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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.

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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

slide2

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

slide3

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.
slide4

Beyond Basic School Health

Filling gapsin 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
slide5

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

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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
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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
slide8

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
slide9

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