Health care provided at or near a school during school hours can improve children’s access to a variety of health care services, such as primary medical, mental health, dental, substance abuse and other services.
Health care services offered at schools are especially important for children who lack routine access to a health care provider, such as the 1.8 million (19%) children in California who don’t receive appropriate preventive medical care4 Most school-based health services are provided in school-based health centers (SBHCs). Currently, only 2% of California’s schools have a SBHC. Those SBHCs that do exist in the state are located in schools where about 70% of students receive free or reduced price meals. A national study found that SBHC usage increased student health care visits significantly: 71% of students who had access to a SBHC reported having a health care visit in the last year compared to 59% of students who did not have access to a SBHC.
School-based health services provide more efficient care and can manage chronic conditions by reducing unnecessary emergency room use and related costs. For example, asthmatic children in schools with a SBHC are 50% less likely to be hospitalized than those who attend a school without a SBHC. A Cincinnati study found hospitalization costs for children with SBHCs decreased by 84%, or nearly $1,000 per child.
SBHCs can lead to academic improvements, including increased student attendance, reduced suspension and expulsion rates and decreased grade retention and dropout rates. Students who receive mental health services through SBHCs also improve their grades more quickly than their peers. A Dallas SBHC found students receiving mental health services had an 85% decline in school discipline referrals.
Figure: States that provide funds for school-based health
(click to enlarge image)
California should expand the number of children with access to school-based health services. Critical behavioral and health screenings, including dental, vision and mental health, should occur at schools, including early care and education facilities, where children already spend the majority of their time. The state should implement this common sense reform to dramatically improve children’s access to care and deliver services more efficiently and effectively.
Figure: Few CA schools have SBHCs
(click to enlarge image)
The federal health care reform law invested over $30 million in creating school-based health centers in California; however, a related federal grant program to provide ongoing operations support for those centers has not been funded. Currently, there is no state funding explicitly for school-based health services.
Recent state budgets have eliminated successful school-based health programs that provided needed mental, dental and other health care services to children. There are continued efforts to restore funding for proven school-based health programs and expand the services they provide to include mental health services for students affected by violence or other traumatic events in their communities.