Shelby County Schools Department of Coordinated School Health

Report
Shelby County Schools
Department of Coordinated School Health
Child Health—A School, Family, and Community Issue. . .
Shunji Q. Brown-Woods, Ed.D., MHA
Director
Coordinated School Health
Presented June 2013 and July 2013
Student Services Discipline Academy
1
Every day in America, children
Reducing the Barriers to Learning
come to school not ready to learn
ASTHMA
No AYP
Community and Parental Involvement is one component of
CSH
2
Session Objectives
 Understand CSH structure, purpose and responsibilities
 Establish expectations for deliverables related to Coordinated
School Health Services
 Review and discuss school health policy and procedure
 Share rationale for determination of school nursing allocation
and assignment priorities
 Individualized Health Care Plans
 CAADS (cardiac, asthma, allergy, diabetes, and seizure related
chronic health issues)
 Explain Tennessee Coordinated School Health Law, Scope and
Components overview
3
Coordinated School Health
Dr. Shunji Brown-Woods
Director of Coordinated School
Health
Clinic/Health
Promotion Manager
Research Analyst
Coordinated School
Health Manager)
Employee Health
Clerk
Nursing
Supervisor
Special Project
Coordinator
4
Health
Services/School
Nursing Manager
District/Charge
Nurse
Administrative Assistant
Mental Health Center
Services Manager
Assistant for
Health
Services/Scho
ol Nursing
Manager
Coordinated School
Health Program
Assistant
Assistant for
Mental Health
Center Services
Manager
Supervising
Psychologists
Clerical Assistants
CSH Purpose & Responsibilities
 Ensure delivery of high quality health services
 Oversee:
 School Nursing/health services
 Mental Health Center services
 Four (4) regional School-based clinics
 Northside High, East High, Westwood High, and Sheffield High School
 Family Care Centers (employee health clinics)
 901-473-2628 appointment line
 State Coordinated School Health grant functions
 School Health Compliance
 Special Projects
 CPR/AED/First Aid training
 Vision/Hearing Screening for students
 CDC HIV/YRBS grant
 Bloodborne Pathogen (BBP) Exposure training and immunization program for
Hepatitis B
5
Establish expectations for deliverables
related to Coordinated School Health
Services
To dos:
1. Medical records/medication administration designee (July 24,
2013)
2. Healthy School Team Administrator Coordinator (July 29, 2013)
3. Healthy School Team Leader (July 29, 2013)
4. Healthy School Team Roster (September 6, 2013)
5. AED protocol and list of Trained CPR/First Aid/AED staff
(September 6, 2013)
6. Immunization audit (October 1, 2013)
6
Review and discuss school health
policies and procedures
Health Care Management Policy #6043
(Comprehensive policy)
7
Purpose
 To provide an efficient and effective district-wide school
health program to address the health education and health
service needs of students attending Shelby County Schools.
 Policy Statement
 The Shelby County Schools’ Board believes that
academic success is impacted by the overall wellbeing of the student; and that a fundamental mission
of the school system is to help students remain
healthy. It is therefore the policy of Shelby County
Schools to provide an effective system of programs to
support student health and learning.
8
Responsibility
 The principal shall be responsible for ensuring that health
care services are available for students attending his or her
school.
 The office responsible for Coordinated School Health
Services is responsible for implementing internal protocols;
and for administering this policy.
 The Superintendent is responsible for ensuring that this
policy is followed.
9
Policy Summary
 Provides definitions for the following:





Early Periodic Screening, Diagnosis, and Treatment (EPSDT)
First Aid
Periodic Health Screening/Evaluation
Individualized Health Plan (IHP)
Inter-Periodic Screening/Evaluation
 Replaces legacy MCS and SCS health related policies
 Covers 11 broad areas in health care management:
 First Aid, Student Accident Reports, Physical Examinations,
Immunizations, IHPs, Medication Administration, Diabetes, Seizure,
Allergy, Communicable Diseases, AIDS, and Psychological as well as
social services.
10
First Aid and Emergency Medical Care
 Faculty and staff of each school shall be prepared to provide
basic first aid in response to general medical emergencies.
 The objective of the SCBE is to have an adequate number of
staff at each site who are trained and certified in CPR and
other first aid emergency techniques.
 In accordance with state law any person who in good faith
provides emergency care or assistance at the place of the
emergency or accident will not be liable for any civil
damages as a result of any act or omission.
11
Student Accident Reports
 Any accident involving students that occur on the property of Shelby
County Schools and/or while under the approved supervision of
District employees shall be reported in writing to the office responsible
for student services within twenty-four (24) hours after the accident
occurs.
 Report should include the following;





