Academic journal article Journal of School Health

Health Services: Results from the School Health Policies and Programs Study 2000

Academic journal article Journal of School Health

Health Services: Results from the School Health Policies and Programs Study 2000

Article excerpt

The importance of providing health services to students is widely recognized. Not only do school health services provide health care to students who otherwise might not have access to care, but because all children's abilities to succeed academically and socially are linked to their physical and mental health, school provision of health services is related to the educational mission of schools.[1,2]

A recent working group of national organizations has identified three core functions of a school health services program: direct patient care such as screening, diagnostic, treatment, and health counseling services; referrals and linkages with other community providers; and health promotion and injury and disease prevention education.[3] Included in the first set of these functions is the administration of medication to students in school and care for students with special health needs. Many schools provide services in addition to these core functions. The nature of these services depends on resources available in both the school and the community, as well as the needs of students.

Although school health services can be described in different ways, models of these services usually form a continuum. For example, Allensworth[4] describes three models: traditional basic care, expanded school health services, and comprehensive primary care services. These models map closely to the models that focus on delivery site: core services provided in the school, core plus expanded services provided in the school, and services provided in school-based health centers (SBHCs) or in other locations not on school property (eg, school-linked health centers or community health centers).[1,4] In these two model types, the definition of "expanded services" varies slightly in the degree to which such services as mental health counseling and social services are included. A third way to describe school health services is in terms of staffing. School health services staff can range from health aides only to nurse practitioners with physician back-up.[5]

Despite the fact that some staffing models do not include school nurses, the importance of having sufficient numbers of full-time school nurses has been well documented.6 In addition, the Supreme Court ruled in 1999 that schools must provide all nursing services required by students to attend school, even one-on-one nursing care.[7] The importance of having school nurses for all students is underscored by national health objective 7-4 from Healthy People 2010: "Increase the proportion of the Nation's elementary, middle, junior high, and senior high schools that have a nurse-to-student ratio of at least 1:750."[8]


Fiscal and technical support for school health services can be found through several mechanisms. For example, funding for school health services is available through Medicaid, as well as other federal programs. Many national organizations provide technical support for school health services in the form of guidelines and recommendations. The National Association of School Nurses publishes various position statements in addition to its Standards for Professional School Nursing Practice.[9] The American School Health Association's Guidelines for Comprehensive School Health Programs include guidelines for school health services.[10] The National Nursing Coalition for School Health has published reports of its national meetings, which describe national issues and priorities and include recommendations for a research agenda.[11,12] The National Health and Education Consortium has published recommendations on training, certification, and supervision of school nurses;[13] and the American Academy of Pediatrics has issued a comprehensive manual on school health,[5] as well as specific guidelines for the administration of medication in school.[14] Schools providing health care to students with special needs can refer to guidelines from Project School Care. …

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