Providing the Right Health Care to the Right Youth, Where They Are and When They Need It

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School-based health centers (SBHCs) are considered by experts as one of the most effective ways to provide primary and preventive health care to children and youth where they are: in school.

For many underserved children, The Children's Aid Society's (CAS) SBHCs are their first and only access to health care.  SBHCs are central to the CAS community schools strategy, along with core academic instruction, expanded learning opportunities (during and after school), and parent/community engagement.  We operate four SBHCs in Manhattan and one in Staten Island as well as two licensed mental health clinics in our schools in the Bronx, where there is also a school-linked model for medical and dental care at the nearby CAS Bronx Family Center.  

“We are very enthusiastic about the opening of our newest, and largest, health center at Curtis High School in Staten Island,” says Adria Cruz, director of CAS School-Based Health Centers and Special Initiatives. Nearly 2,600 students will have access to medical, reproductive, dental and mental health services from this state-of-the-art facility, built and equipped with support of local elected officials, the New York City Department of Education and the federal government. Services began on November 4, 2013.

Cruz adds that the Curtis student health center (CSHC) has been well received by young people and parents alike, and has been deemed ‘an oasis’ by many.  “A team of 12 ‘student health ambassadors’ is helping spread the word. They led tours for parents and students during open school night and parent-teacher conferences. Our goal is to enroll at least 75 percent of the students by June. We already have close to 500 registered.  The principal, Dr. Aurelia Curtis, has been our greatest ally.”   

The CSHC utilizes electronic records and has three exam rooms, three social worker offices, a dental suite, a lab and spacious waiting/reception areas.  It is staffed by a physician, nurse practitioner, dentist, dental hygienist, licensed practical nurse, health educator, medical office assistant, dental assistant, a community outreach liaison and four social workers.

True to the nature of community schools, the process of bringing this project to fruition was collaborative. CAS began working with Curtis High School in 2010. For over a year, the advisory board, which included school faculty, staff, parents, students, and community members, held monthly meetings. The board headed a comprehensive needs assessment that collected input from over 1,200 students, nearly 1,000 parents and approximately 300 school faculty/staff.

The Center is the steppingstone and anchor to a much-anticipated full-service community school, a partnership among the NYC DOE, CAS and the United Federation of Teachers. The advisory board that worked to inform the creation of the SBHC is now evolving into the community school advisory board, making changes to the composition as deemed appropriate by the school leadership and the original board members.

Across Children’s Aid schools, the SBHCs serve over 90% of students, generating over 30,000 visits a year, preventing costly hospitalizations and hundreds of visits to the emergency room.  Our SBHCs also play a central role in fighting health emergency threats such as the H1N1 epidemic a few years ago by providing accurate information and administering hundreds of vaccines.  All CAS SBHCs are now utilizing electronic health records.

In policy terms, staff at CAS SBHCs don’t expect the Affordable Care Act to affect children’s health insurance, since in New York State all children qualify for Medicaid or Child Health Plus B.  However, at the state level there is a greater challenge, the Medicaid Redesign project, which proposed to end all waivers that allow SBHCs to bill Medicaid directly, bypassing managed care plans.

“Stakeholders, including CAS, have been meeting with the State Department of Health to ensure that SHBCs are protected. We definitely need to ramp up our advocacy efforts next year,” observes Cruz, who affirms that Children’s Aid will continue to make every effort to provide comprehensive health care to the right youth, where they are and when they need it, to help them achieve their full potential.