Dear Members and Friends,

In the face of the terrible budget situation, I have been feeling that our job as an organization is to stay focused on our long-term vision of making school-based health care an integral part of our health care and educational systems. We are looking for opportunities, however small, to direct funds to school health centers to keep these services alive as a model for the future. We are encouraged by the fact that, despite the budget, expansion of school health centers is taking place in several districts across the state including Los Angeles and Oakland which are adding over 10 clinics each. That said, we also have some information about proposed state budget cuts below and would like to hear from you about how your clinic might be impacted.

On the organizational front, please join me in offering our best wishes to CSHC's Youth Coordinator Kat Gutierrez, who is leaving us to work in the Philippines and finish college. We first met Kat when she was a high school youth advocate. She has been instrumental in developing our statewide Youth Board and earning it a national reputation as a model for youth engagement.

Finally, it's not too late to register for the NASBHC Convention in Hollywood, Florida, June 25-27. CSHC will host a special gathering for participants from California. It will be a great opportunity to meet colleagues and share stories while hanging out on the beach!

Wishing everyone a great summer,

Serena Clayton
Executive Director

State Policy Updates

Governor's Budget – Impact on School Health Centers
On May 14, 2009 Governor Schwarzenegger released his May Revision of the 2009-10 budget. The budget package signed by the Governor in February 2009 has already been determined to be out of balance due to declining revenues and failure of the propositions. According to the Governor's office, the budget shortfall is now $21.3 billion. The Governor's budget solutions include a mix of program cuts, borrowing, selling state-owned properties, eliminating some state agencies and boards, accelerating revenues, shifting funds and laying off 5,000 state employees. To see the proposal go to the Department of Finance website.

The Governor's proposal is only the starting point for budget negotiations. The final budget must be passed by the legislature and signed by the Governor.

We have identified the following provisions in the Governor's budget that pose a threat to school health centers. If you have additional input, please contact Serena Clayton at sclayton@schoolhealthcenters.org.

Reduction in Education Funding.
The Governor is proposing significant reductions to Prop 98 spending which will force districts to make cuts. Districts have been given some flexibility in implementing 42 categorical programs, some of which are health-related, and could be eliminated. The impact of these cuts and changes on school health centers will be determined by decisions made by each school district.

Cut or Eliminate Healthy Families.
The Governor has proposed to cut eligibility from 250% of the Federal Poverty Level back to 200% thereby eliminating coverage for approximately 225,000 children. Subsequently he proposed to completely eliminate the program, which covers one million children. Besides being a disaster for children who would lose coverage, this measure would increase demand at SBHCs but provide no funding source to cover it.

Cut Rates for Family PACT.
The Governor proposes to cut rates to pre-January 2008 levels. Because many school health centers bill Family PACT and rates do not cover true costs even now, this loss of revenue could threaten many centers.

Reduce Medi-Cal Eligibility and Other Medi-Cal Costs.
The Governor is seeking “flexibility” from the federal government to allow California to make cuts worth $750 million despite the fact that states that cut eligibility are not eligible for increased Medicaid payments through the stimulus. If the Governor is successful in obtaining a waiver from this requirement, some of the measures taken to save $750 million, such as reinstatement of quarterly status reporting or reduced eligibility for parents, may result in children losing coverage and/or provider payments decreasing.

Eliminate Certified Application Assistance.
This provision would make it more difficult for children and families to enroll in Medi-Cal and Healthy Families, thereby decreasing coverage and reimbursement to SBHCs.

Limit Medi-Cal for Qualified Immigrants.
The Governor proposes to limit benefits for newly qualified immigrants and some other legal immigrants to restricted-scope services. Although children and pregnant women would be exempted, children often lose coverage when their parents do. Because school health centers serve many immigrant children, demand could increase without a corresponding source of revenue.

Federal Policy Updates

S. 1034, Reimbursements for School Health Centers
S. 1034, the Healthy Schools Act of 2009, which would allow school health centers to receive reimbursements for treating students already enrolled in Medicaid and SCHIP, was recently introduced into Congress by Sen. Debbie Stabenow (D-MI). Thanks to your lobbying, Sen. Barbara Boxer has now signed on as a bill sponsor! We still need to convince Sen. Dianne Feinstein. Please call Sen. Feinstein TODAY and encourage her to sign on to S. 1034. In Feinstein's office, call Olyvia Rodriguez, legislative aid for education and child welfare at 202- 224-3841.

Tips to Help School Health Centers Seeking Stimulus Funds
The U.S. Department of Education has released a new guidance on use of the stimulus funds, titled Using ARRA Funds to Drive School Reform and Improvement. CSHC has additional information about the stimulus as it relates to SBHCs on our Policy page.


