Andrea Foster joins Dr. Sandie Morgan as the two discuss how integrating health services within school systems enhances student well-being and functions as a vital strategy to prevent human trafficking.
Andrea Foster
Andrea Foster is currently the administrator of Integrated Health within Student Services for the Orange County Department of Education. She provides supportive services and resources to promote healthy environments for over 400,000 students and their families across the county. She wants students to be able to access their education and become productive, successful adults. She has 24 years of school nursing experience across multiple settings and was recently a guest speaker at the annual Ensure Justice Conference.
Key Points
- MTSS (Multi-Tiered System of Support) is a tiered framework that supports students at all levels—from universal interventions like screenings to highly individualized health or academic plans.
- Integrated Health addresses the intersection of medical, emotional, and academic needs, ensuring students are supported holistically across environments.
- Schools function as safety nets, especially when community awareness of MTSS allows families to engage with school systems more effectively.
- Staff training to identify red flags and behavioral patterns is crucial in creating trusting environments where students feel safe to share concerns.
- Rather than punitive responses to tardiness or behavioral issues, staff are encouraged to approach students and families with empathy and support.
- Programs like “Handle With Care” and “FOCUS” facilitate communication from families to schools when a child may need extra care without disclosing private details.
- Health education in schools—whether related to chronic conditions, substance use, or injury prevention—empowers students to make informed choices.
- Digital wellness is a growing area of focus, emphasizing safe, intentional use of technology and awareness of harmful online challenges.
- Students should be taught to critically evaluate online prompts, understand data privacy, and self-advocate when something feels unsafe or inappropriate.
- Empowering students to self-advocate helps them protect themselves and their peers, especially when navigating online platforms.
- Every child needs at least one trusted adult; school staff can foster these relationships by creating open, safe environments for honest conversations.
- Community involvement—through school board engagement, volunteering, or partnerships—can strengthen schools’ ability to support students and families effectively.
Resources
Transcript
[00:00:00] Sandie Morgan: Welcome to the Ending Human Trafficking Podcast. I’m Dr. Sandie Morgan, and this is the show where we equip you to study the issues, be a voice, and make a difference in the fight to end human trafficking here at the Global Center for Women in Justice Vanguard University. This is episode number 343, integrating Health Services in school strategies to keep students safe.
Andrea Foster is currently the administrator of Integrated Health within the student services for the division of the Orange County Department of Education. She provides supportive services and resources to promote healthy environments to over 400,000 students and their families across.
County. She wants students to be able to access their education and become productive, successful adults. She has 24 years of school nursing experience across [00:02:00] multiple settings, and recently she was a guest speaker at our. Annual Ensure Justice Conference, and I think one of the things I loved, Andrea, was how you advocated for where the kids are and what they need.
So welcome to the show.
Thank you Thank you so much for having me. It’s a pleasure to be here.
so let’s start off first with a little bit of an understanding of where your role in Department of Education fits in this concept of MTSS. What is MTSS and why is it such a big deal here in California?
[00:02:46] Andrea Foster: So MTSS stands for the multi-tiered system of support, and this is a tiered system, that we can utilize or a framework. That we can utilize to support students wherever they’re at, and [00:03:00] whatever their needs are. So, tier one is our supports that we provide to all students. these are things like preventative measures.
Other supports like vision and hearing screenings. on the academic side, it’s gonna be your normal academic, accommodations that are made during the school day. Once you get into tier two, this tier is for a select group of students, so students who need some additional support. Typically for support services personnel, these are kids that have been identified as needing some additional support.
And usually those supports are provided in a group setting. And so again, small number of students, isn’t, isn’t a accommodation that is applied to all students, and typically provided in a group setting. these may include, Small group settings
such as maybe a counseling session, with a group talking specifically [00:04:00] about an issue that’s on campus or on the academic side.
It could be a small group session, small, to provide additional support with reading or additional supports with math. So it MTSS really accommodates kids. In every path that they’re on, in the setting and really covers them as a whole child. When we’re looking at tier three interventions, those interventions are really very specific and individualized to a student.
So, if you’re looking at health in particular, these are gonna be kiddos who have five oh fours or who have IEPs or who have specialized healthcare plans, for chronic medical conditions. On the academic side, you would see again, IEPs with academic accommodations or five oh fours with accommodations, to support these kids so that they can, be successful.
[00:04:51] Sandie Morgan: I love that. And so now I’m looking at your job title and this word that’s in it, [00:05:00] integrated student wellness. What does that mean in your everyday administration?
