National Policy Draft

National Policy [Draft]

How to reimagine and rebuild an education system with health and equity at the center.

National Agenda

Our national policy agenda is built on our Change for Good framework, a transformative effort to reimagine and rebuild the education system — and the services it provides beyond the essential task of teaching our children — with health and equity at the center.

Healthy Schools Campaign is hosting a series of Change for Good Forums in 2021, bringing together policymakers and leaders from the health, education, environmental, civic and grassroots communities to discuss how to ensure the health and success of all students.

Federal Policy Recommendations

As a country, we have not invested equitably in school facilities and outdoor spaces, or in the number of school health providers — including school nurses and social workers — needed to meet today’s challenges and address health disparities. The coronavirus pandemic and simultaneous calls for racial justice have exposed the extent, and the impact, of these inequities.

Our federal policy recommendations outline how government agencies can develop and support policies and guidance to build a more equitable system and advance the critical connection between learning and health.

We view these recommendations — and the resulting collaboration across education, healthcare and public health sectors — as an investment in education that reflects the importance of our country’s public schools and creates lasting change in every community.

Learn more about HSC’s work on education policy, environmental health, school food and school health, and the policy issues we help to advance.
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Biden Administration

The Biden administration’s agenda has opened avenues for investment in children’s health and wellbeing. Read our position statements on the American Rescue Plan Act and American Jobs Plan. Here’s an early assessment of President Biden’s education plans alongside HSC’s federal priorities.




Change for Good Framework

HSC’s Change for Good policy framework focuses on four areas: school facilities, school health services, school food and school funding.

Our national policy recommendations offer specific ways for the administration and federal agencies to address these issues.

We believe that rebuilding the infrastructure designed to support our children’s educational and health needs — and addressing the role that institutionalized racism plays in forging and perpetuating failed systems — is a national priority.

This framework is further informed by our on-the-ground programs and national advocacy efforts:

1) School Facilities and Campuses

HSC is the managing partner, with Openlands, of Space to Grow, an initiative that creates climate-resilient campuses and reduces urban flooding. Our unique collaboration with Chicago Public Schools and city departments and districts transforms Chicago schoolyards into beautiful and functional spaces that support outdoor learning and active play as well as serve as a resource for the community.

In addition, HSC has a long history of working on issues related to school facilities, both through our Healthy Green Schools and Colleges program, which supports schools in adopting green cleaning and related practices, and through our work assisting Illinois in developing guidance to integrate health, energy and climate-related issues into school design.   

Why School Facilities Matter

• The average school building is roughly 44 years old. Students and educators are learning and working in crumbling buildings with asbestos, contaminated water, and mold.

• A 2020 report issued by the Government Accountability Office (GAO) on the state of school infrastructure found that 54 percent of school districts must replace or update major heating, ventilation and air-conditioning (HVAC) systems in more than half their buildings.

• According to the GAO report, high-poverty schools were more likely to rely on state funding to cover the cost of building repairs compared to wealthier schools, which were more likely to fund projects through local property taxes.

• Aging and ineffective HVAC systems can lead to poor indoor air quality in schools and exacerbate illness. Even before the pandemic, more than 14 million school days were missed every year due to asthma. COVID-19 affects the respiratory system and asthma sufferers are considered high-risk for severe complications from the virus. That means indoor air quality is even more important as schools look to reopen.

• In a study of the federal role in school facilities, researchers found that between 2004 and 2010, the federal government provided less than .02 percent of school districts’ total capital spending in direct grants for school facilities, mostly awarded through the Federal Emergency Management Agency for schools affected by natural disasters. By contrast, in 2014, the federal government funded a full 38 percent of the nation’s capital investment in wastewater and transportation infrastructure.

2) School Health Services

HSC leads the Healthy Students, Promising Futures Learning Collaborative, a program started by the U.S. Department of Education during the Obama administration to support states in expanding Medicaid-funded school health services. More information about this effort, which can be used to increase the number of school-based health personnel, can be found in this policy brief.   

Why School Health Services Matter

• One in four children in the United States has a chronic physical or mental health issue that affects their ability to succeed in the classroom, double the number just 30 years ago. Left untreated or undermanaged, health issues can adversely affect children’s attendance, their ability to see, hear and pay attention in the classroom, their ability and motivation to learn, and even their chances of graduating from high school.

• Students in underserved communities, particularly students of color, are at increased risk of chronic health problems such as diabetes and asthma that can hinder learning and have a significant impact on long-term health. Ignoring these health inequities undermines efforts to close the opportunity gap.

• One in five children between the ages of 13 and 16 experience mental health issues; less than 20 percent of these children receive the help they need. Of those receiving care, nearly 80 percent receive that care in a school setting.

