DRAFTING AND REVISING SCHOOL POLICIES

A. THE STATE OF HEALTH-RELATED POLICIES IN TODAY'S SCHOOLS

1. Background

Today, schools are struggling to maintain a safe, healthy environment for their students. Many schools and school districts are developing written policies to address issues such as tobacco use, alcohol and drug use, violence, HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome), and the increasing number of students taking prescription and nonprescription medication at school. Input from health care professionals can provide a needed perspective for school decision makers as they consider health-related policies.

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2. Frequently Asked Questions (FAQ) about School Health Policies

Who maintains the school health policies currently in force?

  • Copies of current policies should be available from the state board of education or the local school district office.
  • Some policies may be available from other sources if health services are provided by a community agency.
  • Other school districts in your geographic area can provide copies of policies for comparison.

Who develops school health policies?

  • Policies can be developed by local school boards, state boards of education, the state department of health, the US Department of Education, other federal agencies, or Congress.
  • Both individual persons and groups can be directly involved in the developing school policies, including:
    • The school nurse supervisor or coordinator
    • The school medical advisor or physician
    • School staff, such as central office administrators, special education or support services personnel, health education instructors, and the athletic department
    • School board members
    • Members of the district's school health council, which may include parents and students
    • Attorneys
    • Health department staff
  • Many other persons can be consulted during the development of school policies. Pediatricians can seek input from the state school nurse consultant or other school nurse leaders, leadership of the American Academy of Pediatrics (AAP) Chapter or its school health committee, the AAP Section and Committee on School Health, state health and education department staff, and school personnel from area school districts, and National School Boards Association.

How are the parameters for school health policy established?

  • Federal, state, and local laws affecting school health policy include the Individuals with Disabilities Education Act (IDEA), Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act, state education laws, and state licensure or certification of persons providing health care services and administration of medication in schools.
  • National and state standards or best practices cover a broad and varied spectrum of knowledge and skills in the eight components of a coordinated school health program. (For a review of the eight components, see Section I.)
  • Local guidelines developed to address specific issues or concerns often affect policy.

What are some typical areas covered by school health policies?

  • School health policies often address requirements such as
    • Proof of immunizations
    • Health screening and periodic physical assessments with referrals and follow-up
    • Physical examinations for sports participation
    • Exclusion for and prevention of communicable disease
    • Administration of prescription-only and over-the-counter medications
    • Standing orders or protocol for use of acetaminophen in the health room
    • School health records
    • Staffing of health services
    • Environmental health and safety
    • Emergency health procedures and responsibilities
  • Because school health policies also address requirements established locally, they are subject to wide variation to meet the needs and priorities of the community.

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

  • Procedures for students with do-not-resuscitate orders.
  • Procedures for maintaining confidentiality of health information and controlling access to health records.
  • Adherence to proper qualifications for staff who provide health care and the supervision and monitoring of such care.
  • Procedures for delegation of care, especially for students with medically complex needs.
  • Procedures to follow in crisis situations, eg, suicide attempts, violent episodes, student deaths.

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