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Coordinated School Health and
Department of Health Partnership

The collaboration between the North Dakota Department of Public Instruction (DPI) and the Department of Health (DoH) is critical to accomplishing mutual goals to serve students across the state. Rather than duplicate services, DPI and DoH work together to provide information, technical assistance and training in these areas:

Click on the following partnerships to view the information below:


You can also click on "Back to the Top" after each topic to return to the list.

Asthma & Anaphylaxis

DPI and DoH worked together to develop and pass legislation during the 2005 session which allows students to carry and self administer asthma and anaphylaxis medication at school. See http://www.health.state.nd.us/asthma/ for more information regarding the legislation and web-based training modules for healthcare providers and school personnel.

The American Lung Association of North Dakota is pleased to announce an effort to improve the lives of our asthmatic youth by sponsoring the “Winning With Asthma” program. Community-based sports associations, park and recreation departments, and schools throughout North Dakota are asked to encourage or require their coaches, managers, physical education teachers and referees to better understand how asthma affects athletic performance, so they can help athletes with asthma achieve their full potential in sports.  This FREE 30-minute interactive educational tool is designed primarily for coaches working with young athletes but is appropriate for all age groups. It can be found at http://www.WinningWithAsthma.org . Upon completion the participant will receive a special clipboard detailing steps to take during an asthma attack, a certificate of completion, and a booklet that expands on asthma information written with coaches in mind.

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Cancer prevention includes quality health education about nutrition, physical activity and avoidance of risk behaviors to students of all ages to support prevention, screening and early detection. Coordinated School Health supports the efforts of the DoH Division of Cancer Prevention and Control and participates in the development and promotion of the cancer state plan. pdf icon (external link)

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Child Nutrition

DPI supports the efforts of the DoH Women, Infant and Child (WIC) program services, which includes free health screenings to all participants to determine nutritional risks and referral to other community-based agencies and providers (doctors, public health nurses and support agencies) which would benefit the health of children and families. The Nutrition Program provides consultation and technical assistance, monitors nutrition data, plans and evaluates nutrition programs, coordinates nutrition related activities, and acts as a clearing house for nutrition information and training. Nutritionists working through local public health units partner through the Healthy Weight Council, participate in Healthy North Dakota and work on issues directed toward healthy weight for children and adolescents, through the promotion of increased fruit and vegetable intakes (5 A Day) and increased physical activity and 5 + 5 Communities Program. For more information, visit www.ndhealth.gov/nutrition.

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Dental / Oral Health

The Oral Health program works with various groups to provide oral health information and education about access to care and the Fluoride Program for children through the school system, which targets children in communities that do not have adequate water fluoridation. DPI is an active member of the Oral Health Coalition.

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DPI supports the mission of the Diabetes Prevention and Control Program, which includes improving the lives of people with the disease through education, awareness, proper nutrition, exercise, appropriate medications and self-monitoring of blood sugar levels.

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Disease reporting

Influenza surveillance: The DPI communicates information to the local school districts about influenza activity throughout the school year, promotes the participation of districts in the School Absenteeism Surveillance Program, and relays multiple educational and reference materials and fact sheets to districts for distribution. Follow this link for more information.

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Head Lice

DPI and DoH work together to provide information about head lice, treatment options and guidelines appropriate for use in the home, child care settings, schools and communities. Both agencies support information dissemination such as the following: http://www.ndhealth.gov/head-lice/. pdf(external link)

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Healthy North Dakota

Healthy North Dakota is a framework supporting North Dakotans in their efforts to make healthy choices by focusing on wellness and prevention – in schools, workplaces, senior centers, homes and anywhere people live, learn, work and play. Created by Governor John Hoeven in January 2002, this statewide partnership encouraged all citizens to “take control of his or her life – to exercise more, to eat a healthy diet, to examine their use of tobacco and alcohol … “

In August 2002, a statewide summit was held to define wellness and identify priorities for North Dakota. Identified based on input from summit participants and other interested individuals; developed as a grassroots effort – involving anyone who was, and is interested in participating in their personal, community and state wellness efforts. Healthy North Dakota Priority Areas include:

  • Tobacco use
  • Substance abuse/ Mental health
  • Healthy weight - nutrition
  • Healthy weight - physical activity
  • Health disparities
  • Worksite wellness
  • Community engagement
  • Third-party payers/insurance

DPI CSH staff are involved in many committees which work with school age youth in the risk behaviors of tobacco, nutrition, physical activity, and disparities. For more information, refer to http://www.health.state.nd.us/HealthyND/.