[00:05:08] Andrea Foster: So I, when I am doing programming or providing professional development, or really working collaboratively across Orange County, I’m looking at how health integrates with the whole child. you know, you can’t just look at the child in, in one, domain. You know, we talk about Maslow’s hierarchy of need, and you have to meet all of those needs before.
Anyone can be successful and actualize, their potential. And so, for integrated health, I’m really looking at where health is a cross section with all of these other components. So whether it be mental health, whether it be housing, whether it be, other things that are going on in their lives, as well as their academic status.
So how do we integrate all of this for the success of the student?
[00:05:58] Sandie Morgan: and when we’re [00:06:00] looking at different school environments and trying to integrate this when they have challenges at home? I think we put a lot of our hope in the ability of our schools to become a safety net, and our Ensure Justice Conference was titled This Year, safety Nets.
We’re thinking about online safety to some extent, but just community safety nets. How can we be more.I guess my question is how can we help in those integrated ’cause I think the community has to know how to be part of that MTSS model.
[00:06:48] Andrea Foster: So I would say, just being aware of that multi-tiered system of support and how school districts utilize that to support their students. So really being able to understand the [00:07:00] language. you wouldn’t necessarily, as a community member or a family member need to know what falls within each of those.
Just knowing that that is. What school districts use as a framework and being able to ask, you know, how can the multi-tiered system of support support my student who is experiencing. Fill in the blank. experiencing homelessness, experiencing, a chronic health condition, experiencing academic needs, experiencing trafficking.
so just really understanding the language so that, so that they know what to ask for when they’re at a school site.
[00:07:40] Sandie Morgan: So when I’m thinking about what that looks like, that integrated support, I am thinking about it from a pediatric nursing background and all of my years of communication with school nurses, and there is a [00:08:00] major focus, like in that first column in.
MTSS of prevention that, I mean hearing and brushing your teeth and all of those kinds of things. Where does this aspect of prevention fall When we’re trying to help our kids who need a safety net and the school is a key part of that.
[00:08:26] Andrea Foster: So I think it’s multi-tiered here. So the first I would say is really being able to identify, and monitor for red flags. And so that’s really important. and part of that is. For school district is really providing that training so that personnel are aware of what those red flags are and understand what it looks like to identify patterns, and then be able to build a safety net, of trusting relationships.
You know, creating a, a calm environment, a [00:09:00] non-judgmental space where students feel comfortable to be able to share information, whether that’s in the health office, their. Counselor, their social worker, their teacher, really everyone on a school site is responsible, for creating this safe space and building these relationships with students.
and then using open-ended, language with students, which gives them an opportunity to think, and to provide their own language back. And then checking in with kids regularly to make sure that they have the supports that they need and, if something comes up, they’re, they have the time and the space to be able to share.
[00:09:40] Sandie Morgan: let’s. Let’s do kind of a role play here. I am a kid who chronically comes to school, tardy late. when I was going to school, that meant I would get like a red mark next to my name. What would you be [00:10:00] training the person in the front office to do instead?
[00:10:04] Andrea Foster: So really I would be training the health office because that’s my role. but I would say for. For all staff and, and this has kind of changed in the last couple years, is really again, with the family members, creating that safe space, letting them know that we care about the students and that we want the students to be there and that we’re there to support them, whatever they’re going through.
whether it’s the students or the families, you know, providing resources, so that the student is able to come to school and feel supported enough that they can, access their education and so that families feel like their students are safe at school, and getting what they need.
[00:10:48] Sandie Morgan: I love that because I know, sometimes. If you think about a nine or 10-year-old, who’s late, they aren’t the ones responsible for getting out the [00:11:00] door, finding transportation, and so something else is going on. And so I wanna find a way for that child not to start late in the classroom already feeling chastised and in trouble and raising the.
Anxiety bar that reduces their ability to learn. So thinking through some of those things, I think those are part of the red flags that we’re working on. And I know in the health office, when I was in your training, I was. Very impressed with how many protocols are already in place when kids come in, and those protocols are designed for making sure kids feel supported so that they can access their education.
I think that’s kind of a [00:12:00] new, not. I, I wouldn’t say it’s a new, I think it’s an emerging best practice that we’re not here to, chastise a kid who really may not have any control. We want them to be successful learners. What would you recommend to parents who are struggling and they. Drop their kids off.
What could a parent do to make that a smoother transition? Because maybe they’ve got health issues, they’ve got, they’re in a generation where they’re taking care of. Older adults in their family, their caregivers at both end, or they have a work where their schedule is very different than their kids’ school.
How can parents access help in that space?
