School-based health centers get $100 million in grants

The funds will allow children with acute or chronic illnesses to attend school and improve their health through screenings and disease prevention.

By Chris Silva — Posted Nov. 8, 2010

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School-based medical centers will have a crack at part of $100 million in grant money to help them buy new medical equipment, improve facilities and build new ones.

On Oct. 4, the Dept. of Health and Human Services announced the grants for doctors' offices that usually are based on school grounds and provide comprehensive medical, dental, mental and community-based services to students and families. HHS calls the centers "a major component of the nation's health care safety net."

The additional money will help children with acute or chronic illnesses attend school and improve their health through screenings and disease prevention.

"Healthy children are more productive children," said Mary Wakefield, MD, administrator of HHS' Health Resources and Services Administration, which oversees the health center program. "These grants will improve access to care for children and help maximize their potential to learn."

There are about 1,900 school-based health centers nationwide, according to the National Assembly on School-Based Health Care, a nonprofit based in Washington, D.C. A majority of the centers -- 96% -- are in school buildings, and the remaining ones are in separate facilities on school properties or are mobile programs.

HRSA said it plans to award 200 grants in fiscal year 2011, preferably reaching children living in underserved areas, officials said.

Hiring more medical staff and bolstering telemedicine services are two ways this grant could help Mercy Health System, said Stuart Schrader, DO, medical director of the Center for Innovative Care, which is based in St. Louis and sponsored by Mercy, one of the largest health system corporations in the nation.

Dr. Schrader oversees Mercy's school-based center program in Oklahoma City, and he's trying to replicate the program at other schools. Several professional services are essential to running a school-based center, he said, including part-time physicians, full-time nurse practitioners, social workers, case managers, nutritionists and psychologists.

Telemedicine is an integral component of school-based centers because of the variety of specialists involved, as well as various site locations often managed by one entity, he said. Grants and funding are essential to keeping kids healthy in schools, Dr. Schrader said. "We need to deliver health care in this setting to keep students in school and learning."

Dr. Schrader said overseeing the center is a gratifying experience, because it connects him with medical colleagues who share an interest in providing care for the underserved. The majority of students helped by school-based centers fall through the cracks of the health care system, he said, and are not covered by Medicaid, school medical services or a primary care physician.

"The most inspiring aspect that I've seen so far as I've talked to multiple physicians in the community is that they want to participate in solutions for the schools," he said.

"A tremendous need"

The uninsured population reached 50.7 million in 2009, of which 10% were younger than 18, according to data the U.S. Census Bureau released in September. Physicians believe investments in school-based centers can help reach some of these students.

"We're the primary care provider for more than 60% of the high school students we see," said David Appel, MD, a pediatrician and director of the Montefiore School Health Program, which is overseen by the Montefiore Medical Center in New York City and the New York City Dept. of Education.

The collaboration sponsors school-based centers at 18 sites in the Bronx. Physicians or nurse practitioners and nurses at each site give comprehensive primary care services, including shots, physicals, lab testing and treatment of acute illnesses such as asthma and diabetes.

Dr. Appel hopes to secure a grant to commit to improving telemedicine services among the 18 sites. "It's fantastic that there's a federal grant for capital and equipment," he said. "It's very difficult to find funding, and there's a tremendous need for these services."

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How they're defined

School-based health centers are a major component of the nation's health care safety net, according to the Dept. of Health and Human Services. They improve children's health and wellness through screenings, promotion and disease prevention activities. The term applies to health clinics that:

  • Use physicians and other health professionals to provide primary health care services to children in accordance with state and local laws.
  • Are located in or near a school facility of a school district or board, or an Indian tribe or tribal organization.
  • Organize through school, community and organized medicine relationships.
  • Are administered by a sponsoring facility, such as a hospital, public health department, community health center, nonprofit health care agency, local education agency or the Indian Health Service or the Bureau of Indian Affairs.

Source: Dept. of Health and Human Services, Health Resources & Services Administration

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