Lucile Packard Foundation for Children's Health      

kidsdata advisory

The Lucile Packard Foundation for Children's Health | August 24, 2016

CA Schools Face Acute Shortage of Nurses and Counselors

California public schools are falling woefully short when it comes to student support personnel. The American Academy of Pediatrics recommends a ratio of one school nurse to 750 students. According to the most recent data available on Kidsdata, however, the state’s public schools employed one full-time nurse for 2,784 students in 2015, or nearly four times the recommended ratio. For the 52 counties with available data, none met the recommended ratio. Yuba County had the most impacted ratio by far, at one nurse for nearly 14,000 students.

The state falls behind in other support categories, too. The American School Counselor Association recommends a ratio of one school counselor to 250 students, yet California’s ratio was one to 792 students in 2015, or more than three times the recommended ratio. Rural counties such as Lassen, Calaveras, and Plumas had the most pronounced ratios, at one counselor for more than 1,400 students. In 2014, California ranked 49th in the US (PDF), after Arizona, in its counselor-to-student ratio.

Student support personnel address students’ social, emotional, behavioral, physical, and cognitive needs to help them reach their maximum academic and health potential. Schools that provide students with greater access to nurses and counselors are associated with more positive school climates, which generally lead to better student performance.

Policy options that could improve student access to quality support services include maximizing partnerships and existing funding streams (PDF) to ensure that students have access to school counseling and other mental health services, promoting the delivery of health care services at school by funding school nurses and school-based health centers, and integrating student mental health and health care services into a coordinated and comprehensive system of supports.

Related Data (by State, County & School District)


Helpful Links

National Association of School Nurses

American School Counselor Association

National Association of School Psychologists

California School-Based Health Alliance

The ‘Hidden Health Care System’ in California Schools and Children with Special Health Care Needs, Lucile Packard Foundation for Children’s Health



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Ratio of Students to Pupil Support Service Personnel, by Type of Personnel
Year: 2015

Ratio of Students to Pupil Support Service Personnel


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