[00:12:56] Andrea Foster: Well, I think there are a couple things. One, building a [00:13:00] positive relationship with your school system. uh,whether that’s your teacher, your child’s teacher, whether that’s the principal, whether it’s the worker in the health office, having someone who. You feel confident and confident in that can support you in some of this work.
And then, because they, they will also be providing resources to you when you need those resources. So being comfortable enough to, to ask the questions to those people. But I would also say, having a warm handoff. So if, if a student is really struggling on a particular day or there’s something going on at home. Parents don’t necessarily need to provide all of that information, but what would be helpful is providing even just a simple comment, maybe to the teacher or the principal, to handle that student with care that day. so that, if there’s something coming up that teacher knows that there’s something going on at [00:14:00] home, and they can provide some additional support.
Or if, there’s a test that day, for example, maybe that’s not the best day for that student to take a test. And so the teacher or the administrator really knowing or, or your support person really knowing, that that student needs some additional TLC that day sometimes is really beneficial.
[00:14:22] Sandie Morgan: I love that. Years ago at Ensure Justice, we focused on a program called Handle With Care, and you didn’t have to provide any background information. And then Orange County, we launched our own version, I think it’s called Focus, and the idea of focusing on the child, not what’s happening, but. Knowing that maybe they might have missed breakfast because of whatever happened in their community or in their home.
So that’s an an encouraging piece [00:15:00] of this integrated services to our kids. Let’s move over to talking about education as prevention and where do you see that in your work and in what parents can do to better support their kids? I.
[00:15:21] Andrea Foster: So I would say school nursing in particular does a lot of education in the health office, and a lot of preventative, health education, in regards to bicy ebi safety in regards to, Diabetic management in regards to chronic health conditions. marijuana use, you know, so there’s a lot of preventative education that occurs in the health office.
but it also occurs across the campus, you know, when. Students, are with an administrator. There may be some additional preventative, education that occurs when they’re in PE [00:16:00] class, when they’re in health class. they’re getting a lot of preventative information and that’s so vital, that they have the information so that when they are making decisions, that they’re making decisions, educated decisions.
[00:16:14] Sandie Morgan: And this kind of leads to the panel that you participated on at Ensure Justice. The title of that panel was connected and protected. The Role of Schools in Empowering Students for Digital Wellness. So here’s where. A lot of the work that I did as a pediatric nurse was hands-on, take their temperature, monitor them, deliver medicine, but digital wellness is in, in your space of integrated health.
So what does that look like in in schools?
[00:16:57] Andrea Foster: So everybody is responsible for [00:17:00] digital safety. this isn’t just a parental issue. we know that our kids are online. Much of the day, whether it’s for academics or whether it’s for entertainment. so in the, in the education set setting, it’s really important and incumbent on us to really provide the education of where the pitfalls lie.
how to prevent those pitfalls so students understand, why people would want their data. They understand.how to really look at what’s being asked and whether or not that that’s something that they should provide in any online component, as well as really starting to look at how much they are online and are there other opportunities.
You know that they can utilize their online platforms, but also utilize other opportunities in the classroom that [00:18:00] support each of those. And so just really taking a look at it. And then, you know, we talked a little bit about those red flags, you know, really looking at. Asking the students, what they’re working with and, and what online platforms are they utilizing because we are gonna start to see some of those patterns,specifically some of those patterns where we see kids who are on specific platforms and, that promote these unhealthy challenges, that students often find themselves in the midst of, and, you know, have health.
Have health outcomes that are not positive or have other things that happen in their lives because of those particular challenges. And so just really asking the question of those students, as well as providing that education of, of what’s really happening in the world and, and having a discussion about it.
[00:18:55] Sandie Morgan: wow and finding safe ways to have those conversations [00:19:00] is. The role of our educators in the classroom, and you, you already mentioned, are they using these devices for their academic journey or for entertainment? So when it’s part of their academics, taking it away.
Is not going to solve the problem and may actually limit, their empowerment. Now, you talked about unhealthy challenges. Let’s just talk about that in more plain language. What is that looking like in our schools today?
[00:19:38] Andrea Foster: So I would say probably one of the biggest ones that we, I think everybody heard about, was the, was it the Tide pods or it was the, pods that you put
[00:19:51] Sandie Morgan: yeah, Uhhuh.
