Funding School Health Programs

State Revenue Survey Questions

July 1999

SCHOOL HEALTH PROGRAMS FUNDING SURVEY
This assessment instrument asks for information on various K-12 school health programs (regardless of state funding source). We are interested in amounts appropriated for school health programs by your state legislature. Please indicate amounts only if amounts were set aside for school health programs in law. In your answers, please consider all health related programs delivered through the K-12 education system.

Person Completing Survey:	____________________________________
Agency:	____________________________________
Address:	____________________________________
Phone/Fax:	____________________________________

SCHOOL HEALTH COMPONENTS

Please indicate below how much state general fund and/or state restricted revenues are designated in law to be used to finance the following health related activities in the K-12 education system (if possible, please exclude administrative costs). Also, specify the explicit source of financing where possible. Round to nearest thousand for fiscal year 1997.

If your state does not use state general fund and/or state restricted revenues for a component, please skip to the next question.

1. Health Education Exclude special education services. (For example: substance abuse, HIV, smoking prevention, or teacher training for health education)
FY 1997 Amount:

2. School Health Services Exclude special education services. (For example: school-based health clinics that provide primary health care for students such as wellness check-ups, sports physicals, hearing or vision screenings and immunization)
FY 1997 Amount:

3. Nutritional Services: Exclude state match for school lunch or breakfast programs.
FY 1997 Amount:

4. Physical Education (For example: physical activity promotion programs)
FY 1997 Amount:

5. Counseling, Psychological and Social Services Exclude special education services. (For example: school counselors, social workers, or other mental health services)
FY 1997 Amount:

6. Staff Health Promotion (For example: teacher or school staff wellness programs or teachers as fitness role models)
FY 1997 Amount:

7. Healthy School Environment (For example: programs that promote anti-violence, no smoking zones, smoking cessation, or drug-free schools)
FY 1997 Amount:

8. Parent and Community Involvement (For example: workshops for parents to learn about adolescent development and behavior or other family interactions)
FY 1997 Amount:

For each of the above questions, to which you assigned a value, please answer all of the following questions.

a. What is the statutory citation (administrative rule or executive order) that authorized the health education programs described above?

b. Please describe the programs or projects that are eligible to receive state general funds and/or state restricted revenues for health education. (If necessary, please attach additional documentation.)

c. Briefly describe your state's eligibility requirements for the programs that receive state general funds and/or state restricted revenues for health education. (If necessary, please attach additional documentation.)

d. If the funding cycle differs from the state's fiscal year, please indicate the funding cycle.

e. Briefly describe the target population of the programs that receive state general funds and/or state restricted revenues for health education. (i.e. K-3, K-12, etc.)

f. Please indicate below whom to contact for additional information about these state general funds and/or state restricted revenues available for health education programs.

Name of agency: __________________________
Contact person: ___________________________
Phone Number: ___________________________
Fax Number: _____________________________
E-mail Address: ___________________________