School-based health care helps access and education, providers tell Ohio Children’s Caucus

Ohio legislators heard Monday from those working to bring health care to schools, in an effort to keep kids in school and improve health outcomes where they can.

Representatives from health services agencies, hospitals, and schools spoke to a meeting of the Ohio Legislative Children’s Caucus about the benefits of making schools the center of health for a community, even in communities like Cleveland Heights, where it would seem medical care is readily available.

“We are in a community that’s within walking distance to three hospitals,” said Nancy Peppler, the supervisor of community and school partnerships for the Cleveland Heights-University Heights City School District. “You would think access to health care would not be an issue, but it is an issue.”

The district has students who span all socioeconomic levels, but there is a high percentage — 55% — of families enrolled in Medicaid, and many with transportation issues that make getting to appointments or seeking care a problem, Peppler said.

The district now has a partnership with MetroHealth to provide services like in-person treatment and medical care through mobile units, along with dental care as of about a week ago.

One issue the district tackled head on was immunization, in an effort to remove a barrier keeping students being able to come to school.

“We created a unified strategy for outreach to those families to say they could get the immunizations right in the building and they wouldn’t have to take off work, and the children could stay in school,” according to Peppler.

Other Ohio schools are trying to work with local medical centers to bring about not only better physical health, but behavioral and mental health, especially in areas where care might otherwise be scarce.

“In rural Appalachia, the schools are really sort of the heart of the community,” said Sherry Shamblin, chief strategy officer for Hopewell Health Centers.

The ability to help students through school-based facilities involves a focus on the social determinants of health, like poverty levels, and how they can impact educational outcomes.

The facilities can combine health treatment with things like food pantries to bring about wraparound services to families, not just the students they see, according to Mona Mansour, professor of pediatrics at the University of Cincinnati College of Medicine and Associate Director of Population Health for General and Community Pediatrics at Cincinnati Children’s Hospital Medical Center.

“The trusted partnership with the schools and the community … is just really critical,” Mansour said.

For Third Street Family Health Services COO Javar Jackson, Sr., providing school-based services in 13 centers through three counties brings care that can prevent truancy issues and bring care a student and their parents may not have even known they needed.

“Many of the kids never had wellness visits,” Jackson said. “They’ve had undiagnosed behavioral health issues as well.”

Sparking improvement in school-based health care starts with investment by school leadership, advocates said, and state interest and funding would go a long way to bringing it to more districts and communities.

“School-based health is the whole-child framework in action,” Peppler said. “So Ohio’s whole-child framework needs school-based health to succeed.”

As with any statewide program, the value of school-based health care only improves with better investment.

“Funding for a startup is honestly pretty important, because most of the time that just doesn’t exist in any system,” Shamblin said.