[00:19:52] Andrea Foster: and, and kids were to challenging each other to consume those, which was creating a lot of health [00:20:00] issues. Which, you know, if you look at it from an academic standpoint, not only is it a health issue, but it keeps them outta school, which then becomes an academic issue as well.
but, some of these other challenges, um, there was one here just recently where, adults and, and. Children were challenging each other to run and jump on these really thin rails, and try to, to slide down these really thin rails, um, of which a lot of people broke bones, um, had traumatic head injuries.
again, you know, which prevents them from doing the other things in their life that they should be doing. So really helping students understand that these challenges really aren’t, A good, a good use of their time, and the safety hazards that go along with them.
[00:20:49] Sandie Morgan: And I don’t, I think so much when we talk about online safety, we’re thinking more about some, a child being groomed, and we’ve talked about that on this podcast a lot, and I’ll [00:21:00] put links to some of those. But this idea that physical safety can be compromised by online engagement is something we are not always paying a lot of attention to.
The, the other thing that you just mentioned that makes me kind of curious ’cause you said, and adults doing it too. I have this idea that we have put a lot of pressure on teachers, educators, Professionals in our education community to keep our kids safe online. And the kids are digital natives.
They’ve grown up. I have freshmen in my class right now who from the time they were in kindergarten, had a device in their hands in the classroom. And yet I want someone like you to be responsible for keeping all these kids safe. And every platform is a [00:22:00] new experience for us. We are asking. Adult professionals to add a new skillset, and I think one of the things that you’ve done in Orange County with the number of workshops for school professionals in integrated health is try to provide the resources to help.
That community come up to speed to be able to, respond appropriately. What’s your biggest challenge in that space?
[00:22:38] Andrea Foster: I think the biggest challenge is that technology is just moving so fast that it’s very difficult to keep up with what the next big trend is gonna be, and so. When you talk about providing preventative education,you’re really looking at how do we get the information to them before they [00:23:00] have the opportunity to access whatever we are trying to prevent.
And, in this space right now, it almost feels impossible. And, and I, I would say not only for educators, but for community members and our, Our legislatures and our families, you know, it, it’s just moving so, so fast that the next new thing is there before you even know it’s gonna be a problem.
[00:23:26] Sandie Morgan: Wow. And the quick response that seems like it would fix it is, let’s just take it all away. how effective do you see that as a strategy?
[00:23:41] Andrea Foster: So I don’t think it is a, I don’t think it’s a doable strategy. We have come to a point, where we are moving so fast in technology that it would almost be impossible to take it away. not to mention the fact that you talked about your freshmen who [00:24:00] are, are native to this world. it would be harmful to them.
As well as there is a lot of good that technology is bringing us. it’s decreasing some of the amount of the mundane and tedious things, that, that technology can take care of, which frees us up to do other things that are more important. it’s also the information age, you know, it’s not just all of the, YouTubes and tiktoks and, all of those platforms, it really is being utilized for education. And so to take it away, I, I don’t think, I don’t see that as an, as an option. not at this time. Mm-hmm.
[00:24:45] Sandie Morgan: I, yeah, I can’t imagine teaching. I do. I even do attendance. I. Online and it captures it, and then the registrar’s office has it. So I’m not filling out, forms, which means then [00:25:00] I have time to engage my students and talk about what’s happening in their lives. And, and I think that’s one of the things we have to be aware of is what is the trade off?
How am I using that to benefit my role as an educator? when we were talking about this on the panel about digital wellness, the idea of empowering the students, what are some tips for making sure that kids understand their ability to choose well?
[00:25:41] Andrea Foster: Well, I am a big proponent for teaching anyone to be a good advocate for themselves, whether we’re in a medical space, and they’re advocating for their own health, where whether we’re in the academic space and they’re advocating for whatever they need to [00:26:00] support them in their. Ability to be successful.
It’s the same thing with our media. Really giving them the information that they need, to make good decisions, but also giving them a voice so that they can advocate for themselves what’s working, what’s not working, and then again, creating that safe space where they have an opportunity to share, their advocacy for what they need.
[00:26:29] Sandie Morgan: so what would that look like for say, a fifth grader?
[00:26:34] Andrea Foster: So, what it could look like is if a fifth grader was feeling like, Maybe there’s something online that makes them uncomfortable or there’s someone online asking them for information that makes them uncomfortable, then they would have that space, safe space to be able to advocate for themselves, be able to ask questions about, I’m on [00:27:00] this particular platform and this is what I’m being asked.
I is, is this the right, is this appropriate? Or I’ve been playing this game and my PlayStation says that I need to give it access to my firewall, which would allow them to get in.into their system is, is that the right thing to do because it, you know, after what you’ve just taught me, maybe it’s not the right thing to do.
