The One School, One Nurse Act of 2025 authorizes the Secretary of Education to run a competitive grant program that helps local educational agencies (or state–local consortia) ensure every elementary and secondary school has at least one full‑time registered nurse and that recommended nurse-to-student ratios are maintained. Grants may be used for recruitment, converting part-time to full-time nurse positions, retention incentives (including salary increases), and meeting workforce-ratio targets.
This is a federal, school‑health workforce intervention: it channels federal grant dollars and new regulatory definitions (including the nurse-to-student ratio and a definition of “full‑time”) to address nurse shortages and inequities across districts. For compliance officers, HR leaders, and district finance officers, the bill creates new application, reporting, and hiring-goal requirements, and it seeds potential long‑term budget obligations at the local level after the 5‑year grant period ends.
At a Glance
What It Does
The bill requires the Department of Education to launch a competitive grant program within 12 months that awards 5‑year grants to eligible local educational agencies or state–LEA consortia. Grants may pay for recruiting and hiring RNs, converting part‑time posts to full‑time, salary increases to retain nurses, and activities necessary to meet ratios the Secretary will set by regulation.
Who It Affects
Directly affects local educational agencies (LEAs), State educational agencies participating in consortia, school nursing staffs, district HR and finance offices, and the Department of Education (which must promulgate regulations and provide technical assistance). It also implicates state public‑health partners and the Departments of Health and Labor through required interagency consultations.
Why It Matters
The statute creates the first federal grant vehicle tying federal support to explicit nurse-to-student ratio regulation and disaggregated workforce reporting, shifting some responsibility for school‑nurse coverage from purely local budgets to a federally supported program while leaving sustainability obligations with grantees.
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What This Bill Actually Does
The bill sets up a competitive grant program administered by the Department of Education to shore up school nursing capacity. Eligible applicants are single local educational agencies or state educational agencies working with consortia of LEAs.
The statute gives the Secretary 12 months after enactment to stand up the program and to issue several regulations in consultation with HHS and, for the definition of full‑time, with Labor.
Applications must include a needs assessment showing persistent shortages of school nurses, a description of student health and wellness needs, a multi-year plan for using grant funds (including how the LEA will sustain positions after grant funding ends), and a plan to prioritize hiring from the local community and underrepresented public‑health populations along with metrics to track hiring goals. The Secretary must prioritize high‑need LEAs and state–consortium applications that set concrete hiring goals for diversifying the school‑nurse workforce.Grant awards last five years.
Allowed uses are specific: recruit and hire nurses; convert part‑time to full‑time nurse roles; increase pay or otherwise support retention; and take steps to achieve and maintain nurse‑to‑student ratios that the Secretary will later specify. Grantees must submit annual reports during the award period that document progress toward placing at least one full‑time RN in each school, provide counts of full‑ and part‑time nurses disaggregated by major racial/ethnic groups and gender, and summarize the effect of grant activities on the health needs identified in the application.Operationally, the Department must issue regulations within a year that define what ‘‘full‑time’’ means for school nurses, establish the recommended nurse‑to‑student ratios (in consultation with HHS), and define ‘‘underrepresented populations in public health professions.’' Those regulatory definitions will determine compliance thresholds for grantees and the data elements required in annual reports.
The Five Things You Need to Know
The Department of Education must establish the grant program and issue required regulations within 12 months of enactment.
Grants awarded under the statute are competitive and have a 5‑year award period.
Applications must include a needs assessment demonstrating persistent nurse shortages, a sustainability plan for maintaining nurses post‑grant, and hiring‑goal tracking for local and underrepresented candidates.
The Secretary must give selection priority to high‑need LEAs and state–consortia that set specific hiring goals to increase nurses from underrepresented public‑health populations.
The Secretary—after consulting HHS (and Labor for the full‑time definition)—will specify recommended nurse‑to‑student ratios in regulation and provide technical assistance to grantees.
Section-by-Section Breakdown
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Short title
Names the measure the 'One School, One Nurse Act of 2025.' This is procedural but signals the policy focus: establishing a statutory vehicle to pursue universal school‑based nursing coverage.
Purpose and congressional findings
Sets out Congress’s rationale and cites studies linking full‑time school nurses to better student health, immunization rates, and attendance. Practically, the findings frame the grant program as an equity and public‑health intervention, which can influence how the Secretary prioritizes applications and interprets 'high‑need' in light of disparities noted in the findings.
