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…(EST) Facilitators Sharon Hoover, National Center for School Mental Health Katy Stinchfield, School-Based Health Alliance Speakers John Crocker, Director of School Mental Health & Behavioral Services, Methuen Public Schools Jennifer…
Comprehensive school mental health systems rely on a foundation of educators and school-employed mental health professionals (e.g. school psychologists, school counselors, school social workers), in partnership with community health and…
…on information to: establish a PCMH, enroll in health coverage, stay healthy, prevent disease, and address behavioral health issues. By engaging students in their own physical and emotional health at…
…plan for the mental health needs of the entire school community (including students, school staff, and families) and implement multi-tiered mental health promotion, prevention and intervention supports and services in…
…Health Center, Talkeetna, AK Services provided: primary care, oral health, mental health, sports physicals, staff health education training, and a after-school youth development program What’s Happening: Two hours north of…
…iPad screening tool designed to de-stigmatize sensitive topics so that “Sexual Health is Just Health” and “Mental Health is Just Health.” It’s an ecosystem to improve patient-provider communication, inform population…
What’s Happening Continued… That said, they’ve “only just started,” explains Joe Lock, president and chief executive officer of Eastern Iowa Health Center. As the community gets more comfortable, the nurse practitioner has been referring students to the health center for more comprehensive care.
Note that in addition to working with the Cedar Rapids School District, the health center contracts with multiple school districts in the area, providing a nurse practitioner to oversee primary care several days a week. These nurse practitioners refer extensively to Eastern Iowa Health’s network of health centers.
Path to Get There. Initially, the partnership between Eastern Iowa Health Center and Cedar Rapids School District focused on providing a sexual health curriculum in the middle schools. Despite initial pushback from the community, the FQHC persisted. It started small, from one sexual health education class a year to today, offering a monthly class for students to take.
Eastern Iowa Health Center is part of the community: they see more than 50,000 patients a year and their leadership serves alongside other community leaders on the local health council led by the school district. These relationships proved invaluable in gaining the trust needed to develop services in schools. In fact, many school leaders have become champions of the health center’s services, working within the school itself to help the health center expand sexual and reproductive health education.
On the Horizon. Looking forward, Eastern Iowa Health Center hopes to capitalize on the strong relationships they’ve built to place OB/GYNs in schools and expand their sexual health curricula. “We want to focus on more than sexual health, but this is a place where we can really make a difference,” Lock explains. The FQHC also built a new dental health center and wants to bring dental health into the schools — providing even better access to clinical services that empower students to reach their highest potential.
What’s Happening Continued… Central Ozarks utilizes data sharing agreements in most of its schools. Once a parent consents, the therapist can observe a student in the classroom and lunchroom, giving them valuable insight to support the student. Parents are then updated via weekly phone calls.
Path to Get There. “Our way in the door is full-time behavioral health in the schools,” explains Robert Stiles, chief executive officer for Central Ozarks Medical Center.
Central Ozarks started a school partnership in the 2016-17 school year by providing a nurse practitioner to support the local school nurse; however, they wanted to do more. Due to funding cuts, districts had eliminated school psychologist positions. Central Ozarks saw this as an opportunity to expand their services and began offering weekly therapy sessions in each school.
At first, teachers were skeptical, not wanting to lose out on precious classroom time. In one district, students were being referred to Central Ozarks’ main clinic site, leading to even more missed classroom time. But Central Ozarks knew that having care onsite would mean fewer no-shows at the clinic, less inconvenience to parents, and more student seat time. By the end of the school year, schools saw major changes in classroom environments, as students were getting the care they needed. Once teachers were on board, they were able to help parents feel comfortable with the idea, paving the way to expanding services.