Person’s name
Date of the accident
An explanation of the accident
Care used for treating the individual
Principal signature
 Reports should be kept on file in the principal’s office for one (1) yr.
12
Student Physical examinations and
Immunizations
 Physical examinations, except as exempt by statute, shall be required of students:
 Entering school for the first time (applies to any student entering a District School, including
Pre-K for whom there is no health record); or
 Participating in interscholastic athletics (including any strenuous physical activity program
covered by TSSAA)
 The principal shall ensure that there is a complete physical examination of each
student prior to enrollment.
 Cost of the examination shall be borne by the parent or guardian of the student.
 Physical examinations will not be conducted without parental consent.
 An invasive physical examination does not include hearing, vision, blood pressure, height,
weight, or scoliosis screening.
 Parents will be notified of dates and times when screenings will be conducted and will
receive written notification of any screening results.
13
School Health Screenings/Evaluations
Services
 Services include:
 Vision and Hearing assessments
 Body Mass Index (BMI=Height and Weight)
assessments
 Blood Pressure
 EPSDT
 The district will provide healthcare services
(preventive and early intervention health
services) and health referral services whose test
results indicate a possible condition that may
interfere or tend to interfere with the student’s
academic progress.
 Services shall be conducted by qualified
healthcare providers.
14
 School-Based Health Clinics shall be
available to increase access to healthcare
services for all Shelby County students.
 Health Care monitoring will
occur through school based
health screenings for students
entering PK, K, 2, 4, 6, 8, and
Lifetime Wellness courses.
 Students entering the District
from another district will be
asked to provide evidence of
completion of an EPSDT or
preventive well-child screening
within the last 12 months.
Confidentiality
Employees
Volunteers and Contractors
 Shall safeguard student medical
 Volunteers whose activity may
information from unauthorized
disclosure except as permissible by
law or as a required function to
perform his/her job
responsibilities; and/or in cases
where the student poses an
imminent threat of harm to
him/herself or others.
 An employee who misuses, alters,
removes, or improperly uses
confidential student medical
information shall be subject to
disciplinary action up to and
including termination.
15
place them in a position where
they may gain knowledge of a
student’s healthcare information
as well as other entities
contracted by or working in
collaboration with the District
shall be held to the same
professional standards as an
employee of Shelby County
Schools.
 Sanctions for breach of
confidentiality may apply.
Medical Documentation
Accurate
Medical
Information

Parents/Guardians are responsible for informing school personnel of
significant medical conditions

Medical information will be requested by SCS and completed by the
parent/guardian each school year

The principal shall assure that any/all information
concerning the medical conditions of students is identified
by:
1.
2.
3.
16
Directing a systematic review of all
registration forms and medical
documentation
Mandating that information (suspected or
confirmed) received by a staff/faculty
member be reported to the Principal; and
Encouraging parents/guardians to alert the
Principal of any medical condition
Medical Documentation
Validation
of Medical
Condition
 The principal shall recommend that the
parent/guardian of each student identified as having
a medical condition (or possible medical condition)
be contacted for the purpose of clarifying the extent
of the medical condition, especially in cases needing
further clarification.
 A statement from a health care provider should be
provided by the parent in those cases in which the
medical condition appears to warrant:
 A modification in the standard curriculum or school related
activities;
 The need to supervise and/or administer medication during
the school day; or
 A special alert for school personnel regarding a possible
requirement for emergency first aid.
17
Individualized Healthcare Plans
 IHPs shall be written by school nurse staff to address student specific
health conditions and shall include:
A specified timeframe to develop a student IHP that must be
reviewed with the parent/guardian (at least once per school year);
The medical condition; health assessment; emergency plan;
identified health needs; and procedures/treatments required during
school hours;
Relevant documents, such as a physician’s statement.
1.
2.
3.
The IHP should be distributed to school employees with a
legitimate need to know.

