I. EXECUTIVE SUMMARY MECKLENBURG COUNTY School Health Task Team FY14 OPERATIONS PLAN A plan to fulfill the mission of enabling students to remain In class, on task, and ready to learn. A. Collaborative Approach The School Health Task Team was assembled in March 2013 to review current school health services and prescribe an operations plan for FY14. Given the transition from Carolinas HealthCare System to Mecklenburg County, a collaborative process was necessary to ensure a plan which addresses the complex nature of school health. The Task Team members consisted of school health nurses, Mecklenburg County Health Department (MCHD) staff, Charlotte-Mecklenburg Schools (CMS) staff, parents and medical professionals (see appendix). The Task Team was created to ensure an inclusive and thorough approach to school health. The school health program was previously part of the contract with Carolinas HealthCare System. As of July 1, 2013, the Mecklenburg County Health Department will be responsible for the school health program for the 157 schools within in CMS. There are currently 117 school nurses to serve all the CMS schools. Historically, school health has been challenged with meeting increasing demands for complex medical needs with limited financial and personnel resources. This challenge is not unique to Mecklenburg County. The Task Team s process included reviewing relevant data (statistics on CMS students chronic conditions and youth risk behaviors, nationally accepted best practices for school health, testimonials from parents and educators, etc.); offering innovative solutions to problems; and agreeing to the right approach for the 2013-2014 school year. B. Process Overview Mission of school health is to provide services enabling students to remain in class, on task, and ready to learn. The Task Team s purpose was to recommend a FY14 operations plan for achieving the mission. The second phase of the Task Team s work will be to reconvene in the fall of 2013 to recommend priorities for the longerterm (FY15-17). The Task Team met weekly for 2-3 hours to collaborate on current services, challenges, and solutions. To safeguard the process, the Task Team agreed to ground rules at the first meeting (see appendix). Decisions were made by consensus. The Task Team defined consensus as being able to answer yes to these three questions:
Have I been heard by everyone in the group? Have I heard others in the group? Will I actively support this decision as we move forward? II. COMMON THEMES The Task Team participated in several exercises to identify interests and ideas related to the program. As the sessions progressed, the following common themes emerged: School Health Staff Communication Services & Structure of School Health Program School Health staffing issues included, but were not limited to requirements for nurses, employee morale, and work environment. Communication was a frequent topic both internal to the school environment (ex. communication between School Health staff and CMS staff) and external (ex. sharing information with parents, elected officials, community at-large, etc.). Finally, the services and structure of the program were recurrent during many in-depth discussion and analysis. Alternative business models were offered for consideration. Given the prevalence of these themes, the Task Team used them as the foundation for the strategies for the FY14 operations plan. III. RECOMMENDATION FOR FY14 A. Strategies The Task Team developed strategies to drive decisions on priorities, resources, and services. The strategies represent business operations needs cited by stakeholders and agreed upon by the Team. Strategy 1: Attain optimal staffing levels to ensure quality school health services in all schools. Strategy 2: Build community awareness of the critical need for school health services. Strategy 3: Ensure proven information systems to provide seamless transfer of information, nurse access to information, and reliable data/record management. Strategy 4: Ensure aligned and consistent service in each school and geographic zone. Strategy 5: Foster and sustain collaborative processes and practices among the schools, the school health program, community hospitals, medical associations, and parents.
