AZ DHS Updates

Thank you, Arizona School Nurses!

The Arizona School Nurse Access Program, ASAP, has ended. Arizona School Nurses supported this program, which aimed to increase the number of school nurses in Arizona, especially in rural and underserved areas, while also expanding the core competency of all school nurses through certification and continuing education. All Arizona School Nurses deserve a thank you for supporting and becoming part of this program by mentoring a new school nurse, attending webinars and conferences, and becoming certified school nurses. The number of school nurses who showed their dedication to the profession of school nursing was rewarding and humbling to those who brought you these activities. Again, we thank you. With your commitment to ASAP, we could show the positive outcomes we have gleaned from the program. A summary of these results include:

• 49 ASAP School Nurses were hired to serve 55 rural schools located in 13 of 15 Arizona Counties.
• 104 additional school nurses became nationally certified.
• 41% of district public school students were touched by ASAP (Table 1).

The Arizona Nurse recently published Impacting Student Health in Arizona: One School Nurse at a Time by Samantha Reeves and Pat VanMaanen, which presents more details about ASAP. Please review this article to learn more about how each program under ASAP impacted school nurses and the students they serve in their schools throughout the state.

The Arizona Department of Education (ADE) will continue to support school nurses through the School Nursing and Health Services website, the School Nurse Huddles, the School Nurse Listserv, the Nurses Notes e-newsletter, school nurse committees, and technical assistance. Funding to expand ASAP activities and continue the programs now ending is underway; in the meantime, all ASAP information, including program documents, data reports, publications, and webinars, can be found on the ADE ASAP website. The National Association of School Nurses (NASN) presentation by the ASAP ASU evaluation team is also here. As the evaluation team finalizes and publishes additional reports and findings, these will also be added to the site. This site will also link to the new online NASN School Nursing Practice FrameworkTM (Framework) training. Arizona school nurses will receive free access to the online Framework training sessions due to support from ASAP. Please bookmark the ADE ASAP website to visit and gain access to ASAP and NASN Learnings.

Now Available!

Under the Arizona Opioid Epidemic Act of 2018, the state took steps to address the Opioid crisis. One law component required the Arizona Department of Health to provide training and distribution of Naloxone to community first responders. Laws (36-2267: Administration of opioid antagonist; exemption from civil liability; definition) also allowed schools to implement stock Naloxone programs. Schools that have programs are familiar with starting a stock medication program and know training is available at the Western Region Public Health Training Center at the University of Arizona. This year, thanks to Dr. Ashley Lowe and her team with the College of Nursing and the Asthma & Airway Disease Research Center at the University of Arizona, there is also Naloxone Training for School Personnel available [https://moodle.publichealth.arizona.edu/enrol/index.php?id=540]. For schools working with the SSMP, check with program staff to see when this training will be incorporated and required.

In December 2023, SNOA joined the Arizona Partnership for Immunization (TAPI) and two other organizations to create the Arizona School Vaccine Coalition under the National Leadership Academy for the Public's Health (NLAPH), Cohort 13. The NLAPH is funded by the CDC and delivered by the Public Health Institute. The program just finished in July.

During the seven months, our coalition members (pictured from the left: Lynn Moriarty, Kate Whitman, Dr. Caswell Evans (coach), Laura Smith, and Pat VanMaanen, attended webinars, an in-person retreat, and regular meetings with our coach, Dr. Caswell Evans. We gained incredible insight and new knowledge about health equity, data mining, framing messages, strategic program planning, and sustainability. These tools helped us further understand Arizona's childhood vaccine issues, including declining vaccine rates and increasing use of personal exemption forms and draft actions to change the vaccine rate trajectory in Arizona.

We reviewed the ADHS data provided by the Immunization Data Report (IDR) and conducted additional data analysis to better understand the decline vaccine rates and increasing use of personal exemption forms. Initially, we thought most issues lay in primarily rural areas, but our deeper dive into the data provided this was untrue. Mapping the IDR data based on individual schools revealed that vaccination and exemption rates are not related to zip codes but are school-specific. You can have schools down the street from one another with very different vaccination and exemption rates. We further learned that Arizona charter schools have over two times the average personal exemption use statewide than district public schools, and about half of all charter schools serve predominantly low-income students.

Our Coalition goal has been revised to state that by the end of 2027, Arizona will have a 2% increase in school vaccine rates and a 1% decrease in personal exemption rates. This goal will be accomplished using three strategies: creating a resource hub, a mentorship program, and immunization advocates. A recent survey completed by school nurses and health office staff at the SNOA conference helped inform updates to the current resource hub on the TAPI website.

After completing the formal training program provided by NLAPH and the Public Health Institute, the Coalition team members are eager to put their learnings to work by building the Coalition, adding partners, and sharing their findings. We look forward to seeing SNOA members participate in the Coalition's efforts to meet our goal by 2027. Contact Laura Smith at lsmith@tapi.org to join the Coalition.