New CSHC Policy Brief

School Health Centers and Obesity Prevention
CSHC recently completed a new obesity policy brief that presents evidence for the effectiveness of school-based interventions to promote nutrition and fitness and reduce obesity. We would like to send copies to anyone who can use them or distribute them. Please contact Dara Tom at dtom@schoolhealthcenters.org or at 510-808-4079, to request paper copies or follow the link above to see a PDF copy.

Wilson High School Clinic Opens in April
Wilson High School school-based health center held a grand opening celebration in April after being closed more than a year due to a provider change. Located in East Los Angeles, Wilson's student population is over 2,700, the majority of whom are Hispanic. The new medical sponsor, Bienvenidos, is a nonprofit, community-based organization delivering a comprehensive array of services that empower children and their families to promote strong communities. The clinic is open daily from 7:30 am to 4:00 pm and offers a variety of services to students at no cost, including child health services, reproductive health services, primary health care, and prenatal care.

Charter School Opens Family and Children's Services Center
El Sol, a charter school in Santa Ana, has added health services, dental exams, legal aid, vocational training, and ESL services to its preschool services for children and families in their community. The goal was to register 100 low income families for services within a year; they met their goal in one week. Services are offered through a host of volunteers, along with nonprofits, and public agencies. Read the full story at the OC Register.

Orange County School Health Centers Meeting
Date: 15 June 2009
Place: Costa Mesa, CA (Orange County Dept of Education, 200 Kalmus Dr, Esplanade Building #4, Suite 102)
Contact: Sang Leng Trieu at strieu@schoolhealthcenters.org or 213-694-1250 x4467
More information will be coming soon, including agenda items. Please contact Sang Trieu if you are interested in attending. Lunch will be provided.  

Focusing on Quality Health Programs, Looking Through a New Lens
Sponsors: California Head Start Association
Date: 16-17 June 2009
Place: Sacramento, CA (Holiday Inn Sacramento Capitol Plaza)
Contact: lparent@liifund.org or 415-489-6147
Keynote speaker is Regina Louise, author and motivational speaker. Activities will include breakout sessions, panel discussion on federal review protocols, federal update, information sessions on ARRA money available to Early Head Start, networking reception, exhibits, and two early morning health walks.

2009 NASBHC Convention
Sponsor: NASBHC
Date: 24-27 June 2009
Place: Hollywood FL
Contact: NASBHC registration
The 2009 convention marks the fourteenth convention of the National Assembly on School-Based Health Care. The convention theme builds on last year's theme - "taking action against health inequities," which energized and resonated with the field's quest to deliver the highest standard of quality health care. If budget cuts are influencing your decision to attend conferences, check out the NASBHC website and the  NASBHC facebook page  where you can find other school-based health care professionals who wish to share their hotel rooms. 

Year-End Celebration!
Sponsor: Kids Come First Community Clinic
Date: 25 June 2009
Place: Ontario , CA (1501A S. Bon View Ave)
Contact: Beverly Speak, 909-673-9125 or bspeak@kidscomefirstclinic.org
Come join the year-end celebration to thank all the friends, donors, families, staff, volunteers and community partners for helping the clinic make good things happen in spite of the gloom and doom all around us. There will be food, an awards ceremony, health information and fun. Please RSVP to the contact number shown above.

Voices for Change: Connecting the Dots Between Prevention & Care
Sponsor: California Pan-Ethnic Health Network
Date: 30 June 2009
Place: Los Angeles CA (TCE, 1000 North Alameda St)
Contact: Ruben Cantu, Program Director at rcantu@cpehn.org or 510-832-1160
This is a unique opportunity to bridge the important work of prevention and care. Join us to hear from our diverse panels of funders, physicians, advocates, and youth on how to come together to improve the health of California's communities of color. Voices for Change promises to be a great forum to create new relationships, build advocacy skills, and connect the dots in your daily work.

LA Coalition
Sponsors: LA Coalition of School Health Centers
Date: 12 August 2009
Place: LA Care Health Plan, Los Angeles CA
Contact: Sang Leng Trieu at strieu@schoolhealthcenters.org or 212-694-1250 x4467
More information will be coming soon, including agenda items. Please contact Sang if you are interested in attending. Lunch will be provided.

Wellness Conference
Sponsor: California School Boards Association and CSHC
D ate: 6-7 October 2009
Place: Anaheim, CA
Contact: CSBA website
This two-day conference will highlight issues impacting student and school wellness. The conference has been expanded and CSBA is looking forward to new topics, workshops, presenters and much more. School board members, superintendents, food service directors, school nurses, school/student health council coordinators, teachers, parents and others are encouraged to attend. CSHC will be sponsoring several workshops at this event. Watch for details coming next issue!