Developing Meaningful Partnerships within your School Community

1
Developing Meaningful Partnerships within your
School Community
Advancing Access to Quality Health Care for Youth
2154 NE Broadway, Suite 100, Portland, OR
97232 www.osbhcn.org 503.595.8423
2
Find an Appointment!
1200
900
300
600
3
Kids bring their whole life to school with them
and it doesnt fit in a locker.

• Every student faces life challenges that impact
  his or her ability to learn.
• Supporting kids and addressing health issues such
  as hunger, stress, harassment, substance use and
  unintended pregnancy can greatly improve their
  ability to learn.

4
There is a research-based link between students
physical, social and emotional health and their
ability to learn
5
(No Transcript)
6
Building Bridges Between SBHCs and Schools
7
Why Partner?

• SBHCs And Other Health Professionals Partnering
  With Schools
• Our world and our nation have changed so too
  have our schools. Today, more than ever, school
  health programs could become one of the most
  efficient means available to improve the health
  of our children and their educational
  achievement (Kolbe,2005 p.226)

• Schools Partnering With SBHCs
• The best of teaching cannot always compete
  successfully with the challenges many students
  face outside of school (Lee-Bayha Harrison,
  2002 p.1)

8
What We Know The health-academic outcomes
connection
SBHCs
Graduation GPA Standardized test scores
Health Risk Behaviors
Educational Outcomes
Substance use Mental health Poor diet
Intentional injuries Physical illness
Self-esteem Sexual behaviors
Attendance Dropout Rates Behavioral
Problems
Educational Behaviors
9
Stressors to Child Health and Learning Readiness

• In 2005, 9 of U.S. children had no health
  insurance
• 5 of U.S. children had no usual place of health
  care
• 6.5 million children have diagnosed asthma
• One in five children have a diagnosable mental
  disorder
• 35 of uninsured children had no dental contact
  in two years
• 7 of children had ADHD

• Children with fair or poor health status were six
  times as likely to have learning disability and
  be absent 11 or more days from school
• Over 4 million children (7) has a learning
  disability
• In 2005, 19 of 4th graders and 20 of 8th
  graders missed three or more days of school the
  previous month
• 14 total school enrollment receive IDEA services

(Federal Interagency Forum on Child and Family
Statistics, 2007 National Center for Children in
Poverty, 2007 U.S. Department of Education -
National Center for Education Statistics, 2006)
10
The Terri Story Asthma
Terri has asthma. It is not under control and she
misses many days of school because of it. She
doesnt really know what triggers her asthma, but
she hardly ever participates in physical
activity. Her grades are getting worse because of
her absenteeism.
Physical Health
Implications on Learning
Emotional Health
Social Health
11
Connecting Professional Communities For Children
Childhood Asthma
Nearly 73,000 Oregon children 18 and under
currently have asthma. Asthma prevalence in
Oregon continues to rise and is higher than the
U.S. average. _______ Countys asthma prevalence
rate is __, compared to Oregons rate of 9.9
and the US rate of 7.9
Learning Implications
Health Implications

• About 14 of 8th graders and 9 of 11th graders
  with asthma reported missing at least one day of
  school because of asthma in the past month
  (Oregon)
• Children in fair or poor health such as those
  with uncontrolled asthma were six times more
  likely to have a learning disability and be
  absent 11 or more days from school (Nationally)
• Disrupted sleep caused by asthma contributes to
  poor school performance (Nationally)
• Asthmatic children have higher rates of grade
  failure than non-asthmatics (Nationally)

• Asthma is more common in low-income and minority
  populations. These groups are also at risk for
  higher rates of fatalities, hospital admissions
  and emergency room visits. (Oregon)
• Oregon children were hospitalized for asthma more
  than 550 times in 2006. Children ages 0-5 have
  the highest rate of asthma hospitalizations.
  (Oregon)

(Diette et.al, 2000 Fowler, Davenport Garg,
2001 Halterman,et. al, 2001 Oregon Asthma
Surveillance Report (2007)
12
Coordinated School Health Web Activity
13
The Coordinated School Health Model
14
Policies as Partnership Possibilities
15
School Health Programs and SBHCs

• Grab a post-it
• Individually, write down what comes to mind
• when you hear the words
• School Health Programs
• AND
• School-Based Health Centers

