Guidance for Schools on Developing Health Services Policies

The primary concern of all educators is to ensure that every student achieves academic success. In order to attain this success, students must be healthy and ready to learn. Given the complex needs of many children attending school today, it is imperative that districts implement policies that address not only the educational needs of students, but their health and safety needs as well.

In the context of schools, policy is defined as a general principle, guide for decision-making or rule adopted by the board of education. Policy is typically a broad outline of what should be done and is legally binding. It is distinct from protocol, which is a procedural statement typically developed by health services leadership that includes specific instructions or a sequence of steps for assessing and managing a particular clinical issue.

School health services policies:

• Define the structure of a health services program and guide staff in providing optimal care while avoiding problems.
• Offer direction and guidance for health services provided within the school district.
• Set expectations for students, parents, staff and administrators.
• Provide consistency and continuity across the district and reflect laws and regulations.

This webpage provides guidance to assist the school district’s health services leaders in developing district health services policies.

The Policy Process

Each district has a unique process for developing, reviewing, approving and implementing district policy:

• The health services director, or lead nurse, is responsible for developing health and safety policies.
• If the district has a policy writer, then health services director’s role is typically to provide content for the policy writer to use in drafting policy.
• The medical director or school physician may take the lead in developing policy in collaboration with the health services director.
• If there is no health services director, or lead nurse, the building-level nurses may work with district leadership to develop policies.

In almost all school districts, policy must be approved by the school board before going into effect. Some school districts may require multiple readings of a policy at subsequent board meetings before a vote can be taken. Other districts may only require a proposed policy to be discussed at one board meeting but may require a specified number of days to pass before a proposed policy can be voted upon.

It is important for school health services leaders to understand the process in their district in order to exercise effective and appropriate leadership in the development and review of health services policies. Rules and regulations regarding school board proceedings can often be found on a school district’s website. Alternately, a representative from the superintendent’s office should be able to provide the necessary information. It is also helpful to speak with those involved in the policy process in order to gain a better understanding of the rules and required steps as well as the culture around policy in the district. For example, some school boards prefer to limit what is set in policy, while others view policy as an important legal protection. Prior to engaging in the policy process, it is critical to review federal, state and district rules around lobbying that might regulate how district employees may interact with the school board.

Components of School Health Services Policy

A school district policy is a broad statement that provides overarching guidelines and usually does not include a great level of detail. In general, the specific instructions on how to carry out the policy are found in protocol/procedures, though some school districts include protocol/procedures within policy.

The format and components of school health services policies vary from district to district. When drafting policy, it is helpful to consult existing policies and follow a similar style and structure. The following are key components that are often included in a school district policy:

1. Background or Purpose Statement
   This section includes information about the issue addressed by the policy, provides justification for the policy and/or expresses the policy overall intent.
2. Definitions
   This section defines key terminology used in the policy.
3. Legal Requirements or References
   This section provides a summary or list of federal and state laws/regulations that impact the policy.
4. Body
   This section contains the content of the policy and summarizes what the school district will do, provide and/or be responsible for.
5. Responsibilities and Qualifications
   This section lists the key roles and responsibilities of various positions (e.g. teachers, administrators, nurses, students, parents). Any specific licensing or training that is required in order to carry out certain duties set forth in the policy would be listed here.
6. Cross Reference or Related Policies
   This section lists related policies, if applicable (e.g., a policy on asthma management may reference the school district’s medication policy).
7. Authorizing Information
   The policy document typically contains a policy number and the effective or adopted date.

How to Develop a School Health Services Policy

While the specific procedures will vary from district to district, the steps below provide general guidance on how to go about developing a school health services policy.

1. Identify the issue and be able to articulate why it is a problem. Is there data to support the importance of this issue? Is there a new recommendation for best practice, or a legal mandate that needs to be addressed?
2. Determine whether a policy is necessary and appropriate. Does the issue affect the entire school district? Does it need to be addressed at the policy level, or would a protocol or procedure be more appropriate? Does the district have the necessary resources to implement the policy? Is there evidence, best-practice or law to guide the development of the policy?
3. Determine your role in the policy process and identify the specific steps and requirements for passing policy in your school district.
4. Gather resources to inform the policy, including examples from other school districts; guidance from local, state and national organizations; research articles; relevant laws and regulations; related policies and protocols; and relevant information from employee contracts, job descriptions and employee guidelines.
5. Collect input from community members and partners, including school nurses, the school physician, district leadership, staff, parents, students, public health, community healthcare providers and any others who will be affected by the policy or have expertise to share.
6. According to district procedures, draft the policy or provide expert recommendations and submit for approval. As stated previously, when drafting policy, follow the general style and format used in the district.
7. Provide explanation of what the policy does and why it is needed. The school board should receive an explanation, in layman’s terms, that includes the scope and consequences of the issue, the evidence supporting the policy and the connection to educational outcomes. Depending on the district’s policy process, the nurse leader may provide this in-person, in writing, or through a “policy champion” such as the district’s medical advisor, legal counsel or superintendent.

To be effective, once a policy is passed it must be implemented and evaluated regularly.

This webpage was supported by Cooperative Agreement Number NU38OT000282-04-00, funded by the Healthy Schools Branch - Centers for Disease Control and Prevention. Its contents are solely the responsibility of the American Academy of Pediatrics and do not necessarily represent the official views of the Centers for Disease Control and Prevention of the Department of Health and Human Services.