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Schools’ Role in Systems of Care for CSHCN


Primary Contact: Dian Baker, PhD, MA, MS

Grant Amount: $220,532 for 12 months

Date Awarded:


To obtain information on the experiences of school personnel, especially school nurses, in working with and caring for CSHCN; and to identify recommendations that would improve the integration of schools as part of the system of care for CSHCN.


The findings from this study reflected data from a statewide school nurse advisory council, key informant interviews and a survey of nearly one thousand school nurses in California. Only 43% of California school districts report having school nurse personnel, and on average among those with a school nurse that individual had responsibility for six schools. Consequently, 1.2 million students had no access to a school nurse. Schools may often be unaware of children with chronic health problems unless those problems directly interfere with education and thus those children will have an IEP. In the absence of school nurses, other school staff members must assume health care responsibilities for which they are not only unlicensed/certified but also untrained. Schools generally lack established communications with community child health care providers who could provide some backup to staff. Some of the existing problems can be addressed by district supervisors or the State Department of Education; others may require legislative action.

Related Resources

Health services for California students with special health care needs vary greatly by school district, are provided by a variety of school staff, operate under a confusing patchwork of regulations, and are often underfunded, according to a new study. Researchers from California State University-Sacramento’s School of Nursing analyzed 2011-2012 state education data, interviewed school education experts, and conducted a large-scale survey of certified school nurses who are members of the California School Nurses Association.