On the Horizon. Central Ozarks has worked hard to overcome barriers to providing behavioral health in schools, including Individualized Education Program or IEP restrictions frustrating the billing process and initial teacher skepticism. In the 2017-18 school year, Central Ozarks will provide therapy services in five schools districts, reaching approximately 20,000 students. “This partnership took on a life of its own. We agreed to do it for one district, then another district asked us to step in, then another,” said Stiles. But Central Ozarks is still looking to expand the model, bringing in new provider types—especially dental health—and bringing services to more schools. Stiles explains: “We’ve been expanding throughout the community, and this is the logical next step.”
By keeping the goal of community health in mind, and helping the community see the results of that goal, Central Ozarks Medical Center has been able to support rural youth by providing services where youth can most easily access them: at school.
Path to Get There. Grants from the Pennsylvania Department of Health (PDOH) and the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA) allowed Keystone to offer expanded HIV/AIDS and sexually-transmitted infection (STI) services to the community in 2011. However, chlamydia cases in the community kept increasing. Keystone wanted to do more.
In 2013, Nurse Cochran approached PDOH to request additional funding. The request was denied. Within one year, close to one out of every five people tested for chlamydia tested positive — with the most new cases occurring in 13 to 20 year olds. Nurse Cochran took hold of the situation, writing an article for the local newspaper. And then another. And then another. With the new data in hand, Keystone wanted to get into the schools to provide education aimed directly at those who clearly needed it most.
As the public began to understand the gravity of the situation, Nurse Cochran spoke at a school board meeting about the importance of linking the FQHC with the school. “Kids were learning about sexually transmitted diseases when they got one,” she explained. “Before, no parent would believe it was their child doing those things. They just don’t talk about ‘those nasty things’ — but we needed to.”
In 2016, the local school board allowed Keystone Health to design a sexual health curriculum, and in September 2017, the curriculum will roll out into all schools, not just the high schools.
Nurse Cochran provides these words of wisdom on how Keystone achieved its goal of bringing desperately needed sexual health education services to the schools. “It is all about relationships. We went to school board meetings to show the personal side of accessible care by bringing in former patients. We built community trust and we showed the community the reality of the situation, supported by good data. Now, the school board is requesting we expand services to include dental, occupational therapy, and behavioral health.”
On the Horizon.
In addition to offering expanded health care services through its school-based health center, Keystone hopes to work with other FQHCs that are interested in partnering with local schools or school districts. “I’ve talked to many chief executives of FQHCs, and we need to get into the schools,” Cochran explains. “This has been a wonderful relationship. We have kids who go home and say ‘Mom, you’re not brushing your teeth, you’re not doing it the right way.’ We have a full community impact. All we have to do is get to the schools. When we can, we can do a lot.”
Path to Get There. Grants from the Pennsylvania Department of Health (PDOH) and the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA) allowed Keystone to offer expanded HIV/AIDS and sexually-transmitted infection (STI) services to the community in 2011. However, chlamydia cases in the community kept increasing. Keystone wanted to do more.
In 2013, Nurse Cochran approached PDOH to request additional funding. The request was denied. Within one year, close to one out of every five people tested for chlamydia tested positive — with the most new cases occurring in 13 to 20 year olds. Nurse Cochran took hold of the situation, writing an article for the local newspaper. And then another. And then another. With the new data in hand, Keystone wanted to get into the schools to provide education aimed directly at those who clearly needed it most.
As the public began to understand the gravity of the situation, Nurse Cochran spoke at a school board meeting about the importance of linking the FQHC with the school. “Kids were learning about sexually transmitted diseases when they got one,” she explained. “Before, no parent would believe it was their child doing those things. They just don’t talk about ‘those nasty things’ — but we needed to.”
In 2016, the local school board allowed Keystone Health to design a sexual health curriculum, and in September 2017, the curriculum will roll out into all schools, not just the high schools.
Nurse Cochran provides these words of wisdom on how Keystone achieved its goal of bringing desperately needed sexual health education services to the schools. “It is all about relationships. We went to school board meetings to show the personal side of accessible care by bringing in former patients. We built community trust and we showed the community the reality of the situation, supported by good data. Now, the school board is requesting we expand services to include dental, occupational therapy, and behavioral health.”
