Because children over age 5 are in schools and many young children below age 5 are in child care programs, these institutions (schools and early childhood programs) are important access points for health care services.

Figure 18: Florida School Health Services Nurse-to-Student Ratio Source: State Summary of School Health Services 1998-99: Department of Health Public Health Information Data System (PHIDS) and County Health Department Annual Reports

The early identification of conditions that may affect later health is most critical in the early years. The Head Start program has a strong health component and is required to provide well child check-ups, dental health, mental health, and screenings for children lacking or in need of these services. Investments in school nurses and health care for child care programs can help in the goal of early identification and treatment of children with special health care needs. Schools are ideal for providing health care education and counseling on unhealthy behaviors, outreach to families without insurance, and to deliver or help families arrange for primary, preventive and chronic health care services. Teachers, are busy educating, but see children every day that they identify with health problems. Many children have chronic conditions such as asthma or diabetes that can flair up on a moment's notice. A health care professional is a critical member of the educational team. The recommended nurse-to-student ratio by the National Association of School Nurses is one nurse to 750 students.⁽⁷⁾   In 2000-01, Florida's school health services nurse to student ratio was 1 to 3,076 students in the basic school health program and 1 to 1,604 students in the Comprehensive School Health Services Projects.⁽⁸⁾