Rebecca King MSN, MEd, CSN, RN School Nurse Liaison WVDE-Office of Healthy Schools

1. “Defining the Role of the School Nurse in the 21st Century” Rebecca King MSN, MEd, CSN, RN School Nurse LiaisonWVDE-Office of Healthy Schools

2. With Much Appreciation to School Nurses

3. Healthy Schools Updates • Centers for Disease Control and Prevention (CDC) Funding • New Executive Director…Keith Burdette • Restructuring • Future positions • Policy 2422.8-Medication Administration revisions slated for public comment in December/January • Monthly WebExs • June 11 and 12, 2013 Conference

4. Objective #1: Participants will reflect with updates on the past year of school nursing and school health services.

5. Reflections • 99.85% of 7th and 12th graders vaccinated with Tdap and MCV in the state of WV! Thanks to school nurses! • We the Parents versus WVDHHR in Kanawha Circuit Court was dismissed citing CDC recommendations, WVaCode and WVBE policy

6. Reflections • WVSIIS becomes the only repository for immunization data. WVDE and WVDHHR/BPH currently working towards a School Nurse Reporting module with data sharing and reports per school. • The hope and plan is to view WVSIIS within the WVEIS screen for each student record to make it user-friendly. 

7. Reflections • Survived the ongoing revisions to WVEIS and continue to endure. • WVEIS reports also on the EHCP site. • We, as a team, continue to move WVEIS toward a more sophisticated system for school health data collection.

8. Reflections • Continue with iPad usage for not only data but face-time with students and staff with assignment/delegation of health care, collaboration with other school nurses regarding student needs and multiple health Apps. • Moved into Universal PreK…not the Head Start, Child Care and Public School Kids….the Universal PreK students. The 2012/13 is the year of celebrating.

9. Reflections • We continue to braid funding, share data and understand state and federal regulations for the good of Universal PreKstudents. • You have continued to mange the added 17,000 PreK students, high acuity needs such as insulin administration, Diastat in school and on a bus, sterile suctioning, anaphylactic shock, etc. with FEW to Zero NEW SCHOOL NURSE HIRES.

10. Congrats for making this conference title a reflection of your daily nursing care… Skilled Nurses + Healthy Students = Educational Success

11. Objective #2: • Participants will be knowledgeable and actively discuss the collective vision for school health services in the State of West Virginia.

12. WE MUST… Think Outside of the BOX Student Needs + Staffing + Resources = Lack of sufficient services, Lack of health promotion, Lack of disease prevention efforts Which leads to SAFETY CONCERNS & BURNOUT

13. The DIRTY FACTS • Lack of proper nursing supports during the school day; • Lack of preventive care; • Lack of health promotion activities; • Adolescents without well-child visits and immunizations; • Poor oral hygiene and health; • 17% increase in teen pregnancy population; • Below proficiency on HEAP scores throughout the state; • Leading in Asthma, Obesity, Hepatitis B and C, prescription drug abuse, etc.; and • Etc.

14. Top 5 Medical Diagnoses/Procedures

16. IDEAS • Round Robin

20. More Ideas… • New models which move school health closer to a medical model instead of an education model. • A School Nurse Practitioner at the RESA to support school nursing through leadership, technical assistance, professional development and guidance related to complex care situations.

21. More Ideas… • Utilizing electronic devices to connect students to medical and dental specialist such as endocrinologist and neurologist at school. • Face time and other electronic programs are currently used around the US for nursing practice. We can move student health into the 21st century to break down the barriers of rural and medically underserved WV.

22. More Ideas… • New funding ideas which moves school health closer to case managers for enrollment of Medicaid. • Funding to support the enrollment of students into Medicaid and CHIP, ensuring medical and dental homes along with annual recommended Well Child and Oral Examination, Asthma Action Plans and Immunizations.

23. More Ideas… • Moving toward Full Service Schools. • Offering WVDHHR services within an office at the school, mental health, dental and medical services. Using the school as a community building for services and events in the evening hours. Linking families and students to the supports they need to be healthy, happy and successful in today’s world.

24. Objective #3: • Participants will be familiar with future legislation and rules which actively affect the role of school nurses.

25. 2012 Resolution Studies • HCR 107 Reproductive Health • HCR 128 AEDs • HCR 129 Safety with Student Athletes and Concussions • HCR 132 Expected Teenage Mothers • SCR 33 Wellness, Nutrition and PE • SCR 81 Exemptions for Immunizations • SCR 84 Religious Freedom Act • SCR 95 Student Harassment

26. “Unsuccessful” 2012 Legislation • School Nurse Ratio bills of 1:750; • AED in every school bill; • Concussion bill; • Religious Exemption bill; • Epinephrine bill for training and prescriptions by anyone over 18 years of age; and • Teenage Expected Parents Pilot Program.

27. Objective #4: • Participants will be provided with information on the vision of Full Service School models throughout West Virginia Public Schools.

28. Full Service School • A school which provides for the whole child with integration of the eight components of school health through school nurses, Health and Physical educators, school staff, community partners, medical, behavioral and dental services, parent supports and services in the school, WVDHHR and community supports…Making your school friendly with a whole child, family and community focus.

29. Health Care Reform • WV children with increased insurance coverage • Expansion of Primary Care Center services and funding (currently serving 1 in 5 West Virginians) • School-Based Health Services • Dental • Mental Health • Family Planning Helping us move to full-service communities/schools

30. How do we get there?

31. Strategies • Know legislative rule, state rules and county policy. • Know your nursing practice act and the role of LPN and UAPs. • Support the Medical and Dental Home concept to move West Virginia towards preventive health. • Validate immunization records and follow provisional enrollments through to completion. • Make adolescent vaccinations and well-child visits YOUR priority NOT an AFTER THOUGHT!

32. Strategies • Follow and implement evidence-based practice. Obtain a medical consultant or form medical advisory board for your county’s school health services program. • Form collaborative teams/ relationships with public health and local WVDHHR entities. • Form collaborative teams/initiatives with medical, dental and behavioral health providers/communities.

33. 2012 RESA-RSWS Focus • Work Plan • Local Wellness • Safe Schools (Policy 4373) • Substance Abuse (SBIRT) • Suicide Prevention (ASPEN) • Teen Pregnancy (HEAP, PREP grants) • Physical Activity (Let’s Move) • Nutrition (current WVDE-OCN initiatives) • Tobacco Prevention (Quit Kits)

34. Together we serve the WHOLE CHILD, THEIR FAMILY & THE COMMUNITY

35. THANK YOU! Have a WONDERFUL Thanksgiving!

36. Rebecca King WVDE-Coordinator School Health and Coordinated School-Public Health rjking@access.k12.wv.us 304.558.8830