16
Oregon Educational Governance
Governor
Legislature
Quality Education Commission (11 appointed
members confirmed by the Senate)
State Board of Education (7 appointed members
confirmed by the Senate)
Superintendent of Public Instruction (elected)
School Districts
Superintendents
17
No Child Left Behind A Synopsis
Title I Improving the Academic Achievement of the Disadvantaged Programs include Student reading programs, Education of migratory children, Preventions and intervention for neglected, delinquent , or at-risk children, Comprehensive school reform, Advanced placement programs, School dropout prevention, Title I assessment and other general provisions.
Title IV 21st Century Schools These programs primarily deal with providing safe and drug-free schools and communities, learning centers and tobacco smoke prevention
Title VII Indian, Native Hawaiian, and Alaska Native Education Providing for Indian, Native Hawaiian and Alaska Native education
18
SBHC Contribution Immunizations, and health
records of migrant children served are required
to be supplied to the national database. As SBHCs
treat clients data could be provided to the
schools to input. Prevention intervention
services, information, screening, and treatment
of affected students could be performed at SBHC
sites. Drug and alcohol prevention education,
testing, screening, counseling and treatment
options might already being provided in
SBHCs Health-related services for students with
physiological needs can be supplied on site
NCLB Criteria Title I Part C Education of
Migratory Children Title I Part D Prevention
and Intervention Programs for Children and Youth
who are Neglected, Delinquent, or At-Risk Title
IV 21st Century Schools IDEA Criteria Least
Restrictive Environment
19
Local Wellness Policy RequirementsChild
Nutrition ReauthorizationPUBLIC LAW 108-265-JUNE
30, 2004

• Goals for nutrition education, physical activity
  and other school-based activities designed to
  promote student wellness
• Nutrition guidelines selected by the local
  educational agency
• Guidelines for reimbursable school meals
• A plan for measuring implementation of the local
  wellness policy
• Community involvement
• Oregon Link http//www.ode.state.or.us/search/re
  sults/?id270
• http//www..fns.usda.gov/tn/Healthy/wellness_polic
  yrequirements.html

20
Other School Health Requirements

• State Content Standards and Benchmarks (what a
  student should know and be able to do)
• Law/Policies related to health and physical
  education
• Assessments, Tests
• CIM Endorsements
• Oregon Healthy Teens

21
Health Education State Content Standards

• Concepts (Alcohol, Tobacco, and Other Drug
  Prevention, Prevention and Control of Diseases,
  Promotion of Environmental Health, Promotion of
  Healthy Eating, Promotion of Mental, Social and
  Emotional Health, Promotion of Physical Activity,
  Promotion of Sexual Health, Unintentional Injury
  Prevention, Violence and Suicide Prevention)
• Accessing Information
• Self Management
• Analyzing Influences
• Interpersonal Communication
• Decision Making
• Goal Setting
• Advocacy

22
Oregon Laws Related to Health Education
Instruction
A K-12 Plan of Instruction Based on the Common
Curriculum Goals OAR 581-022-1210 AOD
Prevention Annually OAR 581-22-413 and ORS
336.222 Human Sexuality Education, HIV/STD,
Hepatitis B/C Prevention Education OAR
581-022-1440 and ORS 336.455-475 Emergency
Drills and Instruction ORS
336.071 Anabolic Steroids and Performance-enhanci
ng Substances SB 517 Child Abuse Reporting
and Training SB 379
23
Oregon Laws RelatedTo School Health and Safety
Harassment, Bullying and Intimidation ORS
339.351 to 364 Tobacco Free Schools OAR
581-021-0110 Emergency Plans Safety Programs
OAR 581-022-1420 Physical Education
HB 3141
24
SBHC Certification Standards

• Centers are certified biannually by the State
  SBHC Program Office within DHS
• Two levels of certification Core and Expanded
• Certification is voluntary, however only
  certified centers receive State funding
• Included in certification standards are
  guidelines for facilities, operations/staffing,
  laboratory and clinical services, data collection
  and reporting, quality assurance activities and
  administrative procedures for certification.

25
SBHC Funding

• While the SBHC model of care is consistent,
  funding streams, medical sponsorship and
  management differ from site to site.
• The funding is fragile and resources are scarce.

• Sources of revenue for SBHCs under FQHCs (23
  centers)
• Billing fees 43
• County/city government 26
• Federal funding 13
• State funding 7
• Grants 5
• In-kind donations 3
• Other 2
• Fundraising 1

• Sources of revenue for SBHCs NOT under FQHCs (19
  centers)
• Other 45
• State funding 25
• Grants 12
• In-kind donations 7
• Billing fees 5
• County/city government 5
• Fundraising 1

Data Department of Human Services/Office of
Family Health/Adolescent Health/SBHC
26
Visioning Activity
27

• Education stakeholders ask
• Do school health programs detract from, or
  complement the academic and social mission of
  schools?
• Advocates of school-related health programs ask
• If our programs are unable to demonstrate their
  educational value, will they be able to sustain
  and expand their current place in the health care
  safety net?

