Mercer County board hears proposal to outsource school nursing; vendor says it could save $170,000–$260,000 a year

At a special meeting, the Mercer County Board of Education heard a presentation from a representative of Healthy Kids Clinic/Franklin Medical Centers about a proposed contract to provide school nursing, mental‑health and dental services for the district.

An unidentified school official summarized the district’s recent nursing history, saying the district had employed a nurse practitioner and four school nurses and that the nurse practitioner resigned about a month earlier. The official said the district had borne the full cost of those positions out of the general fund and framed an outside contract as a way to “minimize instructional loss” and reduce taxpayer burden.

The vendor representative described the core offer as school‑based clinical services, standing orders to allow nurses to operate autonomously, a dedicated nurse practitioner and a traveling nurse, and full coverage of clinic supplies. According to the vendor, the contract would be structured so the provider covers 40% of nursing salaries and the district 60% as a minimum split; the presenter said that configuration would “save the district around $170,000 per year” at the minimum and could amount to roughly $260,000 annually at the upper end.

The vendor also described optional additions including on‑site mental‑health therapists (licensed master’s level clinicians), a dental program provided at no cost to families, and case management services. The presenter said the dental and mental‑health elements are optional and may be omitted from an initial contract; she added they can be reintroduced later by addendum.

Board members raised staffing and retirement questions. Several asked whether current school nurses would retain their existing retirement benefits if they continued as district employees or became employees of the contract provider. The vendor repeatedly said individual nurses would be given a choice about employment and that the provider offers a 401(k) rather than the district retirement plan; the vendor said she confirmed existing nurses would have the option to remain in the teacher retirement system if they stayed employed by the district.

The vendor outlined consent and clinical limits: parental consent would be required for nurse‑practitioner services and a separate signed consent plus a phone call to a parent would precede immunizations. She said the clinic does not provide reproductive services or STD testing in school settings and would refer to public health authorities when a legal restriction requires that. To avoid double‑vaccination, the vendor said staff check the district’s electronic health record, the Kentucky Immunization Registry and school records before administering immunizations.

On contract terms and billing, the vendor said she typically negotiates one‑year agreements so pay can be renegotiated annually and that she would present transparent year‑end financial reports showing profit and loss and recommended splits. She described billing insurer payors (private insurance and Medicaid), a sliding fee scale for uninsured patients and a hardship policy for families that cannot pay.

No final contract vote was taken at the special meeting. Board members discussed limiting an initial agreement to nursing services while leaving dental and mental‑health services in the contract as optional addenda; the vendor agreed that optional services could be deferred and added later. Board members asked for additional details and planned to revisit the item at the April 22 board meeting, according to comments during the discussion.

Actions on procedural items occurred: the board moved into and out of executive session under KRS 61.810(1)(f) and later adjourned the special meeting without taking a final contract action.

Notes: the meeting transcript records projected savings figures and proposed split percentages as described by speakers at the meeting; no vote tally on a contract was recorded in the transcript.