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Commenting for this proposal will be open until the close of business on Monday, June 5.

Title of Proposal:

Physician oversight of medical services in the school setting

On behalf of:       

Dr. Cindy Devore

Describe the Idea or Issue:

The AMA, AAP support that all health and wellness programs within a school should be supported and overseen by a physician, ideally one trained in the care of children, such as a pediatrician or family medicine specialist. Children are in schools today with many significant health concerns that require both routine and emergent intervention as well as collaboration between the medical home and school home. Every school division should have a school medical director who is a licensed board certified physician with expertise in children overseeing all health concerns within a school division.

Desired Outcome:

Schools will have health and wellness programs for all students that are evidence based from minor issues such as infection control like head lice to major issues that can impact instruction like return to learning following concussion or anaphlaxis management and infectious disease control.

Schools will assist the medical home in implementing goals for students with complex medical conditions by facilitating rather than obstructing their smooth integration into the school through education of staff and administrators and support of school nurses.

Routine and emergent issues encountered by school nurses will be supported with appropriate standing medical orders that are regularly monitored and updated, including but not limited to safe medication delivery systems, public access defibrillation programs, naloxone, seizure, and anaphylaxis rescue, and other similar essential school issues.

A uniform gold standard of care will be established by the joint efforts of the VA Depts of Education and Health through the VA school medical directors to ensure that all school aged children, regardless of zip code, will have quality access to safe school environments overseen by board certified physicians who understand the needs of children and adolescents.

Additional background materials in appendix.

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