Enhancing School Health Services Through Training, Education, Assistance, Mentorship, And Support Laura Frankel DeStigter, MPH

 62,000 members  Dedicated to attaining optimal physical, mental, and social health for all infants, children, adolescents, and young adults

American Academy of Pediatrics  Our stats:  450 Employees  66 Chapters  29 Committees  50 Sections  7 Councils

National committees, councils, action groups and task forces  NATIONAL COMMITTEES  Adolescence  Bioethics  Child Abuse & Neglect  Child Health Financing  Coding & Nomenclature  Continuing Medical Education  Development  Drugs  Early Childhood  Federal Government Affairs  Fetus & Newborn  Genetics  Hospital Care  Infectious Diseases  Medical Liability & Risk Management  Membership  Native American Child Health  Nutrition  Pediatric AIDS  Pediatric Education  Pediatric Emergency Medicine  Pediatric Research  Pediatric Workforce  Practice & Ambulatory Medicine  Psychosocial Aspects of Child & Family Health  Residency Scholarships  State Government Affairs  Substance Abuse  COUNCILS Children With Disabilities Clinical Information Technology Communications & Media Community Pediatrics Environmental Health Foster Care, Adoption, and Kinship Care Injury, Violence & Poison Prevention School Health Sports Medicine & Fitness  ACTION GROUPS Medical 1 Medical 2 Multidisciplinary Surgical Advisory Panel  TASK FORCES Circumcision Infant Positioning & SIDS Mental Health Leadership Work Group Newborn Hearing Screening

Sections  Administration & Practice Management  Adolescent Health  Advances in Therapeutics & Technology (Prov)  Allergy & Immunology  Anesthesiology & Pain Medicine  Bioethics  Breastfeeding  Cardiology & Cardiac Surgery  Child Abuse & Neglect  Clinical Pharmacology & Therapeutics  Complementary & Integrative Medicine  Critical Care  Dermatology  Developmental & Behavioral Pediatrics  Early Education & Child Care  Emergency Medicine  Endocrinology  Epidemiology  Gastroenterology, Hepatology & Nutrition  Genetics & Birth Defects  Hematology/Oncology  Home Care  Hospice & Palliative Medicine  Hospital Medicine  Infectious Diseases  Internal Medicine – Pediatrics  International Child Health  Medical Students, Residents and Fellowship Trainees  Nephrology  Neurology  Neurological Surgery  Obesity  Ophthalmology  Oral Health  Orthopaedics  Osteopathic Pediatricians  Otolaryngology-Head & Neck Surgery  Pediatric Pulmonology  Perinatal Pediatrics  Plastic Surgery  Radiology  Rheumatology  Senior Members  Surgery  Telehealth Care  Transport Medicine  Uniformed Services  Urology  Young Physicians

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AAP and school health  Council on School Health (COSH)  Policy statements  Manuals and reference guides  State-level school health committees

TEAMS Project

TEAMS project background  Purpose: to assist school districts in making improvements to their school health services  Funded by Centers for Disease Control and Prevention (CDC) School Health Branch  Will work with ~35 school districts over the course of the project  3 cohorts  3-member teams

ORANGE= States with participating school districts

Project rationale  Schools provide a key point of access for health care  Strengthening school health services will help improve the health of students and will lead to better educational outcomes  Children will benefit from a coordinated health system

Project Framework 12 Sustain Evaluate Implement plan and monitor Develop plan Identify issues Adapted from: -Uncommon Solutions -Issel, L. M. (2004). Health Program Planning and Evaluation. Sudbury: Jones and Bartlett. -New Zealand Health Promoting Schools Inquiry Cycle -Strive -Strive Site Level Theory of Change Strategy Phase Implementation Phase Form team

Project activities: Webinars  Year 1 Topics:  Working Together Series  Stakeholder Engagement  Identifying Issues  Demonstrating Success

Project activities: Webinars  Year 2/3 Topics:  Medicaid Reimbursement for School Nursing Services  Coordination between School Health Services and the Medical Home  Diabetes Management  Food Allergy Management  Others, TBD

In-person training

Health services Assessment Tool for Schools (HATS)

Structure of HATS  Module 1 – Services  Chronic and acute conditions  Preventive services  Emergency care  Counseling and health information  Referrals, linkages and care coordination  Psychosocial identification and reporting  Sexual health services

Structure of HATS  Module 2 – Infrastructure  Internal communication  Tracking and reporting  Funding  Administration and staffing  Coordination with school-based health centers

Scoring Green  Good job, key elements in place Yellow  Nice start, but room for improvement Red  Needs attention, key elements not in place

Other project offerings

School leaders

Team accomplishments  Engaged stakeholders  Implemented new services  Increased staffing  Improved data collection and reporting

Team accomplishments  Secured grant funding  Developed new and updated forms and tools  Developed new and updated policies and protocols

Success stories

Biggest challenge for teams

Other challenges  Engagement  Technology  Sustainability

Next steps for TEAMS  Pilot and package resources and training for external use  Document lessons learned and successes  Disseminate

Opportunities  Develop national consensus on definition of school health services  Provide concrete guidance on health services policy and protocol  Promote the importance of nurse leaders/nurse coordinators in each district

Opportunities  Educate pediatricians on supporting school health services; develop and promote new physician- school partnership models  Promote the integration of school health services into the broader healthcare landscape

Opportunities  Develop additional financing streams for school health services  Develop and/or identify and publicize alternative models for providing and funding health services in schools

Questions? Comments?

Laura DeStigter, MPH schoolhealthteams.aap.org My contact info