Facts, Integrated Services

Facts & Figures

Integrated Services

Benefits of Integrated Services to Children & Families

• Co-location of community and family resources in schools has been effective in decreasing student hospitalizations, increasing attendance and improving parents’ involvement in their children’s education.


• The availability of mental health services in schools is critical to children’s well-being. Adolescents are ten to 21 times more likely to utilize a school-based health center (SBHC) for mental health services than a community health center or HMO. Since 1987, 176 SBHCs have opened in California, but they serve only a small fraction of the state’s 6.2 million students.


• When programs that promote socio-emotional skills are incorporated into elementary and middle schools, test scores increase by 11% to 17%. Students’ connection to school and their attitudes about themselves and others also improve. Incorporation of mental health supports in early childhood programs to address behavioral issues has shown similar promise in developing social competence and reducing expulsion rates.


• Head Start and Early Head Start provide educational, health, nutritional and social services for low-income children, ages 0-5, and their families. Children often gain important cognitive and academic benefits through their participation. For example, participants exhibit improved vocabulary, increased school attendance, and are more likely to finish high school.


• Healthy Start, a statewide initiative that expanded schools’ efforts to offer a full spectrum of academic, health and social supports for students and their families, shows promise as an integrated model for removing barriers to learning. Before state funding ran out in 2007, Healthy Start had helped reduce absences in one Los Angeles school by 30%, reduce detentions in one San Diego school by 50% and improve reading scores in one Humboldt County school by 40%. It also helped the efforts of over 1,400 schools across the state.

Cost-Saving Benefits of Integrated Services to the State

• California’s Nurse-Family Partnership® (NFP®) program connects first-time, low-income mothers with registered nurses, from pregnancy through their child’s second birthday, in order to provide ongoing support and resources. Long-term outcomes include improved prenatal health, fewer childhood injuries, increased maternal employment and improved school readiness. Additionally, every $1 the state invests in the NFP® saves more than $4 through reduced crime among participant mothers and children.


• Head Start and Early Head Start provide early learning opportunities, health screenings and family support services. Every $1 invested in Head Start and Early Head Start saves approximately $9 in societal benefits, through increased personal earnings, family stability, and decreased welfare and crime costs. In 2009, more than 100,000 young children were served by these programs, and nearly all (96%) received dental examinations and medical screenings.


• A health home is a coordinated, continuous source of care that is accessible, comprehensive, family-centered and culturally competent. In addition to improving outcomes for children with special health care needs, they also save money. In one Los Angeles-based model, emergency room visits were cut by more than half (55%) when a health home was used to coordinate care for chronically ill children.


• The Alameda County Social Services Agency and Los Angeles County Department of Children and Families are piloting projects that involve collaborating with county probation departments to promote permanency for families at risk of separation. As a result of their efforts, the rate of children entering foster care has decreased in both counties. In 2008-09, they also generated savings of $20 million (Alameda County) and $59 million (Los Angeles County).

Children in Need of Integrated Services in California

• Too few California children have access to a health home. Of the 50 states, only children in Nevada and New Mexico are less likely to have one.


• Although they are eligible, only 2% (7,430) of California’s 332,825 children under age three living in poverty receive educational, health, nutritional and social services offered by Early Head Start. Nationally, Early Head Start serves 4% of eligible children.


• 18% of California’s children under age 12 have never been to a dentist. Funding for California Children’s Dental Disease Prevention Program, which brings dental services to schools, remains suspended in the 2010-11 state budget, further impacting 300,000 children across 1,100 low-income schools.


• While over half (56%) of California’s school-based health centers provide dental screenings, and 12% provide additional preventive care, such as dental cleanings, on-site, they are limited in number. The services are offered in less than 1% of California’s schools.


• Gov. Schwarzenegger used his line-item veto authority to cut $133 million in general fund support for mandated mental health services provided to special education students. Despite this cut and given the tremendous need among these students, $76 million in federal funds will continue to be allocated by the California Department of Education for continued mental health services for special education students.


• Only 88% of California’s foster care children receive recommended medical examinations, and fewer (65%) receive recommended dental examinations.


• 40% to 70% of children in California’s juvenile justice system have some form of mental health disorder or illness, yet only 16% have an open mental health case.

New Federal Opportunities to Promote Integrated Services

• In 2010, California was awarded $7.7 million to fund home visitation activities as part of the Patient Protection and Affordable Care Act (ACA). Evidence-based home visitation programs have been shown to improve pregnancy outcomes, boost children’s health and developmental outcomes, and increase parents’ economic self-sufficiency, thus saving the state money.


• The ACA provides $200 million over four years to support schoolbased health centers (SBHCs) nationwide. SBHCs have a positive impact on absences, dropout rates, disciplinary problems and other academic outcomes.


• The ACA requires states to develop one single, streamlined health coverage application form for children and families. Notable enrollment gains, such as those in Ohio when it simplified its children’s health application, are anticipated for California’s Medi-Cal and Healthy Families programs.


• Express Lane Eligibility, promoted in the Children’s Health Insurance Program Reauthorization Act of 2009, allows state health insurance programs to synchronize eligibility determination information with other public programs. Through this approach, Louisiana was able to increase children’s Medicaid enrollment by more than 10,000 in a single month.

