The Oakland Unified School District wants to be the first major urban school district in the nation to guarantee universal access to primary health care to all its students.
A patchwork of funds — an $18 million initiative funded primarily by the City of Oakland, Alameda County and Kaiser Permanente — is going a long way towards helping the school district reach that goal by the end of the year.
Nine new school-based health centers providing primary care to students were opened or will open between 2010-2012, for a total of 26 throughout the district.
“The greatest challenge of education is the concentration of poverty in urban school districts,” said Alex Briscoe, Director of Alameda County Health Care Services Agency, adding that Oakland schools are a prime example of that challenge.
That kind of poverty, and the health problems that accompany it, can also have a direct impact on how students learn.
“Teachers know that they cannot teach if kids are not in class because they are sick, or their asthma is out of control,” said Serena Clayton, Executive Director of the California School Health Centers Association.
But the concentration of poverty in urban schools also means that a majority of OUSD students qualify for Medi-Cal. When the County opens health centers on or near school campuses, they are reimbursed for most of the services they provide.
Students get services including mental health counseling, physical exams, sports physicals, first aid, vaccinations, dental screenings and treatment, STD screening and treatment and health education about nutrition, fitness, puberty and sexual health at the clinics. Clinic staff also enrolls students in insurance programs and refers them to providers off-site.
Twenty years ago, studies showed adolescents among the least likely to have access to health care and having the lowest rates of primary care use of any age group in the U.S.
“You’ve got to put it where they’ll trip over it,” Clayton said.
That’s what schools, public entities and non-profits have done over the past three decades, starting with teen health centers in high schools that offered preventative health services. Healthy Start began making grants to hundreds of schools for school-based services in the 1990s.
Now there is a more unified effort to provide comprehensive primary care on or near school campuses. All 26 school-based health centers in Alameda County are built and funded through the county, but run by community health clinics.
“They are not just a clinic in a school, they are part of a broader healthcare system,” Briscoe said.
Serena Clayton says school-based health centers provide a unique value to the healthcare system. “They can monitor chronic disease on a daily basis,” Clayton said. “They can do education in a way no one else can—in a classroom 1-on-1 with students.”
Gone are the days of a school nurse sitting in an office waiting to give a student a band-aid. “We have one of the lowest school nurse ratios in the country,” Clayton said. Today, school nurses are integrating into school-based health centers.
The Oakland-based Native American Health Center is involved in six school-based health clinics, two of which they run. Nurse practitioner Bonnie Trinclisti runs the Native American Health Center’s Adolescent Program. Over the past twenty years, she’s seen Oakland’s school-based health centers grow from four nurse stations to 26 clinics.