Update on The School-Based Health Alliance
School-based health centers (SBHCs) provide comprehensive care to children and adolescents in a setting that is trusted, familiar, and immediately accessible: their school. Over the past four decades, SBHCs have grown from a handful to nearly 2000 across the country. The School-Based Health Alliance (SBHA) has played a major role in the expansion.
However, SBHA president, Linda Juszczak, recognizes that although the movement is as strong as it has ever been, there are not enough SBHCs to systemically counter health inequities. “Our vision is that all children and adolescents are healthy and achieving their fullest potential. We have to advocate for more school clinics so that all students can be healthy and ready to learn.”
Last year the National Assembly on School-Based Health Care rebranded itself as the School-Based Health Alliance. “We increased internal resources directed at federal advocacy and policy. In an effort to better serve our field, we are evolving from a predominantly technical assistance and training provider to an even stronger advocacy organization,” Juszczak says.
The Children’s Aid Society has been an active member of the SBHA since it was founded in 1995. “Our relationship is mutually beneficial,” says Beverly Colón, CAS Vice President, Health and Wellness Division. “We attend and present at their annual conferences. We support the federal advocacy efforts they lead, including visiting elected officials in Washington, D.C. We tap into their resources all the time. They are not only a vital source of guidance and advocacy, but also in keeping the field abreast on legislation, data, research, and best practices.”
The SBHA strongly supports community schools (CS). Linda Juszczak spoke at the CAS CS Practicum 2011 about how the strategy’s comprehensive structure optimizes the efficiency of SBHCs. Ms. Juszczak is also an important member of the Coalition for Community Schools’ steering committee.
The following is a brief policy update from the School-Based Health Alliance:
AFFORDABLE CARE ACT (ACA) AND SBHCS
Capital and Construction Funds for SBHCs
The Affordable Care Act set aside $200 million (over four years) for construction, renovation, and equipment needs for school-based health centers (SBHCs). More than 500 grants were awarded, covering nearly every state. This represents one of the single largest expansions of the field in the history of school-based health care.
Insurance Outreach and Enrollment
SBHA expects that the national attention to affordable health coverage will result in some previously uninsured children, adolescents and their parents becoming enrolled in public programs (Medicaid and CHIP) or through the health insurance exchanges. It is difficult to predict whether the law will have a direct effect on the financial sustainability of SBHCs.
State Health Care Innovation & SBHCs
Incentives made available through the ACA have encouraged many state public and private health insurers to develop innovative primary care delivery and payment models that focus on improving health outcomes, rewarding high quality care, and reducing costs. SBHCs can tap into their strengths – integrating primary care, public health, and oral and mental health care – to take advantage of these changes.
The biggest challenge for SBHCs is that most of the innovative primary care delivery and payment models are focused on reducing costs for frequent users and the chronically ill adult population. As a result, children have been largely excluded from redesign decisions, putting the long-term sustainability of SBHCs at potential risk. In Oregon and Connecticut, SBHCs were included in their states reform efforts largely because SBHC advocates made sure that their voice was heard during every stage of the planning and implementation process. To ensure that SBHCs are not left behind, it’s more important than ever for advocates to come together and actively participate in their state’s delivery and payment reform conversations.