Special Cases:



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If a student is identified as special education, IHP shall be a part of the IEP
and shall be maintained in the special education records.
HIV/AIDS cases are considered to be unique and shall be responded to in
accordance with policy and corresponding rules and regulations.
Administering Medicines to Students
If under exceptional
circumstances a student
is required to receive
medication during
school hours and parent
cannot be at school to
administer the
medication, only the
school nurse or the
Principal’s designee will
administer the
medication in
compliance with the
regulations that follow:
(see policy for detailed
regulations)
19
 General
 Written instructions will be signed by the parent or legal
guardian.
 Signed instruction form will be kept on file at the school.
 All medication must be brought to school by the parent or
guardian, unless other arrangements have been approved by
the school Principal, but under no circumstances shall a
student bring the medication to school by himself/herself
 Parents of the student must assume responsibility for
informing the school Principal of any change in the student’s
health or change in medication.
 Should medications of an invasive nature be required to be
given the school personnel for emergency action, proper
physician orders and instructions will be obtained and
proper training will be given to appropriate personnel.
 The school system retains the discretion to reject a request
for administration of medicine.
 A copy of this procedure will be provided to parents upon
their request for administration of medication in the
schools.
Administering Medicines to Students
The
Principal
or his/her
designee
will:
1.
2.
3.
4.
20
Inform appropriate school personnel of the
medication being taken.
Keep a record of the administration of
medication on a designated form and will
keep this record on file at school.
Keep medication in a locked area (exception:
Students may self-carry emergency
medications such as rescue inhalers and
epinephrine).
Returned unused medication to the parent
only or discard appropriately. If discarded at
school, see policy for guidelines and also
through full-length medication administration
training.
Accommodating Students with
Diabetes
 The administrator in charge of student health services is to:
 Consult and coordinate with the parents and health care
providers of students with diabetes;
 Prior to the beginning of the school year, or upon a student’s
diagnosis, train and supervise the appropriate staff in the care of
students with diabetes; and
 Annually provide in-service on the procedure for parents to
notify schools of specific health needs.
 School administrators shall notify their Assistant Principals
and teachers of the students who will use glucose monitoring
devices in his or her school.
21
Accommodating Students with
Diabetes
 The District shall
develop and follow an
emergency/or IHP for
each student with
diabetes.
 The health plans shall be
updated annually and
more frequently as
needed.
22
Parent-Designated Adult
Letter of Intent
Additional Requirements
Indemnity
Seizure Management
 T.C.A. 49-5-415 shall permit an employee, who has been properly trained by a
registered nurse, to volunteer to administer anti-seizure medication in
emergency situations to a student in compliance with the student’s IHP.
 However, if a school nurse is available and on-site, the nurse shall administer the
anti-seizure medication to the student.
 For training of volunteers and administration of anti-seizure medications,
including diazepam gel, the district shall adhere to Tennessee’s “Guidelines for
Use of Health Care Professionals and Health Care Procedures in a School
Setting”.
 The District office responsible for Coordinated School Health will determine
the criteria and response for seizure emergency in Shelby County Schools based
on guideline recommendations by the State of Tennessee.
23
Life-Threatening Allergy Management
 Shelby County Schools shall have an allergy program to promote the safety and
well-being of students with life threatening allergies.
 Therefore, It is the intent of the Board to ensure that safeguards are
implemented for students with allergies determined to be lifethreatening by a medical professional.
 Parents/guardians of students diagnosed with a life threatening allergy should
promptly notify the school upon diagnosis of the allergy.
 An IHP tailored to the needs of each individual child at risk for anaphylaxis, with
accommodations for allergy management will be developed following the
“Guidelines for Managing Life-Threatening Food Allergies in Tennessee Schools.”
 The District shall provide training for school based staff in the appropriate
administration of epinephrine.
24
Communicable Diseases
Policy

Students with a communicable disease may be allowed to attend school provided their presence does not create a
substantial risk of illness or transmission to other students and/or employees.

The Board will follow guidelines and recommendations from Shelby County Health Department regarding
communicable disease handling.

Re-admission
 In the case of a communicable disease, the student may be readmitted on presentation of a written statement from the family
physician, and/or completion of the period of exclusion required by the State Department of Public Health.
 In the case of ringworm, impetigo, or scabies, the student may be readmitted once treatment has begun and proof of
treatment is presented to the Principal or designee.
 In the case of pediculosis (head lice), a student may be readmitted for inspection following treatment. If proof of treatment is
presented to the Principal or designee and no live lice are present, the student may return to class.

