strengthen their system (Academy for Educational Development, 1995). According to this manual, a state-level CSHP infrastructure refers to the basic support system on which the larger, statewide CSHP program depends for continuance and growth. The four primary state CSHP infrastructure ingredients identified in the manual are funding and authorization, personnel and organizational placement, resources, and communication linkages (see Box 5-1).

To provide a sense of the kinds of infrastructure activities under way in states, Appendix G-2 describes some of the experiences and accomplishments in West Virginia—a lead state in the CDC/DASH infrastructure demonstration initiative—as well as Maine's plan (Appendix G-1) for collaboration and integration among education, health, and family services.

Coordination of Funding Streams

A critical function of the state infrastructure is managing the flow of the almost 200 federal funding streams that target children and families, many of which deal with health, education, and social or family services. States, in turn, pass many of these funds on to the local level, perhaps with particular state priorities or stipulations attached. The state and local infrastructures must work together to develop creative approaches for funding local programs from the variety of potential funding sources available.

Examples of federal funding streams arriving at state education agencies and their possible uses for school health include the following:

  • Funds for AIDS/HIV prevention education from CDC/DASH can be used to improve health education in the classroom by training teachers and to improve health services by training school nurses to care for students who may be HIV infected. Funds can also be used for improvement of the school environment and for policy development.

  • Individuals with Disabilities Education Act funds can be used to support the employment of counselors, school psychologists, and school nurses who work with children with special needs.

  • Elementary and Secondary Education Act Title I funds can be used for the delivery of health and counseling services, as well as to increase parent involvement in schools.

  • U.S. Department of Agriculture funds for Nutrition Education Training Programs can be used for teacher training related to nutrition education in the classroom and for training foodservice workers. (In a few states, this program is administered by the health or human services department.)

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