Motivating Pediatricians to Become Involved in
School Health

B. GROWTH OF GOVERNMENT INVOLVEMENT IN SCHOOL

As school health has grown throughout the century, so has the involvement of the various levels of government (federal, state, and local).

1. Federal Government

The federal government has established national programs including the following:

  • The School Breakfast Program was established in 1976 to complement the lunch program that had been in existence since 1946.
  • The Drug Free Schools and Communities Act of 1986 provided support for drug education and treatment efforts in schools; it was expanded to include violence prevention in 1994.
  • The Centers for Disease Control and Prevention (CDC) Division of Adolescence and School Health established a series of grants to assist state education agencies in strengthening health education programs to decrease tobacco use, increase physical activity, and decrease the spread of HIV (human immunodeficiency virus) and other sexually transmitted diseases.
  • The MCHB established grants for school nurse consultants at the state level and encouraged state maternal and child health offices to use MCHB block grants to support school-based health centers (in 1994, 25 states received $12 million under this program).
  • The US Bureau of Primary Care started Healthy Schools/Healthy Communities, which established 28 school-based health centers to serve homeless children.
  • Medicaid provided funding to states for EPSDT services and to support special education services.
  • The Individuals With Disabilities Education Act was passed in 1991 and re-authorized in 1997. It states that school districts must provide Individual Education Plans (IEPs) for each qualifying student and that Medicaid will pay for related services (such as speech, occupational therapy, physical therapy, and counseling) .

SLIDE I-5

2. State Government

State government has been primarily responsible for setting standards in the following areas:

  • Environmental concerns (e.g., asbestos removal, fire safety, accessibility for students with disabilities, food service conditions, sanitary inspections)
  • Health education programs (e.g., requirements for classes, teacher credentialing, texts)
  • Health services (e.g., credentials for staff, immunization requirements, health screening, health records, HIV infection, medication administration)

SLIDE I-6

3. Local Government and School Districts

Local governments have various and unique roles, and individual school districts can have a profound effect on a school's involvement in health education and health services. School health services are most often determined at the school district level.

The School Health Policies and Programs Study, last conducted by the CDC in 2000, provides information on policies and programs at state and district levels across the United States.