School health services include assessing and managing student health needs, developing and housing plans for students with chronic
health issues, and screening and referral procedures, all carried out by qualified staff (e.g., school nurse/school nurse consultant).
Regarding staff capacity, the National Association of School Nurses recommends a maximum caseload of 750 well students for every
school nurse full-time equivalent (FTE). The recommended ratio decreases as the number of students with significant health needs
increase (2015). While most schools have some access to a school nurse, fewer than 40 percent report having one school nurse
present for 31 to 40 hours per week (Figure 6.1). In absence of a school nurse, participating schools designate other staff to address
daily health emergencies and chronic needs of students, including health clerks/health aides, administrators, and administrative
Percetage of schools with access to a school nurse
The ability to see and hear are essential for student learning in standardized classrooms. To identify any sensory impairment, the
hearing and sight of all students in kindergarten, first, second, third, fifth, seventh, and ninth grades must be tested during the
school year by qualified personnel (CDE, 2004). Among participating schools, approximately two-thirds of elementary and one-third
of secondary schools provide hearing and vision screenings and referrals in all grades and for new students, while roughly one-third
of elementary and half of secondary schools do so in only certain grades (Figure 6.2). Once referrals are made, over 90 percent of
schools have a follow-up procedure for hearing and vision problems.
Percentage of schools with annual health services screenings & referrals
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