25
Please see policy for guidance on Tuberculosis or any other communicable disease and exclusion and/or other requirements
for re-admission.
Acquired Immune Deficiency Syndrome
 Mandatory screening for communicable
diseases not spread by casual, everyday
contact, such as HIV infection, will not be a
condition for school entry or attendance.
 If a student’s parents/guardians choose to
disclose the child’s HIV status, all matters
pertaining to that student will be under the
direct supervision of the Superintendent or
his designee. Upon disclosure, the
Superintendent or his designee shall:
 Request medical records from the parent or
legal guardian and the student’s physician;
 Gather information regarding the student’s
cumulative school record; and
 Meet with the evaluation team designated by
the State Department of Education.
26
 Annually, the Superintendent shall ensure
that all employees, including newly hired
staff, receive current HIV training to
include:
HIV Epidemiology
Methods of treatment and prevention
Bloodborne pathogens
Universal precautions
Psychological and social aspects of HIV
Related federal and state laws and
policies; and
 School procedures and policies
regarding HIV-related issues.






 Under no circumstances shall
information identifying a student with
AIDS be released to the public.
Psychological and Social Services
 The District shall make psychological and social service programs available for
all students of Shelby County Schools.
 Each school shall provide a social service program for all students through
cooperative efforts of the principal, teachers, and school counselors.
 The Principal, in consultation with the social service provider and the office
responsible for student support and Coordinated School Health, shall ensure
the development of a program of social services.
 Confidentiality in Psychological Services
 Confidentiality shall be maintained by any District employee providing services
related to psychology services except:
1.
2.
3.
4.
27
Where there is a clear and present danger to the student or other person;
To consult with another psychologist when it is in the best interest of the student;
When the student and/or parent waives this privilege in writing; or
When required by federal law.
Share rationale for determination of
school nursing allocation and
assignment priorities
• Individualized Health Care Plans
• CAADS (cardiac, asthma, allergy, diabetes, and seizure
related chronic health issues)
• Concussion Protocol
28
Overview of Common Chronic Illness
High Priority Health Conditions –
 C Cardiac
 A Allergy
 A Asthma
 D Diabetes
 S Seizure
How we Identify Priority Health Conditions
 Confidential Student Health Forms
 Nurse reviews health information and
communicates with parents/guardians to
determine the appropriate level of care needed to
address student health needs at school.
 Once information is shared at the school level a
school health plan (IHP), Health Information Fact
or Condition Sheet is developed and shared with
school staff who have a legitimate need to know.
(HIPAA) (FERPA)
CAADS
“C” Cardiac Issues
 Any physical activity
restrictions or
limitations?
What do you need
to know?
 Is there an IHP or a
Health Information Fact
or Condition Sheet?
 What are the signs
and symptoms of a
potential problem?
CAADS
“C” Cardiac Issues
 Unable to keep up
physically with other kids
 Getting out of breath with
activity sooner than other
kids
 Getting sweaty with
exercise sooner than other
kids
 Turning blue around the
gums /tongue
 Chest pain with exercise
 Passing out
 Palpitations or heart
skipping or beating
abnormally
 Dizzy with exercise
“C” Cardiac Issues
 If you are
What do you need
concerned, please
call the school nurse
to DO?
CAADS
 If you are not sure
KNOW WHERE
THE AED IS
LOCATED!
err on the side of
caution and stop the
activity
 It is easier to stop
the activity and call
for the nurse before
you need to call 911
CAADS
“A”Allergy *
Legislation & SCS Policy
 Food
 Severe Allergy Plan
 Environmental
 Medication
 Insects
 Specific information and
training is required for
each student
 Response plan varies
student to student
 Some students MAY carry
their medication
CAADS
“A”Asthma
* Legislation & SCS Policy
 TYPES
 Controlled Asthma
 Uncontrolled Asthma
 Asthma Action Plan
 Specific information
 Missed School Days
 Asthma Medication
 Asthma Triggers
 Exercise induced
Asthma (EIA)
 Medication
 Identify Triggers
 A student with both identified
Allergy and Asthma may have
a more severe asthma attack
CAADS
“D”Diabetes
 Students with Diabetes
will have an IHP
 The student’s academic
schedule is key in the
development of the IHP
since many of the
management tasks are time
sensitive
*Legislation and SCS Policy
 The timing and location of
Blood Glucose testing,
school lunch (snack times)
and physical activity
including recess are
included in the
development of the IHP
 IHP will spell out the
timing and frequency of the
student’s diabetes
management tasks during
the school day
CAADS
“D”Diabetes
 Students with Diabetes are
protected under IDEA and
must have free unrestricted
access to water and the
restroom
 Accommodations for
standardized testing
 Students with Diabetes
should have fast acting
carbohydrates accessible in
each classroom including
specials
 Assign a buddy to a diabetic
student
* Legislation & SCS Policy
 Students with Diabetes
must be able to test their
blood sugar and see the
nurse when they
symptomatic
 When in doubt if blood
sugar is high or low give the
student a snack
 Do not allow a diabetic
student who is not feeling
well to walk to the clinic for
a snack or to test
CAADS
“S” Seizure
Folks may experience a seizure
for many reasons:
 Head injury
 Temperature
 Brain tumor
 Brain Hemorrhage
 Low Blood Glucose
 Or perhaps no reason at all
 There are many
different types of
seizures and
seizure activity
 For students with
a known history
of seizure the
school nurse will
develop an IHP
CAADS
“s” Seizure
*
Legislation & SCS Policy
 Seizure response protocol
1.
Provide routine First Aid for Seizure
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Call 911 if a 1st time seizure or > than 5 minutes
Mark the time seizure started
Record all activity on a seizure log
Place student on their side
Place something under the head
Loosen any tight clothing
Do not restrict movements or place an object in the mouth
Protect them from injury by clearing objects out of the area
Do not leave student alone
Continue to monitor, record and observe the student throughout
and after the seizure
Head Injury –Concussion Awareness &
Response
 When is a head injury serious?
 When is a head injury a concussion?
 Who is at the greatest risk for Concussion?
 Most concussions occur without loss of consciousness.
What is a Concussion?
 Concussion - type of brain injury that changes how the
brain usually works.
 Concussion - can be caused by a bump, blow or jolt to the
head.
 Concussions - can also occur from a fall or blow to the
body that causes the head and brain to move rapidly
back and forth.
 Even a MILD bump can be serious.
Protocol for Head Injury
 If a nurse is available, have the nurse assess any student who sustains a head injury
however minor

