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Current State and Local Initiatives


Current State and Local Initiatives

Note: This section is not finished. We will post information from states as we aquire it.

The Making Health Academic project is currently working with four states to help state-local partnerships that, in turn, support school-community partnerships to implement CSHPs. Participating states include Minnesota, North Carolina, and Tennessee.

We hope that descriptions of these states’ experiences will help both seasoned health and education professionals and newcomers to CSHPs. In the future, we will add stories about each state and a discussion area to foster the exchange of ideas and resources.


As a CDC infrastructure state, Minnesota’s Departments of Children, Families, Learning, and Health are currently working together on tobacco prevention, mental health, teen pregnancy prevention, substance abuse prevention, and suicide prevention.

The state agencies are working with six local CSHP pilot sites; four sites received start-up funding in the fall of 1999 and two new sites were added in the fall of 2000. In addition, the agencies are collaborating with the Minneapolis School District’s Healthy Learner’s Board, a successful partnership that will serve as a model for a proposed statewide Healthy Kids Learn Steering Committee (described below).

Government organizations and NGOs representing professional groups, university-based institutes and courses, and parent-teacher associations work together on conferences, joint committees, and training events.

Two major initiatives for Minnesota are enacting legislation and convening a state advisory committee. The two state infrastructure agencies have worked with the governor on legislation for a Healthy Kids Learn Initiative. This proposed legislation was not enacted in the spring 2001 session but will be reintroduced in the next session. Its financing would tie in the state’s tobacco settlement with CSHPs as part of the funding to promote collaboration between schools and communities in pursuit of coordinated school health. It would establish a Healthy Kids Learn Steering Committee charged with developing a multifaceted plan to address some of the state’s most pressing school health problems.

State officials are exploring how best to create and convene an advisory board that will expand Minnesota’s capacity to anchor CSHP implementation strategies and activities. EDC is providing technical assistance to achieve this goal.

  • State-local partnership description
  • State agencies: Departments of Children, Families, Learning, and Health
  • NGOs
  • School-community partnership description
    • Seven school districts
      • White Bear Lake
      • Olmstead County
      • Robbinsdale Area Schools
      • Henning Public Schools
      • Sebeka Public Schools
      • New York Miles
      • Minneapolis
  • Overcoming fragmentation among health programs (Title IV, tobacco control, pregnancy prevention) and between health promotion initiatives and education reform activities (MN Graduation Standards)
  • Immediate challenges
  • Long-term opportunities
  • Website

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North Carolina

As a CDC infrastructure state, North Carolina has created Healthy Schools and designated CSHP co-directors in the State Department of Public Instruction and Department of Health and Human Services. They have created a partnership that includes most state child-serving agencies and numerous NGOs, including the University of North Carolina School of Public Health, the Council of Churches, Citizens for Business and Industry, Communities in School, and the Association of School-Based-Linked Health Centers.

State officials began their strategic planning in 1999 by convening more than 40 school health stakeholders from across the state to clarify a vision of a CSHP infrastructure and to develop goals and objectives for implementing it. These stakeholders established an Infrastructure Council for Healthy Schools. Although the vision addressed building and maintaining state-level infrastructure to support CSHPs, the planners used language that they can adapt to community-level initiatives they are now undertaking.

In collaboration with this statewide Infrastructure Council, state-level staff have identified four school systems that demonstrate readiness to embrace and implement the CSHP concept. Principals from these districts met in late April 2001 to begin to develop school-community CSHP partnerships. The state staff will make site visits to these districts over the summer to identify common needs and ways in which state partners can assist in the development of the local school-community partnerships.

EDC technical assistance includes providing materials about needs assessment, program design and implementation, and evaluation to establish a foundation for CSHP implementation in the four local school districts, and working with the group on identifying specific next steps.

  • State-local partnership description
  • State agencies: State Board of Education/Department of Public Instruction, Department of Health and Human Services, Division of Public Health
  • NGOs: Alliance of Athletics, Health, Physical Education, Recreation, and Dance; Lung Association; Heart Association; School Nurse Association; School Health Association; PTA; Council of Churches; Citizens for Business and Industry; Adolescent Pregnancy Prevention Coalition; Communities in Schools; Cancer Society; Institute of Medicine; Association of School-Based-Linked Health Centers
  • School-community partnership description
    • Four school districts are participating in the project
      • Wayne County: Goldsboro schools; strong community collaboration
      • Montgomery County: strong community collaboration and school health center
      • Ashe County: CSHP functioning in middle school, involved school administrators
      • Iredell-Statesville: strong superintendent, central office Health Coordinator and student assistance programs
  • Overcoming fragmentation among health programs and between health promotion initiatives and education reform activities: CDC Cardiovascular Disease Prevention, nutrition education training, USDA Team Nutrition, Title IV: Safe and Drug Free Schools, Legacy Foundation/tobacco use prevention, abstinence, Making the Grade for school-based health centers, counseling, health and physical education curriculum development, UNC Principals Executive Program Grant
  • Immediate challenges
  • Long-term opportunities
  • Website:

