Sample Op-ed

Delivering Hope to Children with Limited or No Health Care Access

The School-Based Health Care Model

For the first time in 50 years, the majority of our nation’s public school students are low-income (read A New Majority Update-Low Income Students in the South and Nation, SEF).It’s a well-known fact that low-income children and adolescents often experience disparities in health care access and outcomes. This lack of access can result in higher rates of school absenteeism or even chronic absenteeism (10% or more of missed school days). Asthma, lack of physical activity, poor nutrition, substance use, teen pregnancy, aggression and violence, and inattention and hyperactivity are a few of the key health problems that can trigger school absenteeism. These health concerns impede academic success by reducing students’ motivation and ability to learn.

The school-based health care model is an innovative solution that brings health services directly to where children spend most of their time: their school. Because school-based health centers (SBHCs) are conveniently located just steps down the hallway, kids can quickly get the resources and supportthey need to be ready to learn, improve their health, strengthen their connectedness with school, and excel academically.

So what are SBHCs and how do they make students healthier? SBHCsdeliverthe comprehensive care that children and adolescents would normally receive in a traditional medical office: well-child visits, preventive screenings, and immunizations. However, these centers offer services that go far beyond basic primary care. According to a national census conducted by the School-Based Health Alliance, a great majority of SBHCs provide vision screenings and individual chronic disease management. One in five SBHCs provides oral health exams by a dentist or dental hygienist on-site. Many centers also provide care for behavioral health issues such as depression, anxiety, social conflict, toxic stress, and attention disorders.

Today, SBHCs reach an impressive 2 million children and adolescents in more than2,300centersacross the country. They are most often located in schools and neighborhoods that have limited health resources and substantial unmet needs. Schools that qualify for federal Title I funds, or whose student population is largely eligible for free or reduced-price lunch, are typical targets for SBHCs. The largest growth of SBHCs has been in rural, underserved areas, accounting for nearly 60% of new SBHCs since 2011.

The result is clear: school-based health centers are an extraordinary win-win proposition for communities.When critical health care services are offered in schools, students benefit because they don’t have to travel to find a physician. Parents benefit because they don’t have to take a day off of work. The schools benefit because students spend more time in the classroom. Employers benefit because parents don’t have tomiss a day of work. And the community benefits because healthier children are better students and an enhanced education yields productive outcomes over a lifetime.

The future of health care for our nation’s most vulnerable is highly uncertain. If the Affordable Care Act is repealed without a replacement, an additional 4.4 million will be uninsured by 2019. (Georgetown CCF).The nation’s network of non-profit community health centers, which run many SBHCs nationally, are facing a 70% funding cut if Congress does not act by the end of this fiscal year (September 30, 2017). Similarly, if Congress does not act to reauthorize it by September, the Children’s Health Insurance Program (CHIP)—a critical source of coverage for 8 million children from low to moderate income families—will expire. Together, Medicaid and CHIP cover nearly 40% of kids in the U.S., and a majority of children and adolescents served in SBHCs.Congressional proposals to reform Medicaid into a block grant or impose beneficiary caps would limit access to care and potentially narrow the package of benefits, including critical (and cost-effective) preventive services for children and adolescents.

These programs ARE the health care safety net of this nation, and their survival is essential for SBHCs to provide quality care to children and adolescents.

If we rely on our children to one day run our nation and take care of those of us whowon’t be able to take care of ourselves,we need to make sure they’re healthyenough to succeed in school and grow into the productive citizensour nation’s future demands.

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