So really giving them an opportunity to ask those questions. and then maybe not in, maybe not giving them a direct answer, maybe showing them where they can find the answer and supporting them in looking that information up. So that really becomes that advocacy piece where they’re learning. they have the safe space, and they’re able to ask the questions.
[00:27:49] Sandie Morgan: Wow. And then they can take the next step instead of us being like the sheriff going around checking on everybody. I have this [00:28:00] sense that when kids learn to self-advocate, they also, in their little community can become a protective factor. Because they talk to their friends and they say, no, no, no.
You should not listen to that guy on your PlayStation. You need to block him. And the the, I think this has to carry over in homes as well. And the idea that you get to ask all those questions if something is considered. Something you can’t talk about, then we don’t empower our kids to respond and and be more self-reliant and confident in their online experience.
When we were at the conference, you talked about [00:29:00] how, An adult can be a protective factor. And I actually have a quote, you said, every child is one trusting adult away from fill in the blank. And online safety is one aspect. Some of these other things, that you’ve mentioned that result in physical.
Injuries are part of it, but that one, trusted adult. We have put a lot of burden on teachers and on parents, but not every kid has developed that relationship with, A teacher or they haven’t had a stable home life, they’ve had multiple placements in foster care. Tell me about your definition of a trusted adult.
[00:29:58] Andrea Foster: Well, I would say, first of all, [00:30:00] I borrowed that from the California Department of Education, so I wanna give them credit, for that statement. but a trusted adult is someone who gives a, a person, an individual, an opportunity, to be heard, an opportunity to have a voice, and feel like they have a safe space where they can utilize that voice.
And so. People who are around the students, if they can provide those opportunities for students, not only will they, give the student an opportunity to voice, whatever’s going on in their lives, but they also give ’em the opportunity to build a trusting relationship. and it’s interesting when you’re in education, sometimes you don’t.
You don’t know what happens to your students after they leave you, but there’s not a greater feeling of when they come back and they say, you know what? You made a difference in my life. And you don’t remember specifically what you [00:31:00] did other than you gave them an opportunity to, to have a voice and gave them a space where they could use it.
[00:31:07] Sandie Morgan: Wow, that’s so good. So, as we look at this idea of the community response to. Integrated health. Is there something that our community can contribute to their local school that will help improve the opportunities for kids to be safer online, to have healthier opportunities and be more supported in education?
[00:31:44] Andrea Foster: I would say be a part of your community, whether you are a community member, whether you’re a family member, whether you’re an agency that’s providing services, get involved. That’s really [00:32:00] what community schools have always been about, is bringing services to the school site to support students and their families.
And so understand what your board priorities are, understand where they’re spending their money. Um And get involved. Be a part of helping them determine where that money is being spent. Work at your school sites, volunteer at your school sites. understand what your board of education and what your school stands for.
What are their, what are their goals? What are their objectives? And then participate, in all of that.
[00:32:40] Sandie Morgan: We recently did an interview with a former DEA agent, and we talked about following the money, so I love that your advice is so practical. We talk about things at a, at a kind of 30,000 foot level, but. What [00:33:00] I heard from you when I participated on site in one of your workshops, what I heard from you in Ensure Justice and what I hear from today is that it is a community response and being a trusted adult.
Is part of making sure our kids are safe, whether they’re online or out in our communities, and I’m just grateful that we get to partner and keep partnering with our community, and the Department of Education. I encourage our listeners find out what’s going on in your department of education. I love the idea of.
School board meetings, I’d ask people, when is the last time that you went to your school board meeting? And I know people who have never been to a school board meeting, it’s a fun thing to get to do and they let [00:34:00] you ask questions and they appreciate parents and community leaders being involved as so think about those are such good recommendations.
Last word from you, Andrea.
[00:34:14] Andrea Foster: I would say just stay involved. working with schools is one of the best things that I have ever done. And, I would encourage all community members, stakeholder members, family members, get involved with your school setting. it really takes a village, and this is an amazing community, to partner with.
[00:34:32] Sandie Morgan: Thank you so much for being part of our ending Human Trafficking podcast. We wanna start right where the kids are in building strategies for prevention, and I wanna be one of those trusted adults to our kids. Thank you.
Andrea, it’s been such a pleasure having you with us.
Thank you for the important work you’re doing and for sharing [00:35:00] it with us and to our listeners. If you found this conversation impactful, don’t keep it to yourself. Share it with a friend, and be sure to subscribe so you never miss a new episode. Don’t forget to check out the show notes, helpful resources, and more on our website at endinghumantrafficking.org.
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