If the nurse is not available to assess the student have the student sit out and take the next
appropriate action

Follow the CDC’s Concussion ABC’s

Be aware to the signs and symptoms of a head injury

Complete an SCS accident report

The individual who is a witness to an injury is the individual who completes the accident report

Make voice contact with a parent/guardian before the end of the school day
 A voice or email mail message is not acceptable parental
notification
Student Health Services &
Protecting Student Health
Information
43
Confidential Student Health Information
 “. . .personal, sensitive information obtained most often by a
health professional concerning the physical, developmental,
or mental health of an individual student. A student’s health
history might also include sensitive family information.”

Source: Guidelines for Protecting Confidential Student Health
Information. Pg. 11.
Published by ASHA National Task Force on Confidential Student Health Information
44
Important Notes on Student Health Information
 Student health information can be multiple forms
 Oral, written, or transmitted electronically.
 Records often include:
 Mandated immunizations
 Health and physical assessment data
 Health screenings for vision, hearing, blood pressure, height, weight, scoliosis, dental,




45
etc.
Injury/incident reports
Incident reports of alcohol or drug us in school
Health assessments and other evaluation reports related to eligibility for services
under the Individuals with Disabilities Act (IDEA) and 504 of the Rehabilitation Act
of 1973 and
Referrals for suspected child abuse
Important Notes on Student Health Information
 Additional health information might include:
 Student-initiated visits to the health room, assessments, interventions, and referrals (narrative






46
notes)
Records of meetings between education and health professionals for planning or identifying
assessment measures, recommended interventions, and student outcomes
Records for in-school medication, including original, signed orders from a physician, written
consent from parent, and/or guardian to administer a drug and medication logs for both
routine and as-needed (PRN) medications
Physicians’ orders, correspondence, evaluation reports, copies of treatment records,
institutional or agency records
Individualized emergency care plans for students with special health care needs, including
routine and emergency interventions and methods for evaluating student outcomes
Health-related goals and objectives or Individualized Health Plan (IHP) or part of a student’s
Individualized Education Program (IEP) for students whose health conditions affect their
educational needs
Case notes, evaluations, and interventions by other Student Services,
Department of Exceptional Children, or Coordinated School Health staff
Access to Student Health Information
47

Varies by type and purpose

Medical records from outside health care providers and hospitals are generally accessible only to
health professionals.

Staff who provide health and education services to students must be adequately informed about a
student’s condition as the consequence of inadequate knowledge can be serious.

