruction. Yearly amount for 1 nurse@
$38.00 an hour 8 hours a day for
Section 504 Students Only - 180 days = $54, 720.00
2-1:1 nurses will be supporting
504 students Financial impact to date-
Anticipating four (4) based on Delta- T- $57, 339.23
doctor’s orders for medically Aveanna- $6816.18
fragile students Stepping Stones- $64,949.43
Maxim- 0