28
Oregons Children
In Oregon, 12 or over 110,000 children are
uninsured. 68 of SBHC clients reported that
they would not have received health care without
their SBHC School-based health centers are
staffed by licensed health professionals, and do
not replace the important work of school nurses.
29
A Snapshot of Oregons Children

• In 2006 18 of Oregons children live in poverty,
  40 are low-income
• In 2005, 13 of Oregon children ages 0 - 17 had
  been diagnosed with asthma
• 21 of students changed school districts in
  school year 2005 2006

• 42.6 of public school students are eligible for
  free/reduced price lunches
• 24 of Oregon children ages 6 8 have untreated
  tooth decay
• 13 out of 1000 children are victims of abuse or
  neglect
• Last year, 27 of 9 - 12th graders were
  overweight or at risk for overweight.

(OHT 2007, BRFSS 2005, Children First for Oregon
County Data Book 2006)
30
Lake Research Partners Oregon Results

• The majority of voters consider all tested
  services with the exception of prescribing
  medication important.
• Health education around eating right and
  exercising, and counseling for kids with obesity
  and other eating problems, and mental health
  services, including grief therapy, peer pressure,
  bullying, and suicide prevention.
• Support also based on the belief that SBHCs would
  provide care to uninsured and underinsured
  children who would otherwise not receive services
• Support for mental health services is also high,
  with 80 percent of voters saying these are
  important services to provide
• Voters look with roughly equal numbers for stable
  funding from the federal government, insurance
  companies, and paying more in federal taxes to
  pay for these centers.
• Strongest messages Provide Care, Smart
  Investment, Studies, and Disaster Support

31
How can SBHCs aid in creating a continuum of care
for Oregons youth?

• Provide a solution to access barriers such as
  transportation, distance, and clinic hours
  inconvenient to parents
• Bring community resources to the student
• Support students, teachers, parents,
  administrators, and other health professionals by
  keeping children healthy and in school
• Aid in identifying health issues early in a safe
  environment

32
Resources
33
Team Action Planning
34
Closure and Evaluation
35
Contact Information
Jess Bogli, Jessica Bogli Consulting jess_at_jessicab
ogli.com, 503.784.2932 www.jessicabogli.com
Dr. Jeanita Richardson, Turpeau Consulting
Group, LLC richardsonjw1_at_aol.com, 804.674.1976
Maesie Speer, Oregon School-Based Health Care
Network maesie_at_osbhcn.org, 503.595.8423 www.osbhcn
.org
36
Selected References
Diette, G. B., Markson, L., Skinner, E. A.,
Nguyen, T. T., Algatt-Bergstrom, P., Wu, A. W.
(2000). Nocturnal Asthma in children affects
school attendance, school performance, and
parents' work attendance. Archives of Pediatrics
Adolescent Medicine, 154(9), 923-928. Federal
Interagency Forum on Child and Family Statistics.
(2007). America's Children Key National
Indicators of Well-Being 2007. In Federal
Interagency Forum on Child and Family Statistics
(Ed.). Washington, D.C. U.S. Government Printing
Office. Fowler, M. G., Davenport, M. G., Garg,
R. (1992). School Functioning of US Children With
Asthma. Pediatrics, 90(6), 939-944. Geierstanger,
S. P., Amaral, G., Mansour, M., Walters, S. R.
(2004). School-based Health Centers and Academic
Performance Research, Challenges, and
Recommendations. The Journal of School Health,
74(9), 347-353. Halterman, J. S., Montes, G.,
Aligne, A., Kaczorowski, J. M., Hightower, A. D.,
Szilagyi, P. G. (2001). School Readiness Among
Urban Children With Asthma. Ambulatory
Pediatrics, 1(4), 201-205. Kolbe, L. J. (2005). A
Framework for School Health Programs in the 21st
Century. The Journal of School Health, 75(6),
226. Lee-Bayha, J., Harrison, T. (2002). Using
school-community partnerships to bolster student
learning (Policy Brief). San Francisco
WestEd. National Center for Children in Poverty.
(2006). Children's Mental Health Facts for
Policymakers. New York Columbia University
Mailman School of Public Health. Richardson, J.
W. (2006a). Public K-12 Federal Educational
Policy Battlecreek The W.K. Kellogg
Foundation. Richardson, J. W. (2006b). SBHC
Policy Program Public K-12 Grantee State
Educational Policy Battlecreek The W. K.
Kellogg Foundation. Richardson, J. W. (2007).
Building Bridges Between School-Based Health
Clinics and Schools. Journal of School Health,
77(7), 337-343. U.S. Department of Education -
National Center for Education Statistics. (2006).
The Condition of Education 2006 (Vol. NCES
2006-071). Washington, D.C. U.S. Government
Printing Office.