On the Horizon. In addition to offering expanded health care services through its school-based health center, Keystone hopes to work with other FQHCs that are interested in partnering with local schools or school districts. “I’ve talked to many chief executives of FQHCs, and we need to get into the schools,” Cochran explains. “This has been a wonderful relationship. We have kids who go home and say ‘Mom, you’re not brushing your teeth, you’re not doing it the right way.’ We have a full community impact. All we have to do is get to the schools. When we can, we can do a lot.”
Path to Get There. Established nearly 30 years ago, Sunshine Health filled a need for a community where the closest health care provider was 70 miles away. They are designated as a Rural Health Clinic, and serve as an integral part of the community. In 2016, when local schools faced budget cuts, slashing crucial funding for school nurses and counselors, district principals came straight to Sunshine Health for help. During that first year, Sunshine Health provided sports physicals on-site and trained teachers to identify and refer students with behavioral health problems utilizing the curriculum “Positive Action Program.” Since that time, Sunshine has expanded its onsite services to include oral health and primary care.
“Whatever we can fit in with education and other services is how we do it,” explains Melody White, chief executive officer for Sunshine Community Health Center. “We don’t come in with a ‘this is what we’re going to do’ attitude. It’s ‘how can we do it, and what’s going to be effective?’”
On the Horizon. While still in the early stages of forming its relationship with the local schools, White sees it as an extension of the community focus Sunshine Health always had: “We preach healthy communities, but that means we need to start with the young people in our community. The schools are one of the best places for us to do that.”
What’s Happening Continued… The center’s Community Health Workers also train community members at Parent Teacher Association meetings and school events to get healthy thinking out of the school hallways and into homes across the districts.
Path to Get There. After providing behavioral health services for a diverse community for more than 45 years, Valle del Sol became an FQHC in 2014. Over time, President and CEO Kurt Sheppard and his team realized that their behavioral health patients were dying 20-25 years younger than those without behavioral needs due to co-existing physical health conditions and unmet primary care needs. “We felt we owed better to the folks we were serving in our community, so that’s why we sought FQHC status,” Mr. Sheppard shared. As Mr. Sheppard explains, their expanded mission of community outreach has long included working in schools because they wanted to “bring services to those who need it most, right where they are.”
That outreach is part of what makes Valle del Sol such a known and trusted part of the community. In 2015 when school districts’ funding for nurses decreased, those schools reached out to Valle del Sol to oversee the health services. Teachers started off skeptical, since other organizations have tried “family-centric models in the past, with less than ideal results,” Mr. Sheppard explained. “But our team added elements that didn’t exist in prior models.”
As Valle del Sol started services, it worked carefully to bring families and students to the table, and also offered informal training around behavioral health to teachers. These strategies to work with all the stakeholders increased community buy-in to the program. The success was clear in the cultural shift and growing support inside the school. Its work has since expanded out of that initial need, growing in large part through word of mouth between districts.
But Valle del Sol didn’t stop at clinical work. The FQHC aims not just to increase health outcomes, but to truly empower the community. As managed care has become more prevalent, they’ve focused more on Medicaid enrollment and re-enrollment, ensuring community members have access to the care they need. Through its Connect2Lead program, Valle del Sol helps young people advocate for themselves, giving them both everyday life skills and important knowledge about their own health.”
On the Horizon. Through outreach and a focus on community empowerment, Valle del Sol has been able to expand their reach, magnify their impact, and support students and families. They hope to build upon this foundation in the future, adding primary health services, growing the school nurses’ training program, and possibly establishing a school-based health center. “The future of care isn’t in these big beautiful buildings,” Sheppard sums up, “It’s taking the services and the care to where people live, where they work, making sure they have access. It’s creating a community of care.”