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KY Study: Patchwork Approach to School Health Services

April 1, 2011

FRANKFORT, Ky. - Some children's advocates in Kentucky are convinced that more low-income kids would do better in school if that is also where they received physical, dental, and mental health care.

Terry Brooks, executive director of Kentucky Youth Advocates, says the group's new study reveals Kentucky's patchwork of school-based health services varies in quality and investment. It indicates most school districts spend less than one percent of their budgets on onsite health services and few meet the nationally recommended nurse-to-student ratio.

"No one is suggesting that schools suddenly cut teachers or reduce technological support in order to have a school nurse. Instead, what we're looking at is, how can we reconfigure existing resources?"

The research, done during the 2008-2009 school year, found the average Kentucky school district provides one nurse for 1,254 students. The National Association of School Nurses recommends a ratio of one nurse to 750 students.

As Kentucky educators wrestle with improving student test scores, Brooks says connecting mind to body is a key to student performance.

"We know that, while curriculum is important and teaching methods are important, it's also important to have kids who are physically and mentally healthy and well, to maximize their learning."

The Foundation for a Healthy Kentucky commissioned the study from Kentucky Youth Advocates and the University of Louisville. Foundation Executive Director Susan Zepeda says its concern was that Kentucky lacked a complete picture of the quality of school health care services and how they are paid for. The challenges cited in the research present some unique opportunities, says Zepeda.

"There may be a hospital; there may be a Community Health Center. There may be a business that wants to, if you will, 'adopt a school' and help make access to health care stronger in their community, recognizing that link between health and learning."

According to Brooks, some school district health services are supported through philanthropy, while others rely on collaborations with local health departments. As Kentucky moves to provide Medicaid services through a managed-care approach, the move could be a catalyst in ensuring that all 174 school districts have consistent quality and access, says Brooks.

"And this is the time for the governor and for other state officials to embrace this idea and make sure that they are thoughtful as we move into this new way of doing business with Medicaid."

The report, "A Picture of Health: A Report of Kentucky School Districts' Health Services," can be viewed at It also notes that the health-related services offered at schools are very basic overall, generally lacking in the areas of mental health, substance abuse and dental health.

Renee Shaw, Public News Service - KY