Transcript Title

Comprehensive School-Based
Health Programs: The Impact of
School Policies and Programs on
Student Health
DC Action for Children, Washington, DC, June 3,
2003
Julia Graham Lear, PhD, Director
Center for Health & Health Care in Schools, GWU School of
Public Health & Health Services
The Center for
Health and Health Care in Schools
Four Challenges to Building Effective,
Sustainable School Health Programs
Challenge of implementing organizational
change
Challenge of solidifying a quality program
Challenge of securing adequate funding
Challenge of building political support
The Center for
Health and Health Care in Schools
Shared Beliefs About School
Health and Safety
• Children must be safe when attending school.
• Emergency medical services should be available
and urgent services should be provided for
persons in the school building.
• By law, all communities are obligated to provide
the care needed to enable children with
physical or mental health disabilities to benefit
from a free, appropriate public education.
• Schools should educate children about keeping
their bodies safe and healthy.
3
Beyond Basic School Health
Filling gaps in care -- within the
community-based system, especially for
low-income children, those needing
mental health services, and for
adolescents
 Cost-savings & lives’ saving -- through
early intervention and treatment
 Times have changed -- children's parents
may be inaccessible to schools or find it
difficult to pick up child during school day
4
Who’s in Charge: Traditional School Health
Funding & Management Arrangements
Traditional approaches
• School system funding/management eg. Boston, MA;
most New England communities
• School system funding/health department management,
eg. Detroit, MI; Milwaukee, WI
Strengths: Institutional understanding of unique
characteristics of health programs in schools;
community good will; support for individual school
nurses
Weaknesses: Good managers but leadership not involved;
Health must compete with education for education
dollars
5
Who’s in Charge: Newer School Health
Money and Management Arrangements
Newer approaches
• School system funding/private system managementeg.
DCPS/Children’s Medical Ctr, Washington, DC
• School system funding/federal participation via
Medicaid/various management arrangements, eg.
Baltimore County PS, Baltimore City
• School system funding plus local-state dollars for
underserved, Medicaid, philanthropy & private provider
support
eg. Palm Beach County, Fl; Denver, CO
6
Who’s in Charge: Strengths and
Weaknesses of Newer Approaches
Strengths
• Establishes broader funding base and/or
political support
• Changes in program management,
accountability structure will strengthen
content and outcomes of program
Weaknesses
• Requires on-going collaboration,
partnerships
• Requires major changes in management,
accountability measures
7
Characteristics of Effective,
Sustainable School Health Programs
• Data and epidemiologically-driven program
design
• Transparency: Funding, program goals, staffing
and service arrangements are clear
• Accountability: Reports to institutional leaders
and to the public describe program
performance against program goals
• CQI: On-going efforts to improve performance
and measure the improvement
8
Contact Information
The Center for Health and Health Care in Schools
1350 Connecticut Avenue, NW Suite 505
Washington, DC 20036
202-466-3396
202-466-3467 fax
www.healthinschools.org
The Center for
Health and Health Care in Schools