Chapter 1

Coordinated School Health Program

This chapter provides guidance for implementing a coordinated school health program and outlines the roles and responsibilities of school personnel.

Overview

Implementing the School Health Program

To be successful, a coordinated school health program requires collaboration among staff within the school district and community members representing the various components. The New Mexico Coordinated School Health Model includes the following eight components: Nutrition, Physical Education and Activity, Family, School and Community Partnerships, Health Education, Life Skills, Healthy and Safe Environment, Social and Emotional Well-Being, School Health Services, and Staff Wellness. Important team members in this collaboration include the school board members, administrators, school nurses, school health assistants, teachers, counselors, food services staff, and staff at school-based health centers.
School Health Advisory Councils (SHAC)

A coordinated approach to school health improves the overall well-being of young people and enhances their capacity to learn through the support of families, schools, and communities working together. Coordinated School Health is about keeping students healthy over time, reinforcing positive healthy behaviors throughout the school day, and making it clear that good health and learning go hand-in-hand. The School Health Advisory Council (SHAC) is a district advisory council that works on ensuring that health and wellness are at the core of learning. The SHAC is made up of a broad cross-section of parents, business and community leaders, and school personnel. A SHAC facilitates communication and problem-solving about health-related issues of children and youth. SHACs can assist schools in carrying out responsibilities for promoting and protecting the health of students and employees. An active SHAC is an excellent means to enlist parent and community involvement in the schools. The SHAC can provide a way for the schools to utilize valuable professional resources in their programs. The SHAC works with the district to help school communities support wellness and academic achievement.

Every public school district or public charter school in New Mexico is required to have a SHAC. They are an essential part of a comprehensive school district wellness policy. The SHAC and the wellness policy both promote academic success and lifelong well-being of students in New Mexico. The New Mexico Public Education Department (NMPED) has developed a school district wellness policy guidance document which is intended to assist school districts in developing and implementing a comprehensive school district wellness policy as required by NMAC 6.12.6. Other documents essential to a complete wellness policy are found on the NMPED website.

School Administrator Responsibilities

The School Administrator provides leadership for all phases of the school health program including the development and maintenance of policies. He/she works closely with the school nurse in the planning and implementation of the school health program. The School Administrator is responsible for seeing that all students and employees under his/her authority comply with state laws and regulations relating to health and safety issues. It is the Administrator’s responsibility to operate the school in accordance with all federal and state laws, in addition to NMPED regulations.

School Board Responsibilities

The local School Board for the school district assumes responsibility for overall health policies as well as budget, facilities, planning, and personnel. The School Board is an asset to the implementation of school health programs, including a SHAC. One recommendation is to have a School Board member on the SHAC.

School Nurse

The NMPED-licensed School Nurse's responsibilities include, but are not limited to, the following activities:

  • Participating in planning, implementation, and evaluation of the school health program.
  • Acting as an advocate for the health needs and rights of students.
  • Delivering health services to students using nursing processes to assess needs, plan interventions, and evaluate outcomes.
  • Providing and/or assisting with access to health counseling and guidance for students on an individual basis or within a group setting.
  • Participating in health education program activities for students, school personnel, and the community.
  • Facilitating communication between the student, family, medical provider, and the community.

The National Association of School Nurses (NASN) has adopted a Framework for 21st Century School Nursing Practice which outlines the structure and concepts of the complex clinical specialty practice of school nursing.

School Health Assistant

The School Health Assistant is a paraprofessional employed to assist and support the School Nurse so the nurse may have more time and opportunities to utilize professional nursing skills in the school health program. The School Health Assistant, supervised by the nurse, provides health-related services as assigned by the nurse. Completion of a NMDOH- and NMPED-approved training is a requirement for School Health Assistant Licensure.

Licensed Practical Nurse

The principal role of the school Licensed Practical Nurse (LPN) is to assist the licensed School Nurse with the implementation of the school health program by providing practical nursing care for students in the health room and by meeting the complex needs of medically-fragile/severely-disabled students. The LPN must be supervised by the Registered Nurse (RN) School Nurse.

