The Cumberland County Board of Education approved a roughly $1.07 million agreement Tuesday to continue its partnership with the Cumberland County Department of Public Health for 14 school nurses during the 2026–27 school year.
The agreement renews an existing partnership between Cumberland County Schools and the health department, which hires and supervises public health nurses assigned to schools.
The school district reimburses the department for 10-month nurse salaries and related operational costs, while the health department oversees nursing practices, personnel, and liability coverage.
The approved contract totals $1,070,305 for the 2026–27 school year, down $16,170 from the district’s $1,086,475 agreement in 2025–26, according to district contract documents. The district spent $1,101,151 on the same partnership during the 2024–25 school year.
But the renewed agreement comes as staffing shortages continue to stretch school nursing coverage across Cumberland County Schools.
Mary Brown, school health nursing supervisor for the county health department, said vacancies have steadily increased the number of schools nurses are expected to cover.
“We started out this school year with nurses having anywhere from two to three schools that they were covering,” Brown said. “Now pretty much all of our schools, our nurses have three schools and some have four that they’re covering.”
During the school board’s auxiliary services committee meeting on May 5, Shirley Bolden, director of health services, said the district’s partnership with the health department is intended to expand student access to healthcare professionals without directly employing school nurses.
“We pay for 14 nurses, and the goal of that is for us just to increase access to students having a healthcare professional in the building,” Bolden said.
‘Nursing Is Very Hard to Fill’
Bolden described school nursing as one of the district’s most difficult positions to staff.
“Nursing is very hard to fill at this time, because they can name their dollar,” Bolden told board members. “Ever since COVID, their stock went up.”
According to Cumberland County Schools, entry-level school nurses employed through the district earn approximately $45,000 annually, a salary district officials said is comparable to those employed through the Cumberland County Department of Public Health. The salary for school nurses from the health department ranges from $42,879 to $66,446.
According to Bolden, the health department currently employs one school nurse supervisor and three team leads who oversee school nursing operations but do not directly provide services inside schools.
Of 18 school nurse positions providing direct services to students, 14 are funded through the contract with the county. Four of those positions are vacant.
Separately, the school district also employs 18 nurses who provide care for students requiring specialized medical procedures, including G-tube feedings, catheterizations, colostomy care and tracheostomy support.
District officials said the shortages have contributed to expanded nurse coverage across schools. “We will never say no to more nurses, because we will beat the bushes to find them,” Bolden said.
What Happens When a Nurse Isn’t There?
Under the district’s agreement with the health department, school nurses provide at least one day of in-person coverage each week to assigned schools, though campuses with larger student populations or greater medical needs may receive additional time.
“When we had nurses that only had two schools, those schools obviously would get more services, more days of coverage during the week,” Brown said.
During committee discussions, Bolden said larger campuses are often prioritized for additional nursing support.
“Some schools are going to get larger service,” Bolden said, citing larger schools such as Grays Creek High School. “The smaller schools will get one day.”
The agreement between the school district and the health department states nurses provide 35 hours of service each school week.
Even when nurses are not physically on campus, Brown said nurses remain available to school staff by phone.
“They’re always available by phone for any questions or concerns that come up that the school staff may have on the day that they’re not at that particular school,” Brown said.
On days nurses are not assigned to a campus, trained office staff often manage many day-to-day student health needs.
Brown said school staff receive medication administration, diabetes and asthma training to help support students when nurses are covering other schools.
“The school staff really provide the day-to-day stuff on the days that we’re not there,” Brown said.
While school staff often manage immediate concerns, Brown said nurses typically focus on more specialized medical needs when they are physically present.
“When we are there, we’re a lot of time doing the other things that the staff can’t do, like emergency medication training, care plans, coordinating care with doctors’ offices and parents,” Brown said.
School nurses also conduct vision screenings, referrals to healthcare providers, and follow-up care coordination for families.
“We’re responsible for making sure that the parents have secured care for those things,” Brown said.
Recruitment and Outreach Efforts
Despite staffing shortages, health officials say collaboration between Cumberland County Schools and the Cumberland County Department of Public Health has helped maintain student care.
Tamra Morris, deputy public health director for the county health department, said partnerships between schools and public health remain essential as vacancies continue.
“It’s really a team effort to ensure that students are cared for,” Morris said. “We really value collaboration in public health.”
Morris said the department has expanded recruitment efforts beyond traditional job fairs to help fill school nursing vacancies.
“We work really hard to try to do recruitment outside of normal areas of job fairs and extending things to our social media and try to be innovative with new ways to recruit school health nurses,” Morris said.
Morris said Fayetteville’s military-connected population can also make long-term staffing more difficult.
“Fayetteville is a transient community,” Morris said. “We have lots of military families.”
Because many residents relocate due to military reassignment, Morris said some nurses leave positions at the end of the school year.
“So sometimes folks vacate their positions at the end of the school year if they may be PCSing,” Morris said, referring to the military term for a Permanent Change of Station, “or moving to another area.”
Still, Morris said health officials continue working to recruit nurses and maintain student services.
“We wouldn’t turn down additional assistance,” Morris said. “It’s really a team effort to ensure that students are cared for.”
