Developing School Health Services in Massachusetts

Information about Comprehensive School Health Service (CSHS) grant programs

For several decades, recognition of the link between health and education has steadily increased, with greater understanding that a child must be healthy to learn, and a child must learn to be healthy. There is also greater recognition that school health service programs are in a unique position to improve child health status, resilience, and well-being, provide care essential to the student's school attendance, and identify and refer students with certain health risks and conditions. These activities ultimately support the student's ability to learn and contribute to both the school and community state of health.

During the past thirty years, school health service programs (school-nurse-managed model) in the Commonwealth's 351 cities and towns, serving 911,529 public school students in 400 public schools and over 500 non-public schools (FY22 data), have faced many challenges, resulting in the demand for more onsite services. These challenges stem from such factors as changing family structure and support systems, social morbidities, changing priorities for public funds, classroom inclusion of large numbers of children with special health care needs, and many students who lack comprehensive health insurance coverage and/or primary care providers. As the health care delivery system undergoes a dramatic restructuring and hospital stays are reduced, management of many medical conditions, health related problems, disease prevention and health promotion have shifted to the school setting, where children spend their "working days." Yet, until recently, school health services in Massachusetts remained a largely unrecognized component of the health care delivery system serving children and youth.

CSHS grant programs help to support schools and school districts to provide a case management model in order to better address increasing student and family needs.  Grantees are also required to integrate social determinants of health and the role of institutional racism in access to care into their care models.  CSHS grant funded programs use a nurse-managed approach in order to promote the whole-child/whole-family paradigm in the school setting.

Regional Advisor School Districts

CSHS funded districts were also eligible to apply for additional funding to be designated as regional advisor districts to provide consultation to CSHS grantees within their EOHHS defined region.

The general goal of the Regional Advisor CSHS grants is to maximize the existing school nursing expertise, leadership and infrastructure to provide additional consultation to both funded and non-funded schools and districts within a general region. Please note: These programs are expected to meet the requirements of the basic CSHS program, as well as provide ongoing consultation assistance to the funded and non-funded schools and districts.

Additional Resources

RC Brochure September 2023 (PDF)

RC Brochure September 2023 (DOCX)