The availability, quality, and sustainability of school health services are influenced not only by health care policy but also by education policy. The California School-Based Health Alliance therefore works at the local, state, and federal levels to promote education policies that advance school health services and facilitate the expansion of SBHCs.
Education Policy Goals
We have identified the following goals for our education policy work.
- Remove barriers and create incentives for schools to expand health services, including via community partnerships.
- Foster active, strategic state level leadership on school health services.
- Maximize existing/potential state and federal funding sources.
- Promote the use of data to show need and impact, as well as to document service provision.
Education Policy Opportunities
Local Funding and Accountability
California is making significant changes to its school accountability and funding systems, providing new opportunities for greater investment in school health services.
The Local Control Funding Formula (LCFF) is California’s new school funding system. It will provide additional resources to districts that serve the most vulnerable students. The LCFF requires school districts to adopt local control and accountability plans that set goals and lay out strategies in a variety of priority areas. Children’s health advocates were successful in securing a focus on health related priorities, including chronic absenteeism and school climate. Read more here about LCFF and how school health advocates can leverage local decision-making to include school health supports.
We will be tracking the development of policy related to LCFF and will be educating local level policymakers about the role that school health services can play in achieving their goals.
In December 2014, the federal government reversed a longstanding policy that impeded the ability of school districts to get reimbursed for the school health services they provide to students (called the “Free Care Rule”).
This policy change has the potential to significantly increase school district revenue for health services (e.g., funding for school nurses or school social workers) through California’s LEA Medi-Cal Billing Option. The LEA Medi-Cal Billing Option Program provides the federal share of reimbursement for health assessment and treatment services for Medi-Cal eligible children and family members within the school environment.
We expect this change to take place in multiple stages and anticipate that, following clarification about the rule change from the federal government, California’s Department of Health Care Services (DHCS), will send out guidance to schools about how to implement any changes. We are working with other advocates to ensure there is a smooth implementation.
High quality facilities are critical to the success of SBHCs.
California’s Joint Use Program provides matching funding to districts for specific types of facilities projects, such as child care centers, libraries, and gyms. To date, SBHCs have not been an allowable joint use project. In the past, State Superintendent of Public Instruction Tom Torlakson advocated to expand the joint use program; more recently, his recent Schools of the Future report called for the inclusion of SBHCs. We are actively exploring ways to make sure SBHCs are eligible for any future joint use funding. (Currently, the program has no available funding.) Read more about the program here.
The Division of the State Architect (DSA) reviews and approves all construction on public school campuses. However, there are other entities that must also sign-off, including the Department of Public Health (for community clinics) and the local Fire Department. All told, the process can be complex and challenging. Because of its broad, statewide mandate, DSA has a unique ability to disseminate critical information to all relevant parties. We collaborated with DSA to develop and produce a bulletin outlining essential information for SBHC architects. Find list of all DSA bulletins here and read the SBHC facilities bulletin here.
Students come to school with many diverse needs. In recognition of that reality, community schools bring a variety of services onto school campuses with the goal of providing children, youth, and families with comprehensive supports, often including health services. With the recent re-authorization of the federal Elementary and Secondary Education Act, control over education policy shifts considerably to states to define education standards and accountability goals. Additionally, the policy change emphasizes broader education indicators beyond academics. States and districts must incorporate non-academic indicators in their accountability systems, such as school climate and safety. This marks a strong shift in federal education policy that recognizes the importance of student supports and services like those with the community schools model. Visit The Education Trust to learn more. Please see this policy brief on how community schools address poverty and offer the supports students need to succeed in school.