Words of Wisdom from CSHP Experts: A North Carolina Guide
North Carolina Healthy Schools, in conjunction with EDC, has recently completed a document that shares their experiences on implementing CSHPs in their state. 
This document, Words of Wisdom from CSHP Experts: A North Carolina Guide, summarizes lessons learned by leaders of four successful CSHPs in North Carolina. The collective wisdom of these leaders is obtained over substantial periods of time working in school systems to improve health outcomes for children, being involved in community partnerships, and promoting improved academic outcomes.

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Although only recently designated and funded as an infrastructure state, Tennessee’s statewide CSHP efforts have been underway for some years and are quite advanced. The "Tennessee strategy" involves a creative combination of state legislation, executive branch activity, communications, and collaborative program development, with a commitment to building a web of inter-connected activity among all stakeholders. As a result of this steady work by advocates in multiple settings, the CSHP concept elicits broad-based support.

Enactment of the legislation, the Coordinated School Health Improvement Act of 1999, gave CSHPs a significant boost. Starting with a legislative champion/leader, ultimately the legislation elicited the support of the majority in each legislative house, producing a bipartisan commitment to the program. The legislation came with a state appropriation of $1 million to fund and assist local school districts' CSHP implementation. It also provided for the establishment of an Office of School Health Programs in the Department of Education, which works in partnership with a Healthy and Safe Communities/Coordinated School Health Office in the Department of Health.

Together, the state agencies developed program standards and guidelines for a Request for Proposals (RFP) to disburse the funds. By soliciting input for the standards from key constituencies, including educators, health professionals, community and business leaders, and families, infrastructure officials obtained additional stakeholder support.

In response to the state RFP, local education authorities (LEAs) submitted plans describing current and proposed future activities to address children’s health needs through CSHPs. To obtain funding, LEAs were required to pledge to maintain funding for current health programs, which ensures the LEAs’ own commitment to the program. In the spring of 2001, the state awarded grants to 10 local school systems to serve as pilot districts.

The infrastructure directors have created a Tennessee CSHP Coordinators Institute modeled on the American Cancer Society training institutes. In May and June of 2001, they convened two orientation sessions for site coordinators, superintendents, principals, and other local district stakeholders. In addition to conveying substantive messages about CSHPs, the two sessions were designed to obtain input from these districts about their needs and interests. By the fall, the Institute will undertake the more formal technical assistance and training efforts.

Key features of Tennessee’s approach, in addition to the legislation, include the following:

  • All Tennessee’s CSHP materials clearly and consistently communicate the CSHP components, concepts, and implementation strategies.
  • A strong independent advocacy coalition, the Tennessee School Health Coalition, is able to provide outside support to government initiatives.
  • A web of long-standing relationships exists among school personnel, health professionals, community agency personnel, legislators, and volunteers. This web connects these people to one another on the common mission of improving health and education outcomes for Tennessee’s children.

EDC technical assistance involves active participation as part of the Institute team to build capacity in local districts, including gathering information and resources from other states and organizations.

  • State-local partnership description: Tennessee’s Coordinated School Health Program is a partnership effort of the state agencies and local public school systems
  • State agencies: Department of Education Office of School Health Programs, Department of Health
  • NGOs
  • School-community partnership description: The project sites must do the following:
    • Emphasize tobacco prevention and cessation efforts, healthy eating habits to combat obesity, and increased physical activity to counteract sedentary lifestyles
    • Involve students, parents, community representatives, and school personnel in system-wide advisory councils and as members of healthy school teams at each school
    • Develop and expand partnerships with County Health Councils and other community organizations
    • Integrate the Twenty for Tennessee health and safety principles on coordination of school health into the overall school program
    • Provide training for administrators, teachers, and other school personnel
    • Establish baseline data for outcomes and measure progress
    • Employ a CSHP coordinator


Ten Project sites are funded for 2001?:

  • Gibson County/Trenton City
  • Henry County
  • Loudon County
  • Macon County
  • Monroe County
  • Putnam County
  • Stewart County
  • Tipton County
  • Warren County
  • Washington County
  • NGO coalition: Tennessee School Health Coalition (
  • Overcoming fragmentation among health programs (e.g., Title IV, tobacco control)
  • Overcoming fragmentation between health promotion initiatives and education reform activities
  • Immediate challenges
  • Long-term opportunities
  • Website:

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