It is often a challenge to establish systematic structure for assuring appropriate safeguards to protect
confidentiality while enabling education and health professionals to share information that promotes
the student’s health and academic success.
Ethical Responsibilities & Issues
 Responsibility to Respect
Privacy
 “Privacy” is a fundamental right
of individuals to be free from
intrusion.
 Responsibility to Do No
Harm
 Careful consideration of “need to
know” balanced with best interest of
individual students
 Can disclosure be justified for the
student’s benefit?
 To what extent might personal bias
affect my judgment?
48
 Responsibility to Disclose
Some Types of Information
 Suspected Child Abuse
 Self-injury or Suicide
 Possible Harm to Another Person
 Duty to Warn
 If known threat exists to a student has
been identified by health professionals,
then this information should be
disclosed.
Legal Obligations & Confidentiality
 The ability of more students with various health problems to
attend school has increased the amount of confidential health
information with which schools must contend.
 Support services and federal programs also often make decisions
based on health information.
 Professional school staff working in schools should become
familiar with relevant laws affecting student records.
49
Legal Obligations & Confidentiality
 Family Educational Rights and Privacy Act of 1974
 FERPA provides parents with access to all their child’s school
records, including health records, and stipulates that these records
may not be released outside the school without specific parental
consent except in a few circumstances:
 When a student intends to enroll in another school
 Research and/or evaluation studies focused on improving instruction or care; or
 An emergency in which disclosure is necessary to protect the health or safety of
the student or other individuals. Only that information necessary to reduce the
danger may be shared and then only with necessary medical, administrative, or
law enforcement personnel.
50
Legal Obligations & Confidentiality
 HIPAA
 “Education records in public schools are covered by FERPA and
are specifically exempted from the HIPAA Privacy Rule.
Nonetheless, there are multiple practice considerations for
schools that relate to HIPAA” p. 18
 Source: Protecting and Disclosing Student Health Information: How to Develop School District
Policies and Procedures. Published by ASHA 2005
51
Legal Obligations & Confidentiality
 HIPAA
 Some agencies that contract to provide
school health services (i.e. Health
Department) are hybrids performing
both HIPAA-covered functions and noncovered or exempt functions.
 A HIPAA covered provider (i.e. Health
Department) may, without
authorization, talk directly with a school
therapist, medical advisor, nurse, or
health aide about a treatment order for
health care in school. HIPAA permits
such communication.
52

HIPAA “authorization” means “consent”
under FERPA in the context of schools.

When school officials request student health
information from HIPAA-covered entities
for educational reasons rather than for
treatment reasons—It is required that
parents sign a HIPAA-compliant
authorization for the information to be
released from health providers to school
administrators.
Guidelines for Protecting Confidential
Student Health Information
 Distinguish student health information from other types of school records.
 Extend to school health records the same protections granted medical
records by federal (HIPAA) and state law.
 Establish uniform standards for collecting and recording student health
information.
 Establish district policies and standard procedures for protecting
confidentiality during the creation, storage, transfer, and destruction of
student health records.
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Guidelines for Protecting Confidential
Student Health Information
 Require written, informed consent from the parent and, when appropriate,
the student, to release medical and psychiatric diagnoses to other school
personnel.
 Limit the disclosure of confidential health information within the school to
information necessary to benefit students’ health or education.
 Establish policies and standard procedures for requesting needed health
information from outside sources and for releasing confidential health
information, with parental consent, to outside agencies and individuals.
 Provide regular, periodic training for all new school staff, contracted service
providers, substitute teachers, and school volunteers concerning the district’s
policies and procedures for protecting confidentiality.
54
Explain Tennessee Coordinated School
Health Law, Scope and Components
overview
T.C.A 49-6-1001
55
Each LEA is authorized to
implement a coordinated
school health program
under the guidelines
developed by the
commissioner of
education, in consultation
with the department of
health, pursuant to 49-11002 during the 2006-07
school year and shall
implement such program
by the 2007-08 school
year.
CSH Model Components
 Comprehensive school health education
 Physical education
 Health services
 Nutrition services
 Counseling, psychological, and social services
 Healthy school environment
 School-site health promotion for staff
 Family and community involvement in schools
56
57
Students cannot be totally committed
to Learning until basic needs are
addressed
MASLOW
58
School Health Index
The eight modules are:
1. School Health and Safety Policies and Environment
2. Health Education
3. Physical Education and Other Physical Activity Programs
4. Nutrition Services
5. Health Services
6. Counseling, Psychological, and Social Services
7. Health Promotion for Staff
8. Family and Community Involvement
59
School Health Index
 Enables schools to identify strengths and
weaknesses of health promotion policies and
programs.
 Enables schools to develop an action plan for
improving student health.
 Engages teachers, parents, students, and the
community in promoting health-enhancing
behaviors and better health.
60
Our Students
 What are the most pressing issues facing children and youth
in our schools today?
 Are the needs of our students being met?
61
Behaviors that affect health and
learning
 Tobacco Use
 Unhealthy dietary behaviors
 Inadequate physical activity
 Alcohol and other drug use
 Risky health behavior in relationships
62
Effects of Activities related to Coordination
of School Health Components
 Reduced absenteeism
 Improved health awareness through increased screenings
 Increased access to health care services; delayed onset of certain health-risk
behaviors
 Increased health education
 Greater interest in healthier diets
 Increased participation in physical fitness activities
63
Benefits to Students & Staff

