School Based Health Centers - Past and Present

By CLC Consultant, Johanna Heller

Did you know the start of healthcare in school-based settings can date its origins back to the late 1800s?  Large cities like New York, Boston, Chicago and Philadelphia were some of the first to implement school medical inspection programs. These later developed into teams of healthcare providers designed to oversee the health needs of children in schools.

These humble beginnings were largely motivated by the need to survey, identify and rapidly contain via quarantine, the contagious childhood diseases faced by citizens in those days. These diseases we are now able to combat for the most part through a variety of means including vaccines, scientific knowledge and acceptance of the existence of bacteria and viruses, handwashing, and adequate public sewage systems to name a few.

These progressive surveillance programs complemented Society’s new way of thinking about education and the new laws requiring school attendance. Notably, they were not accepted by everyone, and did see protests as the programs developed over time.[i]

The first current day School Based Health Centers (SBHC) emerged in the late 1960s and early 1970s with a focus on family planning access, teen pregnancy prevention and support to adolescent parents. Studies were completed on health outcomes and impact of these initial programs. While the findings have been disputed, the work raised awareness of the programs among the right leaders and eventually a nation-wide push was undertaken to promote the spread of the SBHC Model.[ii] 

In 1995, the nonprofit School-Based Health Alliance was developed and has become the national voice for school-based health care [iii]. Multiple states have State Affiliate programs to share and support the Alliance’s mission, vision and core values[iv]. School-Based Health Alliance provides training, advocacy, and resources to SBHCs across the United States, as well as collecting data on the impact SBHCs are having in our communities.

So, what are School Based Health Centers today? We know if you are not a healthy child, being a productive member of society is difficult as an adult. Likewise, there is a strong correlation between student health and academic achievement[v]

SBHCs are recognized as a tool used to achieve health equity among children and adolescents who unjustly experience disparities in outcomes simply because of their race, ethnicity or family income.[vi] For several reasons, SBHCs have also been found to more likely be financially successful when run by FQHCs[vii] in partnership with schools.

What services are offered at School Based Health Centers?  The types of services offered by SBHCs varies from program to program. Obtaining buy in from the community and school partners can help drive what services your FQHC might bring to your SBHC. Services may include Primary Care, Mental / Behavioral Health Care, Dental/Oral Health Care, Health Education and Promotion, Substance Abuse Counseling, Care Management and Nutrition Education as well as treatment of acute and chronic conditions.

With an emphasis on prevention, early intervention and risk reduction, SBHCs counsel students on healthy habits and how to prevent injury, violence and other threats [vii]­. Some SBHCs serve just students, others can open their doors to students and their families.

What does this mean for your organization? Does your FQHC have a strong partnership with a school in your community?  Have you thought about expanding your services into a school? Do you already have an SBHC operating and have talked of expanding? If so, HRSA has recently posted a funding opportunity to help expand access to health center services at school service delivery sites.

Interested? Contact Grant Consultant, Leanne Cardwell at Community Link Consulting if you wish to talk more about the grant opportunity. Leanne can be reached at leannec@communitylinkconsulting.com.

Source:

[i] “Better Off in School”: School Medical Inspection as a Public Health Strategy During the 1918–1919 Influenza Pandemic in the United States (nih.gov)

[ii] Twenty Years Of School-Based Health Care Growth And Expansion | Health Affairs

[iii] About Us | School-Based Health Alliance About Us | Redefining Health for Kids and Teens (sbh4all.org)

[iv] State Affiliates | School-Based Health Alliance State Affiliates | Redefining Health for Kids and Teens (sbh4all.org)

[v] Critical Connections: Health and Academics - Michael - 2015 - Journal of School Health - Wiley Online Library

[vi] About School-Based Health Care | School-Based Health Alliance About School-Based Health Care | Redefining Health for Kids and Teens (sbh4all.org)

[vii] School-Based Health Centers: A Funder’s View Of Effective Grant Making | Health Affairs