Updated: March 2017

Author: Division of Maternal and Child Health, Vermont Department of Health

This is a new performance indicator for the Division of Maternal and Child Health (MCH) at the Health Department beginning in 2017. Although promoting connections between School Nurses and medical providers has been an activity of the Health Department School Liaisons (12 public health staff located in each of the Office of Local Health district offices that work closely with schools) for some time now. One of the roles of MCH is to promote the recommended health supervision visits as described in the American Academy of Pediatrics’, Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents in the student’s medical home. This is Vermont’s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) periodicity schedule. School Liaisons promote the use of Bright Futures and the recommendation of an annual well-care visit for the school-aged population with schools and medical providers. School Nurses are important partners in both promoting this recommendation, and referring children and families to providers when health related issues are identified.

We encourage collaboration between school nurses and medical providers to support improved health, wellness, and safety for children and youth. Ensuring students are healthy and their special health care needs are addressed helps support educational outcomes and reduced absenteeism.

• The Vermont Department of Health Divisions of Maternal and Child Health and Division of Health Statistics and Informatics.
• Office of Local Health (specifically the Health Department School Liaisons located in each of the 12 district offices)
• Vermont Chapter of the American Academy of Pediatrics
• Vermont Academy of Family Physicians
• Vermont State School Nurses’ Association
• school nurses
• schools
• Local Education Agencies

Keeping students healthy so that they can attend and fully participate in school is very important for academic achievement. School Nurses are important members of health care teams, and are in a great place to connect individuals and families with the medical home. They play an important role in managing chronic health conditions, and they can act as extensions of the medical home as they implement treatment plans and reinforce medical home messaging while students are in school. Coordination and case management for students with chronic or special health condition needs is very important, as is timely and accurate communications with the student, family, school health personnel, and the student’s medical home (and specialists). School Nurses can work with providers to ensure treatment plans are effective and being followed. It is important for medical providers and school nurses to develop a system for referrals and communication to support efforts related to chronic disease management and surveillance for suspected health issues (both are important functions of a School Nurse). School Nurses use electronic health records (EHR) to track important health information for those with chronic illnesses. EHRs are useful for developing individualized health plans and/or emergency care plans for a student. EHRs are useful for tracking the training of school staff for delegated responsibilities, care or education discussed with student and or parents related to disease management and self-care skills, and referrals made to other health care professionals.

For more information about the role of school nurses and connections to medical providers:

• Role of the School Nurse in Providing School Health Services (American Academy of Pediatrics, Council on School Health, Pediatrics, May 2016)
• Framework for 21^st Century School Nursing Practice (National Association of School Nurses)

The Health Department will continue to work with school and medical partners to promote collaboration and coordination to ensure that students with chronic or special health conditions receive necessary medical care to ensure they are healthy and actively able to participate in learning.

The data for this indicator is from the School Health Profiles a system of surveys used to monitor school health policies and practices. The School Health Profiles are conducted biennially among middle and high school principals and lead health educators. Vermont schools have participated in the School Health Profiles since 2002. Originally conducted by the Agency of Education, the Vermont Department of Health began administering the survey in 2014.

This indicator comes from the principal’s questionnaire. The survey question wording is shown below:

Does your school provide referrals to any organizations or health care professionals not on school property for students diagnosed with or suspected to have any of the following chronic conditions? Include referrals to school-based health centers, even if they are located on school property. (Mark yes or no for each condition.)

Condition Yes / No

a. Asthma ………………………………………...............….
b. Food allergies………………………………..............…
c. Diabetes ……………………………………….................
d. Epilepsy or seizure disorder ………..............…..
e. Obesity.………………………………................…………
f. Hypertension/high blood pressure .............…

The numerator for this indicator percentage is the number of respondents indicating “yes” to at least one of the conditions above. The denominator is the number of principals that indicate “yes” or “no” for at least one condition (a-f).