SD22 - The Health Needs of School-Age Children
Executive Summary: The Secretary's Task Force on the Health Needs of School-age Children was an outgrowth of Senate Joint Resolution Number 76 which requested the Secretary of Human Resources to study the health needs of school-age children. The Task Force, under the direction of Secretary of Human Resources, Eva S. Teig, consisted of The Honorable Robert C. Scott, The Honorable Stanley C. Walker, The Honorable J. Samuel Glasscock, the Deputy Secretary of Education, David L. Temple, Jr., the Commissioners of the Departments of Health, Mental Health and Mental Retardation, and Social Services; the Directors of the Departments of Medical Assistance, and Children; as well as representatives from the Virginia Chapter of the American Academy of Pediatrics, Action for Prevention, Inc., Virginia Congress of Parents and Teachers, Virginia Nurses Association, Tidewater Planning Council, Virginia Dental Association, and public/private sector health care service providers. The following discussion will highlight the activities, findings, and recommendations of the Secretary's Task Force Studying the Health Needs of School-age Children. ACTIVITIES OF THE TASK FORCE The Task Force focused its work in three major areas in order to gather the information needed to meet the requirements of Senate Joint Resolution Number 76. The exchange of information, issues, and recommendations was generated through the following activities: 1) Task Force meetings; 2) A survey of school health services for students in Virginia; and 3) Statewide Community Round Table Discussions. FINDINGS The Task Force maintains that while the health of our school-age children has improved dramatically over the past decades, a look beyond the surface reveals that not all of Virginia's children share in this improvement. For example: • Over 50% of Virginia's school-age population at any one time is in need of dental care for the restoration of decayed teeth. • A total of 5,092 cases of gonorrhea in children were reported during 1984-85, constituting 27% of all reported cases in the State. • It is estimated that 10-15% of school-age children are overweight and the incidence of bulimia and anorexia is increasing. • In 1985, 101,517 children and young adults or about 10% of that population were in Special Education programs. Forty-four percent (44%) of enrollees were for learning disabilities, 29% for speech/language impairments; 14% for mental retardation; and 7% for serious emotional disturbances. In addition to the prevalence of traditional illnesses in school-age children, Virginia's youths also face an additional set of health-related conditions collectively termed as the "new morbidity". For school-age children, the "new morbidity" takes the form of problems such as alcohol and drug abuse, teen pregnancy, violent behavior, school drop-out, suicide, depression, and other mental health problems. The ability of Virginia's current school health services system to meet the traditional health needs of school-age children as well as the "new morbidity" varies dramatically across the State. The results of the survey of school health services for students reveal the following about the current school health services system: • Across the State, there is an average of one school nurse for every three schools. • Fourteen school divisions have no school nurses. • A majority of Virginia's school divisions have no medical director or advisory body to assist with school health policies. • Health instruction at the elementary level in Virginia's public school appears to be inadequate. • Compliance with mandatory health screenings decreases substantially at the middle and senior high school levels. • A total of 18 school divisions have no established protocol for emergency medical procedures; 31 school divisions report having no documentation on student injuries occurring on the school grounds. • While many exciting and innovative health activities are being offered by the current school health services system, there still remain unmet health care needs of children. More dental care, nutrition education, family life education, and substance abuse and psychological counseling were cited most often as unmet needs. The Community Round Table Discussions further reinforced the findings of the Task Force meetings and survey. Specifically, the community meetings across the State highlighted the need for: • Increased nursing personnel in Virginia's public schools; • Minimum standards for school health services; • Increased coordination among health and human services providers at the State and local levels; • Mandatory Family Life Education; • Improved access to health care services for medically indigent students; and • Increased health promotion and disease and injury prevention programs in the schools. RECOMMENDATIONS Based on its research and formal discussions, the Task Force recommends the establishment of the following recommendations to strengthen and coordinate school health services to meet effectively the health needs of school-age children in Virginia. Specifically, the Task Force calls for: 1. The number of nurses providing school health services should be increased to allow for at least one nurse in every school or a ratio of one nurse per 1,000 students. 2. Minimum standards for school health services in Virginia should be developed jointly by the Departments of Education and Health. 3. The Departments of Education and Health should establish a nursing position within the state Department of Education to supervise and coordinate the provision of school health services in the Commonwealth. 4. The Department of Education should mandate family life education curriculum in grades K-12 with an emphasis on promoting parental involvement and the fostering of positive family living skills in all public schools in the Commonwealth. 5. The Departments of Health and Education, along with the Virginia Dental Association, should work together on a state and local level to coordinate dental care resources and to increase dental screenings and educational programs. 6. A formal memorandum of agreement should be developed between the Secretary of Human Resources and the Secretary of Education to address overlapping concerns related to the health needs and care of school-age children. 7. The Boards of the Departments of Education and Health should establish a formal agreement to meet jointly at a minimum of twice yearly to advise each of the designated agencies on matters pertaining to school health services policy. 8. The Governor's Task Force on Indigent Care, as well as the Secretary of Human Resources, should specifically address the special health care needs of the school-age child especially the medically indigent. 9. The Departments of Education, Health, and Mental Health and Mental Retardation should co-sponsor at regular intervals continuing education opportunities for school nursing personnel on a regional basis. 10. The Departments of Health, Education, and Mental Health and Mental Retardation should provide for school personnel continuing education opportunities about the new morbidity facing today's school-age children. 11. Every school division within the state should have a school health advisory body composed of public and private sector representatives to assist with school health policy. 12. An interdisciplinary health care plan for school-age children at the local level should be developed with technical assistance from the state Departments of Education, Health, and Mental Health and Mental Retardation as requested. Such a plan should include a component for methods of financing health care services to school-age children. 13. Each school division within the state should establish formal interagency agreements with appropriate community resources involved in the provisions of health care to school-age children. Appropriate community resources may include, but should not be limited to, local health departments, community services boards, social services agencies, institutions of higher education, private sector health professionals, and others. 14. Local school boards should develop, whenever possible, strong relationships with volunteer organizations and the business community for improving the delivery and financing of health care for schoolchildren. 15. The Virginia chapter of the American Academy of Pediatrics should encourage its membership to provide a leadership role at the local level in advocating for and providing a coordinated system of health care for school-age children. 16. The Virginia Congress of Parents and Teachers (PTA) and all other parent organizations should vigorously undertake a parent awareness campaign educate parents about the health needs of school-age children and Increase parental involvement in their children's health. 17 Every school division should establish a cooperative agreement with a physician to serve in the capacity of consulting medical director to provide medical care consultation and backup to nursing personnel. 18. Formal, written emergency medical procedures should be developed in every school division within the state. 19. The state Department of Education should direct all school divisions to maintain appropriate documentation on all student injuries as part of a program of comprehensive risk management. 20. The state Department of Education should continue to monitor and insure that all schools comply with state laws pertaining to vision and hearing assessments. 21. The Department of Education should direct all school divisions to provide time in the curriculum for health education. Further, there should be a strong emphasis on health promotion and disease and injury prevention programs. 22. The Department of Education should assist all school divisions with guidance on the physical education curriculum to develop and emphasize individual fitness programs. 23. The Department of Education should encourage all school divisions to establish after-school programs addressing health issues and concerns. |
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