Summary of School Health Centers

Illinois Coalition for School Health Centers

" Keeping Students Healthy and Ready to Learn "

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SCHOOL HEALTH CENTERS

SUMMARY

History

The Need for School Health Centers

The Role of School Health Centers

The School Health Center Model: A Solution

HISTORY

School Health Centers emerged in the late 1960s and early 1970s to respond to increased knowledge about the risk-taking behavior of adolescents and to provide accessible, affordable primary health care and health education to children and youth. Since this time, the number of school-based health centers in the U.S. has expanded rapidly, from 31 in 1984 to more than 1500 in 2003.

The first School Health Center (SHC) in Illinois was established in 1982 at Austin Community Academy, Chicago. Since that time the number has grown to 46 School Health Centers throughout the state. Approximately 1/3 serve high schools and the rest serve elementary and middle schools.

Chronology of the School Health Centers in Illinois:

1982—The Robert Wood Johnson Foundation funded the first Illinois school-based health center at Austin High School in Chicago.

1985—The Illinois Department of Public Health (IDPH) and the Illinois Department of Public Aid (IDPA)—reorganized in 1996 as the Illinois Department of Human Services (IDHS)—funded five centers using a combination of state and federal funds (e.g. Maternal and Child Health Block Grant, Social Services Block Grant).

1993—Due to a number of complex issues related to the provision of school health services, in particular financial barriers, IDPH and IDPA convened the School-Based/Linked Health Care Advisory Group. The group, consisting of a broad range of community and state agency representatives, began to address some of the issues and to determine how to both sustain the existing centers and expand the network of centers in Illinois.

1994—The Advisory Group developed final recommendations for long term support of the health centers. These recommendations later became the framework for the creation of a coalition.

1995—Ten additional SHCs, supported for five years with declining state funds were funded. Although each center maintains a different mix of funds to support its operation, they survive through unique combinations of funding sources including: state grants from IDHS, federal grants, private foundations, corporations, Medicaid reimbursements, reimbursements from private health insurance plans, and fees for service.

1996—The Illinois Coalition for School Health Centers (ICSHC) is organized in order to address several challenges for centers including redefining their role within the larger health care delivery system due to the growth of managed care and changes to Medicaid which have an impact on school health center revenue streams.

1997—The ICSHC is successful in its efforts to convince IDHS to reinstate declining grant funds to a stable level. The ICSHC, in conjunction with IDPA, IDHS and ten managed care entities, develops revised “Guidelines for the Establishment of school Health Centers”.

1998—Through ongoing advocacy efforts, school health centers were granted their own provider type. Centers which meet the state standards for school health centers and become certified by IDHS can continue to bill Medicaid at fee-for-service reimbursement regardless of a students managed care arrangement.

1999—The ICSHC is successful in securing tobacco settlement funds for school health centers. The increase in funding for the school health center program resulted in the expansion of school health centers across the state and an expansion of services at existing centers.

2000 to Present—The ICSHC continues to advocate at the local, state and national levels for school health centers. The ICSHC organizes successful awareness building events, advocacy days and media campaigns to better educate decision makers and the general public about the effectiveness of school health centers. In addition, the ICSHC continues to provide professional development and networking opportunities to discuss the future of school based health services.

THE NEED FOR SCHOOL HEALTH CENTERS

Children and adolescents face many barriers in accessing preventive health care services. There is growing recognition that the complex problems youth face in society contribute to poor health, education, and social outcomes. Many of the most significant and costly national health problems are caused by behaviors established during youth:

Drug and Alcohol Abuse

Tabacco Use

High-Risk Sexual Behaviors

Inadequate Physical Activity

Poor Dietary Habits

ROLE OF SCHOOL HEALTH CENTERS IN HEALTH CARE PROVISION

School Health Centers often serve low-income children who are in poor health because they have not received routine primary health care services in the past. One in seven teens has no health insurance and private health insurance plans frequently place restrictions on services for teens.

School Health Centers are often considered 'safety net providers' because they provide health services to children and adolescents who would not otherwise have access to services. A student's encounter with a School Health Center is often his/her first encounter with any health care provider, thus the centers are in a unique position to link these children and adolescents to the health care system. Centers are cost-effective in that they play a vital role in providing preventive services that reduce potential for engagement in high-risk behaviors at an early age, thus preventing the need for acute care in the future.

At the centers, students have the opportunity to develop caring relationships with a team of health professionals who can address their physical and mental health needs and promote healthy behavior. A growing number of centers in Illinois and nationally serve elementary schools, providing an opportunity to intervene as early as possible through primary prevention strategies to promote healthy child development and prevent the kind of problems affecting so many adolescents. Nationally, according to a May 1995 Advocates for Youth Fact Sheet:

80% of centers offer primary care (routine physical exams, immunizations, treatment of minor physical injuries, and prescriptions for some medications).
More than 70% provide laboratory tests, manage chronic illness, dispense medication on-site, and diagnose and treat sexually transmitted diseases.
Over 85% offer family planning counseling and mental health counseling for substance abuse and emotional problems.
Many centers serving teens in Illinois provide prenatal care to pregnant students, which significantly increases the chances that their babies will be healthy at birth.
96% of centers offer health education at the health center site, and 86% bring health education into the classroom.

Research has demonstrated that School Health Centers can contribute to:

Fewer school absences (IDHS, 1997)

Higher compliance with required immunizations and physical exams (IDHS, 1997)

Decreased smoking of tobacco and marijuana (ounce of Prevention Fund, 1996)

Fewer hospitalizations and emergency room visits (Santelli, et al., 1996)

Decline in teen pregnancy (Koo et al., 1994)

THE SCHOOL HEALTH CENTER MODEL: A SOLUTION

Schools are often dominant institutions within a community and provide a central location where a range of services can be delivered effectively. School Health centers are planned partnerships with on-going advisory from health care providers, school districts, local health departments, clergy, community leaders and organizations, parents and students.

School Based Health Centers are located on school grounds while School Linked Health Centers are located off school grounds, however, a formal relationship exists to serve the students attending a particular school(s).

School Health centers provide primary and preventive health care services to students while reducing lost school time, removing financial barriers to care and promoting family involvement.

Benefits to School Health Centers include:

Accessibility

Affordability

Convenient for Parents

Child and Adolescent-Friendly Staff

Safe Environment

Promote Healthy Lifestyles

Comprehensive services may include medical, mental health, dental and health education.

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