Benefits of Integrated Services to Children & Families

• Co-location of community and family resources in schools has been effective in decreasing student hospitalizations, increasing attendance and improving parents’ involvement in their children’s education.


• The availability of mental health services in schools is critical to children’s well-being. Adolescents are ten to 21 times more likely to utilize a school-based health center (SBHC) for mental health services than a community health center or HMO. Since 1987, 176 SBHCs have opened in California, but they serve only a small fraction of the state’s 6.2 million students.


• When programs that promote socio-emotional skills are incorporated into elementary and middle schools, test scores increase by 11% to 17%. Students’ connection to school and their attitudes about themselves and others also improve. Incorporation of mental health supports in early childhood programs to address behavioral issues has shown similar promise in developing social competence and reducing expulsion rates.


• Head Start and Early Head Start provide educational, health, nutritional and social services for low-income children, ages 0-5, and their families. Children often gain important cognitive and academic benefits through their participation. For example, participants exhibit improved vocabulary, increased school attendance, and are more likely to finish high school.


• Healthy Start, a statewide initiative that expanded schools’ efforts to offer a full spectrum of academic, health and social supports for students and their families, shows promise as an integrated model for removing barriers to learning. Before state funding ran out in 2007, Healthy Start had helped reduce absences in one Los Angeles school by 30%, reduce detentions in one San Diego school by 50% and improve reading scores in one Humboldt County school by 40%. It also helped the efforts of over 1,400 schools across the state.

Cost-Saving Benefits of Integrated Services to the State

• California’s Nurse-Family Partnership® (NFP®) program connects first-time, low-income mothers with registered nurses, from pregnancy through their child’s second birthday, in order to provide ongoing support and resources. Long-term outcomes include improved prenatal health, fewer childhood injuries, increased maternal employment and improved school readiness. Additionally, every $1 the state invests in the NFP® saves more than $4 through reduced crime among participant mothers and children.


• Head Start and Early Head Start provide early learning opportunities, health screenings and family support services. Every $1 invested in Head Start and Early Head Start saves approximately $9 in societal benefits, through increased personal earnings, family stability, and decreased welfare and crime costs. In 2009, more than 100,000 young children were served by these programs, and nearly all (96%) received dental examinations and medical screenings.


• A health home is a coordinated, continuous source of care that is accessible, comprehensive, family-centered and culturally competent. In addition to improving outcomes for children with special health care needs, they also save money. In one Los Angeles-based model, emergency room visits were cut by more than half (55%) when a health home was used to coordinate care for chronically ill children.


• The Alameda County Social Services Agency and Los Angeles County Department of Children and Families are piloting projects that involve collaborating with county probation departments to promote permanency for families at risk of separation. As a result of their efforts, the rate of children entering foster care has decreased in both counties. In 2008-09, they also generated savings of $20 million (Alameda County) and $59 million (Los Angeles County).

Children in Need of Integrated Services in California

• Too few California children have access to a health home. Of the 50 states, only children in Nevada and New Mexico are less likely to have one.


• Although they are eligible, only 2% (7,430) of California’s 332,825 children under age three living in poverty receive educational, health, nutritional and social services offered by Early Head Start. Nationally, Early Head Start serves 4% of eligible children.


• 18% of California’s children under age 12 have never been to a dentist. Funding for California Children’s Dental Disease Prevention Program, which brings dental services to schools, remains suspended in the 2010-11 state budget, further impacting 300,000 children across 1,100 low-income schools.


• While over half (56%) of California’s school-based health centers provide dental screenings, and 12% provide additional preventive care, such as dental cleanings, on-site, they are limited in number. The services are offered in less than 1% of California’s schools.


• Gov. Schwarzenegger used his line-item veto authority to cut $133 million in general fund support for mandated mental health services provided to special education students. Despite this cut and given the tremendous need among these students, $76 million in federal funds will continue to be allocated by the California Department of Education for continued mental health services for special education students.


• Only 88% of California’s foster care children receive recommended medical examinations, and fewer (65%) receive recommended dental examinations.


• 40% to 70% of children in California’s juvenile justice system have some form of mental health disorder or illness, yet only 16% have an open mental health case.

New Federal Opportunities to Promote Integrated Services

• In 2010, California was awarded $7.7 million to fund home visitation activities as part of the Patient Protection and Affordable Care Act (ACA). Evidence-based home visitation programs have been shown to improve pregnancy outcomes, boost children’s health and developmental outcomes, and increase parents’ economic self-sufficiency, thus saving the state money.


• The ACA provides $200 million over four years to support schoolbased health centers (SBHCs) nationwide. SBHCs have a positive impact on absences, dropout rates, disciplinary problems and other academic outcomes.


• The ACA requires states to develop one single, streamlined health coverage application form for children and families. Notable enrollment gains, such as those in Ohio when it simplified its children’s health application, are anticipated for California’s Medi-Cal and Healthy Families programs.


• Express Lane Eligibility, promoted in the Children’s Health Insurance Program Reauthorization Act of 2009, allows state health insurance programs to synchronize eligibility determination information with other public programs. Through this approach, Louisiana was able to increase children’s Medicaid enrollment by more than 10,000 in a single month.

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