Physically active students are more alert and concentrate better in the classroom.

Students learn to make healthy decisions.

Students and families get emotional support during critical times.

Teachers and staff can be role models for physical fitness and health.

With family involvement in schools, programs reflect the needs, priorities, and values of the
community.

When nutritious food is available at school, students are not hungry and can learn better.
Source: Talking about Health is Academic M-I, OH-9
64
Barriers to Coordination
 Resistance to change
 Teachers are not health care providers
 Encroaching upon territory of practitioners in Health Education, Counseling,
Nutrition, Physical Education, Health Services
 Community Involvement waxes and wanes
 Time and availability
 Funding resources
 Knowledge deficit
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Where do we go from here?
Source: Standards and guidelines for Tennessee’s Coordinated School Health Program 4.204
 Understand the role of the Coordinated School Health.
 Build Healthy School Teams, Staff Coordinating Council, and School
Health Advisory Council at district level.
 Develop and maintain local school system policies that address and
support a coordinated school health program and each of the
integrated components.
 Incorporate into all school improvement plans easy-to-implement
and appropriate assessments and surveys, improvement strategies
and services, and integrated learning activities that address the
health and wellness needs of students and staff.
66
Strengthening Relationships in Schools
 Encourage Interdisciplinary Work
 What is your role?
 Who are the major players?
 What is the process for strengthening integration?
 What is strategy for clarifying roles?
67
Four Key Processes
Communication
Cooperation
Coordination
Collaboration
Source: Talking About Health is Academic (Module III)
68
The Four (C’s)
 Good communication often leads to better cooperation and
coordination.
 Cooperation draws on the spirit of the individuals and can foster
positive exchange and sharing of ideas and materials.
 Coordination requires time and commitment and build on the
groundwork established through informal information sharing.
 Collaboration means creating formal relationships among
individuals and organizations committed to a common vision,
mission, and goals. Everyone’s work is ultimately strengthened.
69
Getting Beyond Turf issues
 Clarify roles
 Understand what others do and learn how you can
complement them in their role
 Contribute your professional background and
knowledge towards the mission of Coordinated School
Health
 Assess personal objectives for participating at the
current level you participate
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How can we promote and support
change?
 It is first important to understand the steps a system
takes to develop a coordinated approach to school health
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Key Players and Leaders identified
Assess and map resources
Planning
Encourage a supportive environment
Ensure adequate time and commitment
Manage relationships
Guided Questions to Aid in School
Health Planning
 How do you plan to manage aspects of school health and
policy compliance for your school?
 Healthy School Team—(designate one administrator as a HST
Coordinator and also one faculty member as the HST Leader)
 Medication Administration—(must designate one clerical staff person
as the medical assistant and also designate a back-up person) annual training
required
 Plan for addressing individualized health concerns
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Guided Questions to Aid in School
Health Planning
 What is your approach for ensuring all faculty and staff are
oriented and trained appropriately in the following:
 Health Care Management Policy #6043
 Basic First Aid
 Chronic disease signs and symptoms (e.g. cardiac, allergy, seizures,
diabetes, asthma, etc.)
 Bloodborne Pathogen (BBP), HIV, Universal Precautions
 Do you anticipate the material covered in this Coordinated School
Health training to be relevant for school operations? Why or why
not? What could be improved for your purpose of content redelivery?
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Questions?
 Main phone: 901-473-2658
 Office phone: 901-473-2693
 [email protected]
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