“Could someone help me with these? I’m late for math class.”

School-Based Health Centers (SBHCs): An Intersection of Health and Education for Children & Adolescents

Iliana White, Program Manager School-Based Health Alliance May 20, 2015

Schools = epicenter of family & community health

• They are hubs of community engagement and mobilization

• Barometers of social issues and factors • Accelerants of opportunities

• Intervene at critical stages of children and adolescents’ development

• Influences socialization, behavior change, and development

What is a school-based health center?

Trusted Familiar Immediately

accessible

Common Characteristics High-Performing SBHCs

• Located in or near a school facility and open during school hours.

• Organized through school, community, and health provider relationships.

• Staffed by qualified health care professionals.

• Focused on the non-academic barriers to academic success that can interfere with a student’s learning.

Winning Recipe for Student Success High quality, comprehensive, child-focused primary care

+ Public health orientation

(school as target) +

Strong school partner that provides welcoming environment

= First class support for children and adolescents at

high risk for poor health and academic outcomes

Services Provided • Comprehensive primary care • Prevention & early intervention

• Injury and violence prevention • ATOD Use Prevention • Healthy Eating and Active Living Promotion

• Behavioral health • Reproductive/sexual health • Oral Health • Vision

37.4% 33.4%

29.2% SBHC Staffing Profiles (n=1381)

Primary mental health plusPrimary care and mental healthPrimary care only

Primary Care

Mental Health

Nursing or Clinical Support

Oral Health

Health Educator

Dietician

85.8% (n=1185)

15.9% (n=219)

16.0% (n=221)

10.7% (n=148)

100% (n=1381)

70.8% (n=978)

Provider Types

in SBHCs

66.6% 73.1% 60.8% > 31 HOURS/WEEK AFTER SCHOOL BEFORE SCHOOL

67.7% located in schools characterized as Title I (n=1199)

76.8% serve schools where more than 50% of students are eligible for free or reduced-price lunch (n=1194)

50.7% 37.4% 37.1% 33.1% 18.9%

Students from other schools

Family of student users

Faculty or school personnel

Out-of-school youth

Other community members

Populations Eligible to Use SBHCs

2 of every 3 SBHCs serve at least one population other than students (n=1264)

School/SBHC Integration & Collaboration

school improvement team

31%

crisis management team 50%

student-led groups: student government and clubs 26

%

after-school program team 19%

community school committee 28

%

IDEA (Individuals with Disabilities Education) Team 18

%

school wellness committee 68%

86% of SBHCs

participate in at least one

school team or committee

(n=1265)

SBHCs: The Evidence Base use of primary care inappropriate

emergency room use • Greater than 50%

reduction in asthma-related emergency room visits for students enrolled in NYC SBHCs

SBHCs: The Evidence Base hospitalizations

• $3 million savings in asthma-related hospitalization costs for students enrolled in NYC SBHCs

access for hard-to-reach populations - esp minorities and males • Adolescents were 10-21 times

more likely to come to a SBHC for mental health services than a CHC or HMO.

SBHCs & Academic Success absenteeism and tardiness

attendance

in GPA over time

academic expectations, school engagement, and safety and respect

Public Health-Education Partnership Opportunities Health equity Immunizations Disaster preparedness Teen pregnancy Violence, bullying

STIs HIV/AIDS Obesity Suicide Substance use Learning readiness

Primary Care

Public Health

Education

Not just health care, but concerted efforts around students’ well-being • As a model, the SBHC can bring attention to issues that

may be overlooked AND be a key part of a collective process

• SBHC staff (and sponsors) have a lot of expertise • Are often underutilized, not involved, not

considered, or left untapped • SBHCs collect data (quantitative, qualitative, anecdotal)

that provides a cross-sectional snapshot of students’ health

Responsive rather than reactive: Realigning health with care

Product: broaden concept to ameliorate effects of nonclinical determinants

(Inadequate food, housing, safety)

Place: beyond medical complex neighborhoods

Provider: nontraditional team members (Community outreach workers, heath educators,

coaches, resource coordination)

Learning Factors and Environments: “Make or Break”

• What enables and what inhibits a child’s ability to learn?

• Is the school climate conducive? • How can SBHCs intervene and respond?

“Could someone help me with these? I’m late for math class.”

LOCATIONS ACROSS THE U.S. AND IN YOUR BACKYARD

Alaska Marshall Islands Hawaii Puerto Rico & Virgin Islands

Locations of SBHCs Nationwide (n=1930)

2010-2011 school year

In the tri-state area

Number of SBHCs (2010-11 school year) • New York—231 • New Jersey—24 • Pennsylvania—31

WHO WE ARE The School-Based Health Alliance

Our Vision

All children and adolescents are healthy and achieving at their fullest potential. Our Mission To improve the health status of children and youth by advancing and advocating for school-based health care

Our Goals 1. Support Strong School-Based Health Care

Practices 2. Be the national voice 3. Expand and strengthen the SBHC movement 4. Advance policies that sustain SBHC

NASBHC Offerings • Policies • Programs • Funding

Advocacy

• Webinars • Free on-line content • Professional Services

Training & Technical Assistance

• Individual ($100) • Organizational ($500)

Membership

School-Based Health Alliance Offerings

SBHC Leadership at the State Level

Arizona California Colorado Connecticut Delaware Florida Georgia Illinois Louisiana Maine

Currently have 19 established state affiliates and 6 emerging affiliates

*Emerging Alabama Arkansas Montana Nevada

Pennsylvania South Carolina

Maryland Michigan New Mexico

New York North Carolina Ohio Oregon Washington West Virginia

OPPORTUNITIES FOR COLLABORATION

Find out more about the SBHCs in your area

Connecting with the SBHC field

• Through your state SBHC affiliate or association (if one exists)

• Through the sponsoring organization(s) of SBHCs in your region

• Through state and national SBHC conferences

Resources

General www.sbh4all.org/aboutsbhcs SBHC Data www.sbh4all.org/data Archived Webinars www.sbh4all.org/webinars

Thank You!

Iliana White, MPH, CHES, CPH Program Manager

School-Based Health Alliance 1010 Vermont Avenue, NW Suite 600

Washington, DC 20005 202-638-5872 Ext. 214 (p)

iwhite@sbh4all.org www.sbh4all.org