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HIV/AIDS and Sexually Transmitted Diseases

DPI and DoH work in collaboration to provide education and information to reduce the spread of HIV and sexually transmitted diseases in North Dakota. For more information, visit www.ndhealth.gov/disease.

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DPI supports the efforts of North Dakota Immunization Program through communication with the local school districts across the state on various information regarding immunization schedules and vaccine-preventable diseases.

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Injury Prevention

DPI works with the Department of Health to develop interventions to reduce injuries to North Dakotans, with special emphasis on children. DPI supports the Risk Watch injury prevention program, Basic Emergency Life Saving Skills (BELSS) training, child passenger safety, bicycle helmet use, suicide prevention and playground safety.

  • Risk Watch: Risk Watch is a comprehensive injury prevention program for schools. Developed by the National Fire Protection Association (NFPA), Risk Watch is a school-based curriculum that links teachers with community safety experts and parents. The curriculum is divided into five age-appropriate teaching modules (Pre-K/Kindergarten, Grades 1-2, Grades 3-4, Grades 5-6, and Grades 7-8), each of which addresses the following topics: motor vehicle safety, fire and burn prevention, choking, suffocation and strangulation prevention, poisoning prevention, fall prevention, firearm injury prevention, bike and pedestrian safety and water safety.
  • Basic Emergency Life Saving Skills (BELSS): BELSS is designed to increase the number of school-aged youth who are competent in emergency health skills (the spectrum of knowledge, attitudes, and skills necessary to prevent, prepare for, and respond to serious, unexpected situations that require immediate action and encompasses injury prevention, safety, first aid, CPR, AED, emergency preparedness, and coordinated school health programs). BELSS is the first comprehensive model of emergency health in schools. Training workshops are intended for school nurses, health teachers, physical education teachers, elementary teachers, health service directors, safety/security directors, social workers, EMS personnel, and ALL those responsible for teaching emergency health skills to school district youth and staff.

Contact the North Dakota DoH Division of Emergency Medical Services at (701) 328-1220 for information on training opportunities in your community. For more information, refer to www.ndhealth.gov/injuryprevention.

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Insurance - Covering Kids and Families in North Dakota

Thousands of North Dakota children are without healthcare coverage because parents are not aware that their kids qualify for Medicaid, Healthy Steps or The Caring Program for Children. A statewide effort by the North Dakota Covering Kids and Families Project with Dakota Medical Foundation as the Statewide Lead Agency, is working to connect eligible families to healthcare coverage by enrolling them in existing North Dakota coverage programs. These efforts are enhanced by the endorsement of Governor John Hoeven and involvement of North Dakota legislators, the Department of Public Instruction, the ND Insurance Commissioner, the Department of Health, and the Department of Human Services. County social service agencies, business representatives, school districts, daycare centers, the medical community, faith based organizations, service clubs and citizen volunteers are also involved in this effort. The Statewide Project conducts and coordinates outreach strategies and work to simplify and coordinate the enrollment process. .For more information on the application process or to learn more about Covering Kids and Families in North Dakota, visit the North Dakota Insurance Department website. 

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Weighing and Measuring Students in School Settings Position Paper

The percentage of youth who are overweight, obese or at risk for becoming obese has increased, and the North Dakota Healthy Weight Council (HWC) comprised of dietitians, nutritionists, physical activity educators, physicians, nurses, and other health professionals understand the health risks associated with overweight and obesity.

When done appropriately, weighing and measuring students in schools may be one way to address the obesity issue. The HWC developed this paper to ensure that weighing and measuring students in school “does no harm” and preserves each student’s physical and emotional well-being.

