Integrated health plan proposed for schools

Health department says it could alleviate nurse shortage

By Nick Tabor, New Era Senior Staff Writer 

Donna Crick no longer needs to worry about the school nurse being absent from Crofton Elementary, where her insulin-dependent daughter attends.

The school no longer shares a nurse with Lacy Elementary School — because Lacy now has a diabetic student as well.  

The Christian County Health Department's initial plan for saving on payroll costs hasn't worked out. So in the midst of serious budget shortfalls, the department is now considering an alternate model, called Coordinated School Health, that would depend more heavily on educators.

"There is so much more that should be done in the schools with school health other than nursing," Health Department Director Mark Pyle wrote in an email. "As a community we will need to figure out how to use all tax dollars (school system, health department, others) to efficiently offer a coordinated school health program."

Pyle plans to meet with school officials and discuss this within the next three months. So far he has only discussed it with the Kentucky Health Department Association.  

Early this school year, the health department tried to get by with 14 full-time nurses for the county's 15 schools. For the rest of this year, a part-time nurse will fill the 15th slot, Pyle said.  

Next year the department may or may not return to full staffing capacity. The Coordinated School Health endeavor could affect this decision.

The state has a grant for the implementation costs, according to its website.

The coordination model emerged in the 1980s. It involves eight components: health education in classrooms, physical education, health care, nutritious meals, counseling and psychological services, physical and aesthetic surroundings designed for health, promotion of health among staff, and heavy parental involvement.

For example, the healthy environment initiative might involve looking for biological or chemical agents that hurt students' health, and reexamining temperature, noise and lighting. The health education in classrooms might involve separate courses for each grade, and could comprise of injury prevention and emotional health.

Centers for Disease Control and Prevention has a generic plan to give school districts a starting place.

Once the superintendent and principals get on board, they should appoint someone at each school to oversee health issues, and they should revise mission statements to include health, the CDC recommends.

Later they should start a district-wide health council and create a health team of teachers, parents and students at every school.  

A plan for Christian County could be tailored for students' greatest health needs. They could focus, for instance, on obesity in elementary schools and smoking, drug use and unsafe sex in the high schools.

The CDC's plan puts the onus on school districts. But Pyle imagines spreading responsibilities around, both in terms of funding and supervision.

In the early meetings, he wants to discuss which agency can provide each service most efficiently.

“Maybe it is more about changing the funding structure," he wrote. "The question is not and should not be how many nurses are employed as school nurses, but what services are provided and how efficient the program is in serving our students."

 For more information on Coordinated School Health, visit www.cdc.gov/healthyyouth/cshp/index.htm.