Teaching/Instructional Staff

The instructional staff involvement in the school health program includes the following responsibilities:

  • Making informal observations regarding the health status of students and reporting concerns to the school nurse.
  • Incorporating and coordinating health education as directed by the school district's K-12 health curriculum.
  • Ensuring that students receive adequate first aid services.
  • Encouraging students to evaluate their own health and health behaviors and to take responsibility for seeking improvement.
  • Setting a good example as a role model regarding desirable health habits, attitudes, and practices.
  • Accommodating all students' health needs in the classroom.
Counseling Staff (Counselors, Social Workers, Psychologists)

The counseling staff's involvement with the school's health program is essential for a successful program and might include the following responsibilities:

  • Providing individual and group opportunities to promote emotional and social health, personal growth, and self-understanding, as well as teaching problem-solving and decision-making skills.
  • Identifying students who demonstrate emotional and/or behavioral disturbances and cooperating with staff and supporting personnel in assessing those students and assisting their families to seek help through school and community resources.
  • Serving as resource personnel to other school staff for the planning of in-school services, the development of applicable curricula, and the identification of available alternatives to serve students.
  • Assisting the teacher, administrator, nurse, parent, and any other appropriate person(s) to help meet the needs of students engaged in counseling.
Food Services Personnel

The food services personnel assist the administrator in the organization of the school meal programs and assume responsibility to provide nutritious meals to students in accordance with state and federal laws. In addition, local school districts must consider individual accommodation for students with special nutritional needs.

School-Based Health Centers

School-Based Health Centers (SBHCs) provide comprehensive health services, so that students can avoid health-related absences and get support to succeed in school. SBHCs are a cost-effective and accessible way to provide age-appropriate primary care, behavioral health, and dental services for students in schools. SBHC services are complementary to, and supportive of, the services provided by school nurses and other health professionals in the school setting. The National Association of School Nurses has published a fact sheet describing the difference in roles between the SBHC and the School Nurse and how they collaborate together to enhance student health, overall well-being, and academic success. More information on school-based health centers can be found at the New Mexico Alliance for School-Based Health Care.

Licensure

The NMPED requires licensure for various levels of school health staff, as well as teaching staff. School Nurses must be licensed by the New Mexico Board of Nursing as well as the NMPED. Health Assistants must attend a one-time training by the NMDOH prior to being licensed by the NMPED.

Health Office Requirements

The health room is designed to meet the needs of the school population it serves. It is to be accessible to all students, parents, and staff and meet the American Disabilities Administration (ADA) requirements.

Per the New Mexico Administrative Code 6.27.30, a school facility shall have spaces for the delivery of student health, counseling, testing, and ancillary programs. The student health or nurse's suite shall have space to isolate any sick student(s) from the other students. It shall include secure storage for records, medications, and supplies, and it shall have a telephone.

This space shall be a designated space consisting of at least 1 net sf/student of the planned school program capacity or average enrollment with a minimum of 150 net sf. The student health or nurse's suite shall have a connected accessible restroom, not included in the minimum.

Additional considerations from the New Mexico Public School Adequacy Planning Guide are as follows:

  • The school nurse's area should, if necessary, be adjacent to and entered by way of the school's central control and reception area.
  • The school secretary should, if necessary, have direct visual contact with the health reception area.
  • There should be sufficient space to conduct eye examinations (minimum of 20 feet).
  • The office for the nurse or the nurse's aide shall be provided with a telephone.
  • Student health records must be maintained in secure storage.
School Nursing Staff Medical Oversight

The NMPED licenses school nurses in New Mexico. However, it is the NMDOH that provides the medical oversight of all school nurses per the New Mexico State Statute 24-1-4(B) of the Public Health Act. The New Mexico Public Health Act of 2016 states “a regional health officer shall provide medical oversight to school nurses in the regional health officer’s region. A school nurse shall make reports relating to public health as the regional health officer in the school nurse’s region requires.” Regional School Health Advocates assist the regional health officers and the school districts in their regions in compliance with this statute.

School Nurse Evaluation Tools

Representatives of the NM School Nurse Advisory Committee (SNAC) developed supervision and evaluation tools for the different levels of school nursing using the NM School Nurse competencies and the National Association of School Nurses' position statement on school nurse supervision and evaluation.

Evaluation Tools for Non-Medical Supervisor Use

Two nurse evaluation tools are available for use in those schools where a non-medical person evaluates the performance of the School Nurse. For the non-medical evaluation of nurses, there is a tool for the building principal or on-site evaluator and another for the superintendent or other evaluator outside of the school building. With the increasing complexity of the health and social needs of students, leadership for the School Nurse is critical in coordinating various health services. Use of these evaluation tools can assist in defining the role of the School Nurse and assessing her/his skills to meet the health-related goals of the school and/or school district (see links below).

Evaluation Tools for Medical Supervisor Use

The tools developed for the professional licensed School Nurse are aligned with NMPED competencies for school nurses and are for use by the supervisor evaluating the clinical performance of the nurse. It is recommended that they be used in conjunction with the non-medical tools for evaluation of the nurse’s performance. For nurses who do not have medical supervision, these tools can be used as support to address this issue with school administration and to discuss who might assume that role.

For more information, see:

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