Erica Snow is the senior program officer of Health Coverage for the Colorado Health Foundation.
Many Colorado children are going "back to school" for their health care needs.
That's because Colorado's 55 school-based health centers (SBHCs) provide accessible, affordable and high-quality physical, behavioral and oral health care to a steadily growing number of students in the state.
While each SBHC program is different, their facilities are located within school grounds. Most are staffed by a multi-disciplinary team of medical and behavioral health specialists. Sometimes, dental professionals are also included on the team. Currently, 23 of Colorado's 178 school districts host SBHCs. Generally, SBHCs are located in communities where access to care is limited for a large number of children because of low income, lack of health insurance or geographic isolation.
Studies show school-based health care positively impacts students in many areas including:
Increased access to preventive and mental health care
Increased care coordination and referral completion
Reduced emergency and urgent care visits
Increased health knowledge among students
It's worth noting that SBHCs aren't just conveniently located for students – they're important for the educational experience. After all, sick kids can't learn, but thanks to SBHCs, students who would otherwise fall between the cracks of the health system have a place to go.
According to a fact sheet from the Colorado Association for School-Based Health Care, of the 28,930 children seen at SBHCs in 2011-12, 27 percent were uninsured, 53 percent were enrolled in Medicaid or Child Health Plan Plus (CHP+), 13 percent were covered by other types of insurance and 6 percent did not report. For the 27 percent of kids who are uninsured, most school-based health centers assist eligible families in applying for Medicaid/CHP+. As yet another side benefit, SBHCs have been shown to reduce costs for Medicaid programs because they reduce emergency room and inpatient utilization.
Services provided at SBHCs might include comprehensive well-child and well-adolescent exams; immunizations; treatment for illness or injury; management of chronic conditions such as obesity, diabetes or asthma; mental health assessments and treatment; prevention programs including smoking cessation, violence, pregnancy, and substance-abuse counseling; and nutrition counseling. As seen in this 9NEWS profile, SBHCs also provide dental services, including dental hygiene education, screening, sealants and fluoride varnish.
Recognizing the important role school-based health programs play in the health and wellness of Colorado's children, the Colorado Health Foundation launched a $10.8 million, four-year initiative in June 2009 to support SBHCs in communities throughout the state. Under the Foundation's School-Based Health Care Initiative, we set out to support the planning and implementation of more than 20 new school-based health centers.
Based on the number of students already served by SBHCs in Colorado, it is estimated these new centers will provide services for an additional 15,000 students each year.
Of course, merely making money available doesn't ensure that these SBHCs are effective or sustainable in the long-term. To help SBHCs move toward sustainability, the Foundation requested that they complete a four-year business plan and financial pro forma. A team of evaluators was then asked to determine if these tools have been effective in helping SBHCs make progress and to track development on eight sustainability factors. The team's mid-term findings are now available online via an executive summary, "The Colorado Health Foundation's School-Based Health Care Initiative."
While the Foundation's school-based health care initiative is still ongoing, the takeaways from the evaluation provide a good starting point for improving a concept that provides a crucial safety net for Colorado's vulnerable children and youth, many of whom might otherwise fall between the cracks and not get they need in order to stay healthy and in the classroom.