Academic journal article Journal of School Health

School Health Services

Academic journal article Journal of School Health

School Health Services

Article excerpt

When health services first became part of the school program at the end of the 19th century, its primary role was communicable disease control.(1) Changes in society, health care delivery, education, and the family have increased the need and demand for school health services. New paradigms are evolving for school health services as school systems develop comprehensive school health programs to address the diverse and complex health problems of today's students. Increasingly, educators recognize that physical and psychological health have a direct affect on children's ability to learn. Although the full potential of school health services has yet to be realized, its place as a critical component of the educational system is well established.

Although a universally accepted definition for the term "school health services" does not exist, school health services may be described as a coordinated system that ensures a continuum of care from school to home to community health care provider and back. Traditionally, screening activities and first aid have been part of school health services. Because the number of students with chronic health problems and the number of medically fragile students have increased,(2) individualized health plans, emergency care, medication administration, specialized health care procedures, implementation of human immunodeficiency virus (HIV) infection policies, and provision of health education and counseling to students and staff also are included, depending on state and local practice and mandates.

To facilitate the uniform implementation of school health services, the National Association of School Nurses (NASN) developed School Nursing Practice Roles and Standards,(3) and the American School Health Association (ASHA) developed Guidelines for Comprehensive School Health Programs.(4) These standards and guidelines describe the goals, objectives, and outcomes of school health services and provide direction for professional nursing practice and the role of the school nurse in terms of professional development, interdisciplinary collaboration, community health systems, research, and program management. In addition, in Healthy People 2000, two national health objectives address discrete health services for school-aged youth:(5)

13.12 Increase to at least 90% the proportion of all children entering school programs for the first time who have received an oral health screening, referral, and follow-up for necessary diagnostic, preventive, and treatment services.

20.11 Increase immunization levels as follows: Basic immunization series among children in licensed child care facilities and kindergarten through post-secondary education institutions: at least 95%.

These objectives may be achieved through adoption of appropriate policies that address relevant record keeping, attendance restrictions, provision of school health services, and referral to health care providers in the community.


The federal government supports school health services through several programs. The Universal Access to Immunizations Program (UAIP), administered by the Centers for Disease Control and Prevention (CDC), provides immunizations through health care facilities and schools at a nominal cost to those children not covered by private insurance.(6) CDC also provides assistance to all state and some local education agencies and national health and education organizations to develop HIV policies and programs for youth.(7) As part of this effort, the National Association of State Boards of Education (NASBE) in collaboration with many other national organizations developed Someone at School Has AIDS: A Guide to Developing Policies for Students and School Staff Members Who Are Infected with HIV to assist state- and local-level policymakers with the difficult issues related to HIV infection and AIDS(8) and the National School Boards Association (NSBA) established the HIV and AIDS Resource Database to provide assistance and sample HIV infection policies to districts. …

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