Making Great Strides: Seizing Local Opportunities to Advocate for School-Based Health Services

NASBHC Conference 2007Washington, DC

Presented by:

Melva D. Visher, MA, RHIA, Vice President Community Health

Kaleida Health, Buffalo, NY

Assunta Ventresca, Director Health Services,

Buffalo Public School System, Buffalo, NY

Learning Objectives

At the end of this workshop, participants will be able to:

1. Apply successful strategies for local advocacy

2. Use suggested materials or design your own materials to educate local policymakers on student health needs and essential services for children

3. List shared challenges and effective methods of engaging parents in local advocacy efforts.

Buffalo, New York Community Profile

Total Population: 292,648 (U.S. Census) Buffalo Public School Registration 37,483 Students

(PK-12) Non-Public School Registration 4,000 (PK-12) 64

Public schools and 20 non-public (Catholic, charter) school facilities

In 2005, 12 SBHCs located in Buffalo Public Schools (10 operated by Kaleida Health, 2 by Catholic Health System)

Regulatory Environment

- Since 1913 NYS Education Department (Section 901, Article 19) Law requires “medical inspection” (aka: school health services) provided in school districts across the state

- School districts in Buffalo, New York City and Rochester were exempted from the legislation, as these cities’ local public health departments were providing school health services when the NYS Education Law was enacted

- In Buffalo, the Erie County Health Department provided and funded school health services for Buffalo Public Schools between 1913 and 2005

Regulatory Environment

In March 2005, the Erie County Health Department eliminated all funding for school health services

Buffalo school-age children were left without school health services for the first time in more than 90 years!

The “Call to Action”

1. Usually 3 reasons people engage in advocacy

• Hope

• Rising Expectations

• Anger

2. The Buffalo experience/local advocacy agenda was prompted by anger

What is Advocacy?

Successful Advocacy

Identifying Problems + Finding Solutions

= Changes in Policies and Programs

An Introduction to Advocacy by: Ritu Sharma

Basic Elements of Advocacy

Select an Agenda Use Data & Research, Identify Advocacy

Audiences, Develop & Deliver Message Build a Coalition Make Persuasive Presentations Evaluation of Efforts

Advocacy Agenda

Ask yourself: Will your issue bring a diverse group of

individuals to the table? Will that group be powerful enough to bring

about change? Will the group remain committed over

time?

Data & Research/Audience & Message: The Buffalo Experience

Local Foundation convened a “workgroup” on Student Health Services – worked over a 2 month period.

Foundation funded the research and development of a White Paper on student health needs/services in Buffalo

White paper included recommendations that the Buffalo Board of Education provide funding for full-time nursing services in Buffalo schools, and New York State Health Department expand the number of SBHCs

Build A Coalition Buffalo Coalition Members Represented a Diverse

Group:– Health Insurers– Erie I BOCES– Health Systems (Catholic Health System and Kaleida

Health– Parents– Local Foundation (convener)– Diocese of Buffalo– United Way– Colleges/University– Buffalo Public Schools– Erie County Department of Health

Persuasive Presentations

To Buffalo Board of Education and School Administration

To local lawmakers To local advocacy groups To parent networks To school administration advocacy groups To the media

Tools and Tips

Engagement Letters Petitions Local Action Network Media/Traditional & Non-Traditional State/Local School Health Coalitions NASBHC Sign-On Materials Partnerships Parental Engagement

Results: Final Workgroup Recommendations

Full funding of school health services by Buffalo Board of Education (estimate 90 health professionals required)

Expansion of the number of SBHCs Optimize Medicaid funding for nursing and

health services for eligible students, based on their individualized (health) education plan (IEP)

Funding Resulting from the Buffalo School Health Advocacy Efforts

$1.2 million from Buffalo Board of Education in Fall 2005 to restore part-time health services for 2005-06 school year

$5.2 million annually from NYS Education Department to support full-time health services for 2006-07 AND 2007-08 school years

3 new SBHCs opened in Fall 2006 operated by Kaleida Health, funded by NYS Department of Health

2 additional new SBHCs are awaiting approval to operate (Catholic Health System)

Shared Challenges of Advocacy

Perceived apathy Not a priority Gaining attention for the cause Sustaining the momentum Communicating, communicating,

communicating

Build and Sustain Momentum

Strike while the iron is hot Build public awareness via media,

community meetings and other means Get key policy-makers involved in the

cause (Legislator’s press conferences) Partner with other/neighboring communities

facing similar challenges (strength in numbers)

Engage Parents

Find parents of children with chronic health needs (shared passion)

Involve surrogates of parents (clergy, community groups, educators, etc.)

Educate, educate, educate… then communicate, communicate, communicate!

Make the cause a high priority for parents Anger and inequities are powerful motivators

References Buffalo City School District: Choice Committee

Demographic and Other Information About the Buffalo Public Schools – March 2004

Community Health Foundation of Western and Central New York. Health is Fundamental: A Community Report on Health Services in Buffalo Schools – June 2005

Sharma, Ritu R., An Introduction to Advocacy. Website: www.aed.org/tools and publications

U.S. Census Bureau (www.census.gov) website Buffalo City Fact Sheet