Similarly, organizations such as the National Association of School Psychologists, the American School Counselor Association, and the National Association of Social Workers have published position statements and standards for their professions. The American School Food Service Association has recently released standards for school foodservice and nutrition practices (American School Food Service Association, 1995). The National Association of School Nurses has defined roles and standards for school nurses (Proctor et al., 1993) and provides a system for disseminating information and training to nurses who practice in schools. A majority of states have state school nurse consultants, many of whom have distributed sample policy and procedure manuals from their state department of health or education or both, to guide the development and delivery of health services in local settings. There is similarity, however, in the types of services offered from one school system to the next, which is likely the result of several factors. Some of the factors that contribute to these variations include student needs, community resources for health care, available funding, local preference, leadership for providers of school health services, and the view of health services held by school administrators and other key decisionmakers in the school systems. The goals and program elements of school health services vary at the state, community, school district, and individual school levels. Common Elements of School Health ServicesĪlthough a universally accepted definition of the term ''school health services" has not been adopted, the School Health Policies and Programs Study (SHPPS) has described school health services as a "coordinated system that ensures a continuum of care from school to home to community health care provider and back" (Small et al., 1995).
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