This study identifies the gaps between the skills needed for successful coordinated school health and the coordinators' ability to perform those skills. District health coordinators acknowledged that certain skills are important in developing coordinated school health programs, yet the extent to which they were able to perform these skills is limited. This makes it essential to address those skills and competencies through continuing education and professional development opportunities provided through workshops and state professional associations, where the highest percent of development opportunities occurred. Collaborative efforts with voluntary health organizations, state education departments, and institutions of higher education also can enhance the quality of district health coordinators and improve the status of coordinated school health programs. (Contains 2 tables and 1 figure.)