B. Accountabilities & Timeline Strategy 1: Attain optimal staffing levels to ensure quality school health services in all schools. Action Steps Accountability Target Date* (3-mo/6-mo/12- Provide opportunities for professional development for all employees of school health. Evaluate alternative business models and proven best practices to enhance current school health services. Establish market rate and performance standards for each position in school health. Conduct an annual employee climate survey for all employees of school health. Proactively recruit registered nurses with Bachelor s Degree and/or certified professionals for positions in school health. Monitor turnover among school health staff, identify significant trends and service impacts. Reallocate responsibilities (ex. administrative tasks) to unlicensed school health personnel. Achieve the 1:750 nurse to student ratio**. Create a substitute nurse pool to prevent gaps in service. Create an internship/apprenticeship program with NC colleges/universities. Office of Management & Budget Board of County Commissioners County Manager s Office
Strategy 2: Build community awareness of the critical need for school health services. Action Step Accountability Target Date (3- mo/6-mo/12- Identify communication strategies to communicate the school health program s goal, strategies, action steps, and progress with performance outcomes report. Report performance outcomes quarterly and annually to leadership of CMS and County. Create a School Health Awareness campaign for the community, schools, and parents. Create a full-time communications position dedicated to the school health program. Use social media to effectively communicate with the community at-large, parents, etc. the mission of school health and important issues. Conduct focus groups to gather data from stakeholders (parents, teachers, medical community, etc.). Host information forums to promote school health issues. Share annual school health report with community/stakeholders regarding student health and safety, access to nurses, etc. BSSA - Public Information BSSA - Public Information BSSA - Public Information BSSA - Organizational Improvement BSSA - Public Information
Strategy 3: Ensure proven information systems to provide seamless transfer of information, nurse access to information, and reliable data/record management. Action Step Accountability Target Date (3- mo/6-mo/12- Provide nurses with communication tools necessary to succeed specifically, smart phones (voice and data capabilities), laptops, etc. Train school health staff to effectively use allocated technology devices (ex. smart phones). Achieve seamless connectivity to data no matter which location the nurse is serving (ex. accessing electronic health records). Maximize use of current electronic medical record system. BSSA Information Technology BSSA Information Technology BSSA Information Technology BSSA Information Technology BSSA Organizational Improvement Strategy 4: Ensure aligned and consistent service in each school and geographic zone. Action Steps Accountability Target Date (3- mo/6-mo/12- Clarify roles and service expectations among school health staff and CMS staff. Achieve standards for health rooms including design, square footage, equipment inventory, etc. Establish a Service Level Agreement (SLA) between CMS and the school health program. BSSA Asset & Facility Management Strategy 5: Foster and sustain collaborative processes and practices among the schools, the school health program, community hospitals, medical associations, and parents. Action Steps Accountabilities Target Date (3-
Proactively participate with the School Health Advisory Council to ensure community involvement in school health issues. Define roles/expectations for school health and CMS staff to support a coordinated approach to school health. Connect with community partners and stakeholders to create an infrastructure of information sharing to benefit school health. mo/6-mo/12- IV. NEXT STEPS The Health Department will update the County Manager s Executive Team on the progress of the plan at the 3-month, 6-month, and 12-month interval or more frequently if requested by the County Manager and/or his designee. The Task Team appreciated the opportunity to collaborate with multiple agencies and community partners on school health. The Task Team will reconvene in August 2013 to begin monthly meetings the focus of which will be building upon the attributes of the program and identifying areas for improvement. *Start date is July 1, 2013. **As recommended by the National Association of School Nurses, medical associations, etc. Appendix 1 School Health Task Team Members Name Agency Title Polly Baker Mecklenburg County Health Manager Ann Clark CMS Deputy Superintendent Carmel Clements Mecklenburg County Division Director
Bobby Cobb Mecklenburg County Deputy Director Glenna Cook School Health School Nurse Hilda Diaz School Health School Nurse Dr. Ophelia Garmon-Brown Community (Novant Health) Senior VP of Community Partnerships Rebecca Herbert Mecklenburg County Business Manager Debra Kaclik CMS Director of Arts, Health & Physical Education, and PreK-12 Curriculum Support Programs Michelle Lancaster Mecklenburg County General Manager Nancy Langenfeld CMS Coordinated School Health Specialist Dr. Wynn Mabry Mecklenburg County Health Director Mona McGruder School Health School Nurse Clinical Manager Susan Parker School Health School Nurse Barb Pellin Mecklenburg County Assistant to the County Manager Linda Sullivan School Health School Nurse Clinical Manager Teri Saurer Community Account Manager Michael Vaccaro (Parent Advocate) Community (Novant Health) Ulliance, Inc. Senior Director of Women's and Children's Services
Appendix 2 School Health Task Team Ground Rules GROUND RULES School Health Task Team Spring 2013 We speak with one voice outside this room. Whoever is here makes the decisions and the group moves forward. Commit to attend and no proxy. When possible, share all the relevant information at the same time. Seek common ground, and make decisions by consensus (see below). Engage the possibilities--think creatively and build on each other s ideas. Focus on interests--not positions. Balance advocacy and inquiry. Discuss the undiscussable. Disagree openly-- bring the parking lot conversation in the room. Demonstrate mutual respect. Acknowledge successes-even the small ones. Consensus has been defined as being able to answer yes to these three questions: Have I been heard by everyone in the group? Have I heard others in the group? Will I actively support this decision as we move forward?