The guidelines address appropriate circumstances for measuring height and weight, and describes the appropriate method of weighing and measuring students.

Weighing and Measuring Students in Schools:  A Position Paper.

Weighing and Measuring Students in Schools:  Executive Statement  http://www.ndhealth.gov/nutrphyact/ExecutiveStatement10-07.pdf

Guidelines for Collecting Heights and Weights on Children and Adolescents in School Settings  These guidelines were developed by the University of California Berkeley, Center for Weight and Health, College of Natural Resources http://nature.berkeley.edu/cwh/PDFs/color_weighing.pdf

Healthy Weight Council Toolkit new icon

Healthy Weight Toolkits Flyer

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MMES Program

The North Dakota Moving More, Eating Smarter Communities (MMES) Program, formerly known as the 5 + 5 Communities Program, celebrated 10 years in 2008. Goals of the Moving More, Eating Smarter Communities (MMES) Program are to encourage North Dakotans move more on most days of the week and to make smart choices from every food group. In 2007-8, seventeen community coalitions with the potential to reach over 50 percent of the state’s population were officially noted as meeting the criteria for recognition. Criteria include coalition membership that specifies persons with nutrition and physical activity expertise and influential community leaders; and a plan that includes promotion, outreach and evaluation, as well as interventions to include awareness, skill development, and policy/ environmental changes.

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Pandemic / Influenza

The Department of Health coordinates the influenza and pandemic planning efforts with the Governor’s Office, National Guard, and other state and local agencies. DPI participates as part of the statewide planning team. Refer to the DPI home page for pandemic information. For more information on influenza, refer to www.ndflu.com.

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Primary Points of Contact

DPI CHS staff work closely with multiple state-level partners to stay current about various health related topics. Primary points of contact have been designated between several agencies to best meet the needs of schools, communities and other callers/contacts. The attached Primary Points of Contact was developed to help direct questions and technical assistance to the most appropriate person.

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Public Health Units

North Dakota's public health system is made up of 28 single and multi-county local public health units. Services provided statewide for school-age children include: blood pressure, scoliosis and vision screening, immunizations, preschool conferences and community wellness programs. Additionally, public health nurses have served as a resource for schools. For more information, visit www.ndhealth.gov/localhd/.

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School Health Services Guidelines

In North Dakota there is approximately one school nurse for every 4000 students, which requires school staff to provide for the health care needs of students and others.

The School Health Guidelines were developed as a resource for school personnel who provide health care, and as a quick reference to some of the health care procedures trained personnel use in schools. Individuals performing the procedures in schools must receive training from a competent, qualified person.

In each section, procedural information is condensed on a flow chart, and a detailed narrative description follows each flow chart.

Students who need care should have instructions from a healthcare provider in their file, and a 504 Plan developed by a committee consisting of the student (if appropriate), the student's parent(s)/guardian(s), the student's teacher(s), the administrator, and the healthcare provider/school nurse.

The student's health issue and corresponding need for reasonable accommodations should be identified and documented in the plan. Likewise, the plan identifies the specific accommodations, which will be implemented by the school. The 504 Plan can be accessed by staff that work with the child, and should be updated at least annually.
Generally, schools must have written permission from the parent or eligible student in order to release any information from a student's education record. However, FERPA allows schools to disclose those records, without consent, to the following parties or under the following conditions (34 CFR § 99.31):

  • School officials with legitimate educational interest;
  • Other schools to which a student is transferring;
  • Specified officials for audit or evaluation purposes;
  • Appropriate parties in connection with financial aid to a student;
  • Organizations conducting certain studies for or on behalf of the school;
  • Accrediting organizations;
  • To comply with a judicial order or lawfully issued subpoena;
  • Appropriate officials in cases of health and safety emergencies; and
  • State and local authorities, within a juvenile justice system, pursuant to specific State law.

