What do you suppose this last minute addition to today’s NJ Senate Eduation Committee hearing is about?
S3156(Gopal) - (pending intro and referral) Permits boards of education to lease certain school property to federally qualified health centers without bidding.
It seems to me that our legislators are paving the way for School Based Health Clinics. If so, it appears to be part of a pattern of laying broad foundations for agendas without first determining whether those initiatives are aligned with the will and best interests of We the People.
As always, it’s necessary to separate stated purpose of School-Based Health Centers (aka the agenda marketing campaign) from the very real potential impacts they may have on our children and communities.
SBHCs are different from traditional school nurses. This is not simply first-aid and addressing illnesses and accidents that come up at school. SBHCs are essentially designed to provide pediatric medicine - diagnosing, treating and offering preventative and ongoing care - during school hours when parents are separated from their children…
While there is merit to providing health services to the underserved, a preoccupation with removing “barriers to care” eclipses issues regarding informed consent, parental consent, surveillance, patient privacy and even the necessity/appropriateness of some of the services that are offered to children.
SBHCs increase adolescent use of health care. Many teenagers, especially male teenagers, are reluctant to seek health care in a traditional medical setting because of cost, confidentiality concerns, and parental involvement.18–20 By providing convenient and confidential care in a familiar setting with supportive staff, SBHCs reduce barriers to care for adolescents, particularly in the areas of sexual and reproductive health, substance use, and mental health issues.21–26 In one study by Stone et al27 in the San Francisco school district, SBHC users reported a caring relationship with program staff. In another study by Allison et al28 in the Denver Public Schools area, adolescent SBHC users were more likely to have received a health maintenance visit, more likely to have received vaccines, and less likely to have used emergency care than other users. SBHC users were also less likely than other users to be insured. (emphasis mine)
School health programs can provide critical information about and access to vaccinations. School health providers might also be able to leverage community partners and relationships with families to increase vaccination coverage.
Good Morning CHD does an excellent job of breaking down some of the issues around SBHC’s, including threats to parental consent and privacy, vaccine registries, legislation, and ways to advocate here.
**Edited to add some great resources from Stand for Health Freedomhere and here.
As long as we’re on the subject of legislation, perhaps we can find ways to close the loopholes around consent.
On a 2022 webinar hosted by the US Department of Education entitled Expanding School-Health Center Partnerships, Tammy Greenwell, Chief Operations Officer, Blue Ridge Community Health Services, Inc. describes how school-based health centers can work around laws that prohibit making contraception available on school grounds:
(At the 1:21:25 mark)
So in the state of North Carolina, you're not allowed to make contraception available on school grounds. So it is against the law. So we do not make contraception available on school grounds. However, what happens between the provider and the student in the course of their visit and how prescriptions or other things are communicated, that is really between the provider and the patient relationship. We also do a lot of health education and promotion. We make sure that students know we are a safe place to come. We also work very collaboratively with the school nurses who are with the local health department. So we make referrals. We want to make sure the students are seen and that they're taken care of. And if it's not by us, we're going to find a provider who can do that for the student. We also follow North Carolina Minor Consent Law… So if someone comes in, there are four conditions. One of those being family planning and STI treatment that minors can consent for without their guardians consent, then we follow those procedures and we follow the law for minor consents as well.
And then, of course, there’s the issue of vaccinations…
By middle school focus would become geared toward continued health and wellness, catching up on immunizations, wellness care, as well as education on primary prevention of substance use.
In addition to vaccinating children at their community sites, health centers have posted more than 7,600 school based COVID vaccination clinics. And these are new relationships that have the potential to be built upon in the future.
You can also get a sense of how grants/funding and partnerships could muddy the waters around responsibility and accountability…
So, while a health center may use a school parking lot for a mobile dental clinic or an office space in a school for a mental health provider, or has space in a school where they provide comprehensive services to students in the school and in the community, these are all effectively extensions of the health center. They are working on behalf of their organization under the direction of their patient majority board. So, while they can provide health center services in a school under a defined set of circumstances, they can't provide services on behalf of the school.
…I think that the key takeaways here is that health centers are not federal assets, they're independent organizations, again, governed by those patient majority boards. So, they and their boards are deciding and requesting as needed, our approval to add sites in schools, to add services beyond those that are required and make those related decisions in order to best meet the needs of their community. They receive grants and other benefits by being part of the health center program and remaining compliant with all of our requirements.
…The takeaway though, is that a grant from HRSA is a relatively small portion of the pie. Medicaid is actually the largest source of revenue for health centers nationally that could vary tremendously based on the actual population that is served by health center. But on average, the grant from HRSA supports less than 20% of the revenues. They also have other state and local resources, other third-party payers, Medicare and self-pay. And the takeaway of this is that health centers come to a potential school partnership with a billing infrastructure, and the potential to maximize revenues in a way that can provide services in a school that depending on a variety of factors could possibly be supported without additional resources. So, if there is a health center near your school, your students are likely already a part of the population they serve. And the sweet spot of a partnership between a school and that health center could really be a mutually beneficial relationship where the health center has greater access to the population…
Partnerships are at the heart of all of this. And for success, we particularly need partnerships between schools and school district and the health centers… Very often, the education partner will provide some contributions to the partnership like those you see on the left hand column here. Space and school, access to IT services, cleaning services, sometimes security, utility services, staff support for the health services delivered by the health center staff. So that means promoting and supporting the use of the school-based healthcare services. And very often, education partners contribute these services in kind, but they also find some funds for these services as well, and these contributions. Sometimes from ESSA, from ESSA's funding, as well as title for some examples of where education partners fund their contributions.
You can read the full transcript for the webinar here. Webinar slides are available here.
Foundations for our intended futures are being built all around us. Now is the time to ask questions and maybe say NO.
*As always, this has been in the works for a while. You can learn more at the links below:
No bidding paves the way for more complex corruption especally in already poor & underserved communities. A lot of school properties are old & need of extensive repairs. RFPs should be part of the process for transparency within every bidding process.
No bidding paves the way for more complex corruption especally in already poor & underserved communities. A lot of school properties are old & need of extensive repairs. RFPs should be part of the process for transparency within every bidding process.
Such important reporting done here! Thank you! I hope people wake up soon. I know this same thing is being proposed in MI. Sad.