Making the Connection II
School Health Services
DEFINITION OF COMPONENT
The goal of a school health services team is to ensure that
students are healthy, in school, and ready to learn. Models
of these services—in terms of policies, staffing, funding,
and access—vary across states and schools. Allied health
personnel provide school health service on-site in the school
health office, in a school-based or
linked health center or clinic, or through
partnerships with community- and
public health agencies. (3, 4, 5, 8, 9, 11)
In most schools, the school nurse
is the coordinator for school health
services. The school nurse handles
first aid and emergency care,
referrals for immunizations and care,
faculty and staff training regarding
health, and promotes student and
staff wellness. School nurses screen
for barriers to learning. The school
nurse is an advocate linking home,
school, and the medical community
in support of student health and
academic success. (1, 4, 16, 17, 19)
School-Based Health Centers
School-Based Health Centers (SBHCs) are primary care
clinics located in a school building or near the campus.
SBHCs are staffed by nurse practitioners, physician
assistants, doctors, nurses, mental health professionals,
and health assistants. SBHCs bring the medical clinic to
the school so students may receive the care they need,
regardless of their ability to pay. SBHCs minimize time
missed from classes and, for parents, time missed from
work. In 2010, there were approximately 2,000 SBHCs in
44 states serving about 1.7 million students. (3, 8, 11, 12)
IMPACT ON STUDENT
Today’s student population is more medically diverse than
in the past, and federal law requires schools to provide
safe and supportive learning environments for students
School Health Services
with a wider variety of disabilities and chronic illnesses than
ever before. School health services can provide necessary
supports to enable students with a variety of handicaps to
function in school and achieve. In addition, they can work
to prevent or reduce risk behaviors and identify and refer
students for treatment when necessary, thereby making
educational success more likely. (8, 9, 12, 17, 18)
STORIES FROM THE FIELD
Health Services as Part of a
Coordinated School Health
The Helfrich Park Middle School
in Evansville, Indiana, has been
recognized by the CDC as an
exemplary coordinated school
health implementation site. In
collaboration with area hospitals,
Helfrich students receive physicals,
dental care, dietary counseling,
and routine screenings. Health
services dovetail with nutrition,
physical activity, and health
education offerings. (10, 9)
Examples of School-Based Health Center Results
- In Massachusetts, students had a 50% decrease in
absenteeism and 25% decrease in tardiness two months
after receiving mental health counseling in their SBHC.
- In North Carolina, African American male clients of the
SBHC were three times more likely to stay in school than
their peers who did not use the clinic services. (10)
RECOMMENDATIONS FOR BEST
By School Nurses:
Student health needs are best addressed by a full-time
nurse in every school building. The national standard
has been a ratio of one nurse for every 750 students.
Increasingly, the professional consensus is that the
recommended ratio should be based upon need. The
school nurse is a primary contributor to assuring the
physical and emotional safety of the school community. (1,
4, 7, 16, 17, 19)
Examples of recommended best practices for school health services by school nurses include to:
- Provide health screenings for vision, hearing, dental, scoliosis, speech, and language
- Provide acute care services (e.g., first aid, CPR, epinephrine injection, and others)
- Provide chronic disease management (e.g., asthma, diabetes, seizure disorder, and others)
- Build regular communication between families, schools, and medical providers
- Help staff stay current on topics such as autism, allergies, diabetes, bullying, ADHD, and others
- Be part of the school’s crisis management team
- Build cultural and linguistic competencies in order to serve the school’s particular population and reduce disparities and inequities
- Interface with academic goals of the school; ensure that
adults see the relationships between student health and
safety, attendance, and achievement
By School-based Health Centers:
BIBLIOGRAPHY (selected references)
- American Academy of Pediatrics. Role of the School Nurse in Providing
School Health Services. Pediatrics. 2008; 121(5): 1052-56.
- Basch C. Healthier Students Are Better Learners: A Missing Link in School
Reforms to Close the Achievement Gap. Teachers College, Columbia
- Colorado Department of Public Health and Environment. School-Based
Health Centers, Best Practices, 2011. Available online at http://www.
- Connecticut State Department of Education. Competency in School Nurse
- Council of Chief State School Officers. Policy statement on school health,
- Dunkle MC, Nash MA. Beyond the Health Room. Council of Chief State
School Officers, Resource Center on Educational Equity. 1991.
- Education Development Center, Inc. What is a Coordinated School Health
- Geierstanger SP, Amaral G. School-based Health Centers and Academic
Performance: What is the Intersection? National Assembly on School-
Based Health Care. 2005.
- Lewallen TC. Healthy learning environments. ASCD INFOBrief. 2004; 38.
- Little DM. School-Based Healthcare. Southeast Education Network. 2010; 12(3).
- Maine Department of Human Services, Bureau of Health. The Maine
School-Based Health Centers Standards. 2003.
- National Assembly on School-Based Health Care. The Role of School
Based Health Centers in Improving Health Equity and Reducing Health
- National Association of School Nurses. Coordinated School Health
- National Association of School Nurses. School Nurse/School-Based Health
Center Partnership. 2001.
- National Association of School Nurses. The Role of the School Nurse in
School-Based Health Centers. 2001.
- New York State Association of School Nurses. Duties of the School Nurse. 2008.
- Rhode Island Department of Education, Coordinated School Health
Program. Component: Health Services. 2008.
- Swingle CA. The relationship between the health of school-age children
and learning: implications for schools. Lansing, MI: Michigan Department
of Community Health, 1997.
- Robert Wood Johnson Foundation Series on Charting Nursing’s Future.
Unlocking the Potential of School Nursing: Keeping Children Healthy, In
School, and Ready to Learn. 2010.
- Vinciullo F, Bradley A. A Correlational Study of the Relationship Between a
Coordinated School Health Program and School Achievement: A Case for
School Health. Journal of School Nursing. 2009; 25(6): 466-77.
- Van Cura M. The Relationship Between School-based Health Centers,
Rates of Early Dismissal from School, and Loss of Seat Time. Journal of
School Health. 2010; 80(8): 371-77.