Written by Dr. Kelly Kapitz
Several decades ago, school health generally involved ice packs, Band-Aids, and the occasional medication. Typically, these services were provided by a school secretary, teacher, or (if very lucky) a health aide. Today, however, the complexities of the health-care needs of students entering K–12 education are exponentially different.
School nurses and their health aides now often provide life-saving care.
Recent data collected from several rural Marathon County schools suggests that school nurses and health aides experience over 20,000 office visits annually. Services range from managing allergies to clearing tracheostomies and everything in between.
Several years ago, the Marathon County Special Education medical advisor, Dr. Jeffrey Lamont, proposed a project that would help support all students in Marathon County. Already an acting school medical advisor for 8 of 10 local districts, Dr. Lamont wanted to enhance the supports available to school nurses and districts by creating a countywide school medical advisor program, stating:
“The overall purpose is to ensure that all kids are able to fully participate in school activities regardless of their health care needs. With the increased diversity of health care needs that kids bring to school, it is important to provide the school nurses and their staff with the support they need to provide great continuity of care.”
Under Wisconsin law, school districts are required to have access to a registered nurse and up-to-date emergency medical plans, as well as access to a physician medical advisor.
The makeup of a school district’s student body in 2018 looks very different from that of 20, 30, or 40 years ago. More students come to school with unusual or complex medical conditions, thus school nurses are being called to go above and beyond to serve those children’s medical needs.
A countywide medical advisor can support the work of school nurses by providing them with real-time access to a physician to consult on complex cases or to assist them with accessing the medical community for resources. The role is complementary to the great work and services that school nurses and districts are already providing.
School nurses working in rural communities are particularly challenged since one school nurse is often shared by several smaller districts. In larger districts, one nurse can be spread between multiple buildings. This pilot program is especially appealing to them, as it helps put student health care in the spotlight of educational conversations. Trina Kaiser, school nurse for the Abbotsford, Athens, and Spencer school districts, commented:
“The Medical Advisor is an asset to the school nurses in that the position helps us navigate and communicate with other medical entities that we collaborate with. Dr. Lamont’s role bridges that gap. The project also allows school nurses to have a community of practice to help standardize our procedures and improve our services to students.”
Now referred to as the Central Wisconsin Nursing Consortium, school nurses have a vehicle for addressing the pressing issues they face with a greater voice.
Marshfield Clinic was an early supporter of the idea and helped to give it wings. For the 2018–19 school year, Marshfield Clinic is providing grant funding to give all schools in Marathon County access to Dr. Lamont’s services.
The advising services do not include direct services to students. Rather, the medical advisor is able to provide support and guidance to the 10 school districts on:
- Health issues
- Navigating medical systems
- Training and support to school nurses and health aides
- School policy
- Standing orders
- Helping families access services
This school medical advisor project is unique in the state. While other school districts utilize physicians as medical advisors, there are no other collaborations in Wisconsin that include such diversified stakeholders. Often districts will select a local physician to provide standing orders and some emergency procedure supports. These physicians provide this support in addition to their already heavy workloads. The countywide medical advisor, however, is a physician who is fully dedicated to school health issues and is able to address issues as they arise. This type of service is unknown in any of the other 71 counties.
The medical advisor project also brings together private, school, and County organizations to support school health: The Marshfield Clinic, the Marathon County Health Department, and area school districts are all working in concert to improve care for children. The 10 school districts participating in this program include:
- D.C. Everest
Jay Schrader, Vice President, Community Health & Wellness, Marshfield Clinic Health System, helped to launch the program and recognizes the opportunity to provide excellent continuity of care for all students in Marathon County:
“This is an important initiative to Marshfield Clinic Health System and an exciting,
innovative way to support our schools in providing school health services to our children.”
This isn’t a special education issue; it’s an all-student issue . . .
Many students miss school each year due to illness or injury. Most of these students are not students with disabilities. School health is about improving the over well-being of the entire student body by reducing absences, connecting families to providers, and increasing education opportunities for school nurses, health aides, and staff. Also, by improving and standardizing school communication with the medical community, students will experience a better continuity of care.
The partnership aims to open doors to collaboration and innovations and solidify the commitment of health system leaders to both school and community health. This project is a win for the schools and the community.
School nurses who wish to learn more about this initiative may call Dr. Lamont at his office: 715-261-1980.
Kelly Kapitz, PhD
Director | Marathon County Special Education
Dr. Kelly Kapitz is the Director of Special Education for the Marathon County Special Education Department. She has 30 years of experience as both a school psychologist and director of special education and pupil services. Currently the Special Education Department supports 6 school districts, 428 students, and 104 staff. Kelly’s entire career has been in the services of Wisconsin rural schools. Her passion is supporting all students in acquiring a high-quality educational experience. Kelly and her husband have three children and enjoy tending their apple orchard and traveling. Email Dr. Kelly Kapitz.
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