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School Nurses

School nurses are used in several districts across the state through the DoH public health unit structure. They work with school-age students as much as schedules allow and provide staff training, student screenings and assessment and other tasks as deemed appropriate. Both agencies support the use of school nurses and are collaborating on multiple avenues to increase access to school nursing services. The purpose of school health and wellness services (school nursing) is to support the educational process by contributing positively to the health, health attitudes and behavior of today's child and consequently tomorrow's adult. School nursing is a specialized practice of professional nurses that advances the well-being, academic success and life-long achievement of students. School nurses are continually working with students and staff to promote healthy lifestyles and educating about steps they can take to protect and strengthen their physical and emotional well-being. The role of the school nurse is to enhance the education process by maximizing the health and well-being of school age children and adolescents. The school nurse works with the building staff and parents to ensure that each child is in the best possible physical and emotional health to benefit from school experiences. The school nurse implements programs and services designed to provide for the detection and follow-up of health problems, crisis intervention for ill and injured students, health counseling and referral, control of infectious disease within the school environment and planning with other school personnel for the appropriate education placement of the students with health problems.

In North Dakota, there is no state mandate or funding for school health and wellness services. Currently, the model used predominately to provide these services is through the local public health units; however, these services vary greatly throughout the state.

A small number of schools, such as Bismarck School District, Fargo Catholic Schools Network, Fargo Public Schools and Grand Forks School District are fortunate to receive school health and wellness services on a regular basis (mostly due to additional grant money they have received), while in other parts of the state, schools may have access to a school health and wellness services for only a few hours a week, for health screenings, immunizations or on a consultation basis only, or not at all.

Regardless of the services provided, the majority of health units and/or schools rely heavily on local grants to sustain their programs; however, this mechanism of funding is not reliable or consistent from year-to-year.

Currently in North Dakota, there is 1 nurse for every 3,067 students. The National Association of School Nurses recommends:

  • One nurse for no more than 750 students in the general school population.
  • One nurse for no more than 225 students in the mainstreamed population.
  • One nurse for no more than 125 students in the severely chronically ill or developmentally disabled population.

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System Standards

The “North Dakota System Standards for a Healthy and Safe School Environment” were developed to assist educators in the planning and implementation of a whole school approach to healthy eating, physical activity and a safe, caring and respectful culture and climate. The system standards are not a mandate, but schools are encouraged to use them as part of their school improvement process when addressing health-related and affective goals.

The supplementary tools included with the system standards are the “School Improvement Checklists” to use to assess the school in three areas addressed in the standards including the rubrics with four levels. A glossary is included as part of the system standards document. There is also a list of recommended resources for schools to use to implement the standards.

North Dakota System Standards for a Healthy and Safe School Enivornment PDF icon
This document includes three system standards: 1) Whole School Approach to Healthy Eating; 2) Whole School Approach to Ensuring Physical Activity; and 3) Whole School Approach to Providing a Safe, Caring and Respectful School Culture and Climate.  They were developed to assist schools that may consider using them in the school improvement process.  Supplementary tools included with the system standards are “School Improvement Checklists” to asses the school in the three areas, “Rubrics” for four levels, a glossary, and resource list to assist schools in the implementation process.

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DPI supports the mission of Tobacco Prevention & Control - improve and protect the health of North Dakotans by reducing the negative health and economic consequences of the state's number-one cause of preventable disease and death -- tobacco use. DPI also supports the goals, particularly the preventing the initiation of tobacco use among young people, promoting quitting among young people and adults and eliminating nonsmokers' exposure to secondhand smoke. Tobacco Prevention & Control has developed a white paper on comprehensive school tobacco policies, a model school policy for tobacco use, a list of North Dakota schools reporting a tobacco-free school grounds policy, tobacco strategies and tobacco-free schools sign template. Additionally, their staff and website can provide additional information, resources and training on cessation, smoke free laws, smokeless (spit) tobacco and the Quitline. Refer to www.ndhealth.gov/tobacco for more information.

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North Dakota Department of Public Instruction
Kirsten Baesler, State Superintendent
600 E. Boulevard Avenue, Dept. 201
Bismarck, North Dakota 58505-0440

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