Two major trends have affected the responsibility of the public schools in providing health education and services over the past 2 decades. First, the structure of the family and the demographics of the school-aged population have changed dramatically, placing greater burdens for child welfare on school systems. Second, the leading causes of morbidity in the United States have changed from infectious diseases to behavior-related chronic diseases (injuries, homicide, and suicide). In light of these changes, the National School Boards Association (NSBA) is focusing on the needs of the whole child, a holistic approach to education, and a coordinated youth policy. This document discusses how to establish a health program that encompasses health education, health services, and healthy school environments. Several primary obstacles to implementing school programs include: (1) directives concerning health education; (2) the already-packed education agenda; (3) the fact that local needs may not be adequately considered; and (4) the impact of coordination with other agencies that provide health education and/or services. This guide aids policymakers in overcoming these obstacles by describing the elements of exemplary programs and illustrating processes for achieving them. Examples from four existing programs provide guidelines and identify resources for school board members, school administration staff, and their communities. (35 references) (LAP)