All schools need a full-time nurse, preferably with a baccalaureate, says the AAN. For every dollar spent on school nurses, more than two dollars are saved in medical care and other costs, yet many schools don't have a school nurse, according to a position statement from the American Academy of Nursing (AAN) published in the January-February issue of Nursing Outlook. Toward this goal, nursing schools should train more school nurses, including advanced practice nurses, and the Centers for Medicare and Medicaid Services and health insurance companies should help to fund school nurse programs. To support the need for school nurses, the statement cites the evidence on increasing numbers of school children with chronic conditions, depression, and other mental health issues owing to bullying and violence. Because of an increase in vaccine exemptions, outbreaks of measles, pertussis, and other infectious diseases are increasing. School nurses have been shown to increase immunization rates, improve the management of chronic conditions, and decrease absenteeism.