• Research shows that access to school nurses and other health providers can improve both health and academic outcomes, particularly for students with chronic health issues. Increased access can lead to reductions in chronic absence, improvements in care coordination and reductions in healthcare costs (by reducing the number of emergency room visits).

• Despite the clear connection between school health services and student success, more than half of public schools do not have a full-time school nurse or school counselor and only 5 percent of students have access to a school-based health center. Significant disparities exist: Students in low-income schools are less likely to have regular access to a school nurse and other health providers compared to their peers in higher-income schools.

3) School Food

HSC has long worked with Chicago Public Schools to help shape the district’s school meal program. We launched a citywide Cooking up Change student culinary competition, now a national event, and are committed to strengthening nutrition guidelines and ensuring universal access to school meals.  

Why School Food Matters

• According to the U.S. Department of Agriculture, 16.7 million children under age 18 live in households where they are unable to consistently access enough nutritious food necessary for a healthy life.

• Hunger impairs concentration and cognitive ability, thus interfering with students’ ability to learn, and results in physical symptoms such as headaches and stomachaches that cause children to miss class time.

• At the same time, increases in childhood obesity have been well-documented. Obesity puts children and adolescents at risk for developing diseases and health conditions that hinder their quality of life and can follow them into adulthood.

• Schools play a critical role in addressing this dual challenge by providing regular access to healthy school breakfasts and lunches through the federal school meal program, with more than 30 million children participating in the USDA National School Lunch Program and 12 million participating in the USDA School Breakfast Program.

4) School Funding


Why School Funding Matters

• There can be no equity when, as studies have found, school districts in wealthier areas and those that serve mainly White student populations receive thousands more per student (from state and local funding) than districts in low-income areas and those that serve mostly students of color.

• We need to think beyond simply “equal” funding: Students in poverty and from historically underinvested communities need more funding than those in wealthier communities.

• Core services that have a significant positive influence on instructional quality and student outcomes are systematically unavailable to students in low-income schools relative to students in higher-income schools.

• Research shows that increased spending on education leads to better student outcomes. When states invest in their public schools and create more equitable school finance systems, student achievement levels rise. The positive effects are even greater among students from low-income households.

• There has been real progress in states that have provided significant, additional resources for low-income students. Weighted student funding — which differentiates school budgeting based on the demographics that each school serves—can fund quality programs that have the greatest impact on the student population.



Policy Recommendations

Healthy Schools Campaign welcomes the Biden administration’s support for states, school districts and communities in creating equitable conditions to improve student health and academic outcomes. This work is more important than ever — and long overdue.

Prior to the 2020 election, HSC developed specific recommendations for the next administration, outlining how federal agencies can support policies and offer guidance that improve children’s health and education.

Informed by our Change for Good framework, the recommendations are continually updated, based on new executive and legislative actions that affect school facilities, school health services, school food and school funding. LINK TO OR EMBED GOOGLE DOC


Advocacy Positions

Healthy Schools Campaign believes that all children deserve the fundamental security provided by adequate food, healthcare and housing. View the national policy actions we initiated or signed on to over the past two years (2020-2021). NOTE: Create new spreadsheet pulling key items worth noting publicly from this one

Please visit the Issues section to learn more about HSC’s work specific to:

[NOTE: The draft version of national policy positions is available here.]

Also include:

NOTE: Create new page for HSC’s policy wins and successes in reverse chronological order – to be placed under About/Impact – and link to it from here (call-out box).

Keeping all the information in one place will make it easier to locate and update. It also can serve as a “20-year mark” document showcasing two decades of sustained activity and successes. An impact graphic would be another good thing to add.

HSC Publications

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Providing Health Services During School Closures | March 2021
This national issue brief examines the challenges schools have encountered while providing physical, behavioral and mental health services during the Covid-19 pandemic. It considers the impact of state and federal policies, including how state Medicaid programs are responding to ensure reimbursement and funding, and documents emerging best practices and guidance, especially around telemedicine and parental consent.

Schools Are Key to Improving Children’s Health | January 2020
This national policy brief primarily addresses the opportunities to expand on health services delivered within a school by school nurses and other district-employed providers (school psychologists, social workers, counselors, occupational therapists, physical therapists and speech-language pathologists), using a policy clarification issued by CMS.

A Guide to Expanding Medicaid-Funded School Health Services | December 2019
This in-depth guide provides background on school-based Medicaid and outlines various opportunities to advance state policy changes required to access federal funds. It is designed for anyone working to expand access to school health services, including state and local education agency staff, state Medicaid agencies, school health providers, public health professionals and children’s health advocates.

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Note - updated to the HSC Newsletter list 1.3.2017 per the updated newsletter configuration