DRAFTING AND REVISING SCHOOL POLICIES

SCHOOL HEALTH POLICY CHECKLIST

Questions to Ask

What school health policies are currently in force?

  • Copies should be available from the board of education.
  • Request policies from other sources if health services are provided by a community agency.
  • Be prepared for any possibility.

What is the process for local development and implementation of school health policies?

  • Role of school medical advisor or physician.
  • Role of school board.
  • Role of specific school personnel.
  • Role of other significant people.
  • Format used for school policy.

Who are the key people to work with when drafting or revising school health policy?

  • A school nurse supervisor or coordinator.
  • Other school personnel, possibly including a central office administrator, the director or supervisor of special education or support services, athletic director, or health education supervisor.
  • Chair of school health council (if available).
  • Area resource persons with experience in writing school health policy (eg, school nurse supervisor or coordinator, education administrator or school board attorney, health department, or school physician or nurse supervisor from nearby school district).
  • State resources may include state school nurse consultant; state agencies of education and health; school health section of state AAP chapter; and state associations of school nurses, school health, school boards, school administrators, or directors of special education services.

How are the parameters for school health policy established?

  • Federal, state, and local laws exist that affect on school health policy (e.g., Individuals with Disabilities Education Act (IDEA), Section 504 of the Rehabilitation Act of 1973, Americans With Disabilities Act, state education laws, state licensure or certification of persons providing health care, and medication administration in schools.
  • National and state standards or best practices for coordinated school health programs cover a broad and varied spectrum of knowledge and skills in the areas of:
    • Health education: curriculum components, qualification of staff.
    • Health services: differentiated roles and qualifications, serving individual needs of students with health conditions, levels of care (assessment, intervention, referral, and follow-up).
    • Safe and healthy school environment: physical and socioemotional climate.
    • Physical education and sports participation: promoting physical fitness.
    • Nutrition: access to nutritious meals and classroom instruction on food choices.
    • Health promotion for staff: promote positive role models.
    • Counseling, psychological, and social services: assessment, intervention, and referral.
    • Parent and community involvement: resources to enhance well-being of students.
  • Local guidelines developed for specific issues or concerns.

What are typical areas covered in school health services policies?

  • State law requirements: eg, proof of immunizations, health screening and periodic physical assessments with referral and follow-up, physical examination for sports participation, exclusion for and prevention of communicable disease, administration of prescribed medications, school health records, staffing and environmental health and safety, emergency health procedures and responsibilities, and special health services.
  • Local requirements: Wide variation based on the needs and priorities of the community.

What are the critical issues in school health services that may require school health policy development or revision?

  • Policy and procedures for a student with a do-not-resuscitate order.
  • Confidentiality of health information and access to records.
  • Qualifications of staff providing health care and the supervision and monitoring of such care.
  • Delegation of care, especially for students with medically complex needs.

Summary

As educational institutions, schools need the cooperative efforts of both education and health care professionals to develop and revise school health policy.

A pediatrician can fulfill significant roles in this activity, such as:

  • An advocate for a safe and healthy school environment.
  • A promoter of school health policy that meets the individual health needs of students through school-based services or appropriate referral and follow-up.
  • A consultant to the school nurses and other school staff to enhance comprehensive health programs.
  • A collaborator with school professionals to improve health and educational outcomes for students.
  • A liaison between the school and other community health care professionals to identify issues and encourage improved communication and resolution of school health-related problems.

Resources

American Academy of Pediatrics Committee on School Health; Nader PR, ed.. School Health: Policy and Practice. Elk Grove Village, IL: American Academy of Pediatrics; 1993

National Association of State School Nurse Consultants, Members list