Grant program authorization and timeline
Directs the Secretary to establish the competitive grant program within 12 months and limits awards to 5‑year periods. That timetable creates a near‑term implementation deadline for rulemaking, application design, and outreach, while the five‑year award structure sets the temporal window during which grantees are expected to build capacity.
Application requirements and selection priorities
Specifies the information applicants must submit: needs assessments showing persistent shortages, student health needs, a multi‑year plan that addresses sustainability after grant expiry, and hiring‑prioritization and tracking for local and underrepresented candidates. The Secretary must prioritize high‑need LEAs and state–LEA consortiums that include hiring targets for underrepresented groups—tying equity goals into award decisions.
Permitted uses and reporting obligations
Enumerates grant uses: recruitment, conversion of part‑time to full‑time roles, retention measures (including raises), and maintaining ratios set by regulation. Grantees must file annual reports documenting progress toward one full‑time nurse per school, providing disaggregated counts of full‑ and part‑time nurses by major racial/ethnic group and gender, and describing changes in the health needs identified upfront—creating both operational and data‑reporting obligations for districts.
Regulatory duties and definitions
Requires the Secretary to regulate recommended nurse‑to‑student ratios (in consultation with HHS), to define 'underrepresented populations in public health professions,' and to consult with HHS and Labor to define 'full‑time' for school nurses. The definitions and ratios set in these regulations will determine compliance benchmarks and the scope of technical assistance the Department must provide.
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Explore Education in Codify Search →Who Benefits and Who Bears the Cost
Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- Students in high‑need schools — Increased access to a full‑time registered nurse reduces time out of class for health visits, improves management of chronic conditions (asthma, diabetes), and supports vaccination and screening efforts.
- Uninsured and underinsured children — For students lacking continuous access to healthcare, school nurses become a primary site of care; federal support expands service availability where gaps exist.
- School staff and administrators — Shifting health triage and chronic‑care management to trained nurses reduces teacher time spent on medical issues and can lower staff liability and burnout.
- Public‑health workforce diversity initiatives — The grant requires hiring‑priority plans for local and underrepresented candidates, creating a pathway for recruitment and career development for nurses from those communities.
- State and regional health systems — Better school‑based nursing can reduce avoidable ED visits and improve public‑health outreach, which benefits broader community health coordination.
Who Bears the Cost
- Local educational agencies — While federal grants cover initial recruitment and retention costs, LEAs must plan to sustain positions after the 5‑year award period, potentially creating long‑term payroll obligations.
- State educational agencies acting as consortium leads — They may need to manage grant administration, interdistrict coordination, and compliance reporting, adding administrative costs.
- The Department of Education — Must develop regulations, provide technical assistance, and monitor grantee reporting; these implementation duties will require staffing and oversight resources.
- Smaller and rural districts — May face higher per‑nurse recruitment costs and competition for workforce, and could need to redirect limited local funds to maintain positions post‑grant, increasing fiscal strain.
- Budget trade‑offs at the district level — Increasing nurse salaries or converting PT to FT roles may require reallocating funds from other programs or seeking new revenue, affecting other services.
Key Issues
The Core Tension
The central tension is between using federal grants and regulatory standards to quickly expand nursing coverage (and standardize nurse‑to‑student expectations) and the reality that sustainable, equitable school nursing requires sufficient and regionally distributed nursing supply plus durable local financing; the bill addresses the first with time‑limited dollars and federal regulations but leaves the harder problem of long‑term workforce supply and local fiscal sustainability to states and districts.
The bill creates a federal funding and regulatory overlay on what has historically been a local education responsibility; that design raises several implementation challenges. First, the national supply of registered nurses varies regionally.
Districts awarded grants may still struggle to recruit RNs in markets where hospitals and home‑health providers compete for the same workforce, and the statute does not provide incentives tied to licensure portability, loan forgiveness, or tuition assistance beyond salary increases. Second, the five‑year grant term seeds positions temporarily but places the onus on grantees to sustain jobs after grants expire—the statute requires a sustainability plan but provides no federal continuity funding, creating a risk of program attrition once grants end.
The requirement that the Secretary set nurse‑to‑student ratios and define 'full‑time' in regulation is consequential but vague in the bill. How prescriptive those ratios will be (nationwide uniform standard versus adjustable bands by school type and student needs) will determine compliance costs.
The reporting mandate requires disaggregated workforce data, which benefits measurement and equity tracking but increases data collection burdens and raises privacy and interoperability issues with existing HR and student‑information systems. Finally, prioritizing hiring from local and underrepresented populations advances equity goals but may slow recruitment in areas with small local labor pools or exacerbate competition for scarce candidates across neighboring districts.
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