H.R. 305 — One School, One Nurse Act of 2025

This section states the purpose of the Act—to assist states and local educational agencies in ensuring that every elementary and secondary school has at least one full-time registered nurse on staff and maintains recommended nurse-to-student ratios, including through nurse recruitment, hiring, and retention—and includes congressional findings on school nurse shortages, benefits for student health and attendance, and the role of nurses in addressing chronic health needs and supporting school climate.

This section establishes a competitive grant program, to be administered by the Secretary of Education not later than 12 months after enactment, under which eligible entities (i.e., local educational agencies (LEAs) or partnerships between a state educational agency (SEA) and a consortium of LEAs) may receive five-year grants to address persistent shortages of school nurses or full-time school nurses. Grants may fund (1) recruitment and hiring of school nurses, (2) conversion of part-time school nurse positions to full-time, (3) retention efforts including salary increases, and (4) maintenance of recommended nurse-to-student ratios (to be specified in regulation). Applications must include a needs assessment demonstrating shortages, descriptions of student health and wellness needs, a comprehensive plan for grant uses including post-grant retention, and strategies to recruit and track hiring from local communities and underrepresented populations in public health professions (to be defined in regulation). The Secretary must prioritize high-need LEAs (as defined in the Higher Education Act of 1965, 20 U.S.C. 1021) or SEA consortia thereof, and applicants setting specific hiring goals for underrepresented school nurses. Grantees must submit annual reports on progress toward employing at least one full-time registered nurse per school, nurse-to-student ratios, disaggregated employment data by race/ethnicity and gender, and health needs addressed. Not later than 12 months after enactment, the Secretary must issue regulations, in consultation with the Secretary of Health and Human Services (and the Secretary of Labor for the definition of "full-time"), specifying nurse-to-student ratios for elementary and secondary schools, defining underrepresented populations and full-time school nurses, and providing related guidance and technical assistance. The section defines school nurse as a registered nurse qualified under state law to provide specified health services to students.