Celebrating Success and Exciting Updates: Here’s What’s New at CSHA

Dear Affiliates, Members, Partners, Funders, and CSHA Community:

We are excited to share an update with you about CSHA’s search for a new executive director and the structure of our organization during this transition period. We have contracted with an executive search firm and have posted our formal job announcement online at CSHA’s website. Our hope is to secure a new executive director by early 2018.

CSHA’s Leadership Team is currently overseeing day-to-day management of the organization during this transition period, with input and guidance from the staff and Board. Amy Manta-Ranger, Director of Programs, has graciously accepted the role of Acting Executive Director and is supported by other members of the leadership team, including Lisa Eisenberg, Policy Director; Dawn Valadez, Development Director; and Maria Salzano, Director of Operations. Additional consultation support is provided by Serena Clayton, former CSHA Executive Director, and Kristin Andersen, former CSHA Associate Director.
With the support and combined experience of current and former staff, Board members, and an executive search firm, we are well-positioned to quickly identify and hire a new executive director. Despite this transition, our work continues, and our commitment to strengthen the school-based health care movement in California is unwavering.

We’re also excited to share the news that the number of SBHCs in California has grown to 257, and we are able to provide more technical assistance to the field than ever before! We are working with partners to expand region-specific training through convenings in the Central Valley and Los Angeles County. Register today for the LA County School Health Centers Conference on October 30!

Work is underway to develop new sustainability toolkits for the field to help address the need for long-term SBHC funding. We are exploring new ways to integrate the best practices in substance use prevention and trauma-informed approaches across the state. Through our Fight Fund project, funded by The California Endowment, we are providing training and technical assistance to SBHCs so they can better provide information about schools and SBHCs as sanctuary sites for undocumented students and families.
Finally, we are excited to share that planning for the 2018 California School-Based Health Conference is underway. We’re already getting amazing workshop proposals, and we anticipate record attendance of 500 providers, educators, and advocates to join us in Sacramento on May 17-18, 2018Submit your workshop proposal today!
Thank you for your commitment to put healthcare where kids are—in schools!  We’d love to hear from you if you have any questions or suggestions. 

On behalf of the staff and Board, thank you,


Amy Manta-Ranger
Acting Executive Director

P.S. Become a member or renew your membership today to secure your exclusive members-only early bird registration rate for our 2018 California School-Based Health Conference in Sacramento on May 17-18, 2018.

New Opportunities for CSHA Leadership

The Board and staff of the California School-Based Health Alliance (CSHA) are proud of the work we have done in the past year to grow the school-based health care movement across the state. In a time of great uncertainty about health care, the Alliance has worked to secure its place as a leader in the field. We will continue to pursue opportunities to strengthen the Alliance and deepen our commitment to the health and success of California’s children.

Today we announce that Judy Appel, Executive Director, has resigned to pursue an unexpected opportunity to run for California State Assembly (District 15). The recent announcement by Assemblymember Tony Thurmond to run for California State Superintendent of Public Instruction created the chance for Judy to continue her service to her community in a new capacity: the State Assembly. Judy remains committed to the mission of CSHA, and the Board and staff applaud her dedication to public service.

We recognize the need for a full-time, permanent executive director to lead CSHA and build on the momentum and success of the school-based health care movement. As we initiate a nationwide search for a new executive director, the Board and staff are developing an interim plan that will ensure the continued, smooth operation of the Alliance.

CSHA continues to play a pivotal role in putting health care where kids are—in schools. The commitment of our members, funders, and the communities we serve continues to be the bedrock that allows us to make exciting and important changes that drive the school-based health care movement forward and improve the health and success of children across California.

Creating Change for Young Male Survivors of Violence

“I wish that people like me had come and talked to me when I was young,” Malik Ali comments as he reflects on his own experiences growing up in Richmond, CA, where violence was pervasive and supportive role models were few. As a young person, he struggled in school and was in and out of the juvenile justice system. Today, his perseverance and resilience to overcome the obstacles of his youth are gifts that he draws upon to reach young men like him. “My goal is to serve as a role model, mentor, and counselor,” he remarks.

Ali is one of four clinical case managers hired this year as part of the Young Men’s Empowerment Collaborative (YMEC). The YMEC is a partnership between the West Contra Costa Unified School District, the California School-Based Health Alliance, Bay Area Community Resources, the YMCA of the East Bay, Catholic Charities of the East Bay, and other community-based organizations. The collaborative aims to increase educational and health equity for boys and young men of color who have experienced complex trauma stemming from community violence and crime across five schools in Richmond, CA, by meeting the following goals:

  1. Create a supportive school climate for young male survivors of violence by enhancing restorative, trauma-informed systems of care and strengthening the ability of school staff to recognize trauma survivors, respond effectively, and refer them for appropriate services.
  2. Increase the portion of young male survivors of violence who are identified and served by expanding screening and outreach.
  3. Create an effective response to violence through the use of evidence-based interventions in school-based health centers to help boys and young men of color at school.

    Malik Ali (left) and Shawn Baker (right) serve as YMEC Clinical Case Managers with the YMCA of the East Bay.

Nearing the end of the first year of implementation, the YMEC cultivated relationships with nearly 300 young men of color on school campuses. 43% of these students reported experiencing high exposure to traumatic events, like community violence. Subsequently, they were referred to the YMEC Clinical Case Managers, like Ali, and invited to participate in young men’s groups that focused on helping them understand and address their trauma and grief. The groups also provided these youth with skills to cope during stressful, triggering moments and connected them with others who may share similar experiences.

In reflecting on the impact that the YMEC has already had, Ali adds that the collaborative has increased resources and supports for students to cope with their stress and triggers. “Students now have a space that they can go to when they are feeling overwhelmed and a person who they can call on day or night and will listen to them without judgment.”

Funded by the U.S. Department of Justice’s Office for Victims of Crime.

Fresno OKs Six New SBHCs

The Fresno Unified School District Board of Supervisors on February 8, 2017, approved six new school-based health centers (SBHCs) to benefit nearly 7,000 students.

Fresno Unified School DistrictStudents “benefit from having quality health care, which keeps them in school longer, makes them more successful, and immediately impacts their learning,” Acting Fresno Unified Superintendent Bob Nelson said at a press event announcing the plans to build the new SBHCs.

Fresno opened its first school-based health center at Gaston Middle School in 2014. Kaiser Permanente Northern California Community Benefit provided generous support to facilitate the planning of the new SBHCs in partnership with Fresno Unified. The six new sites will be operated in partnership with Clinica Sierra Vista and Valley Children’s Healthcare and are planned for Addams and Bakman elementary schools; Tehipite and Sequoia middle schools; and Duncan Polytechnic and Sunnyside high schools. 

Fresno Unified School DistrictCalifornia School-Based Health Alliance Project Director Salina Mendoza provided Fresno Unified with background on the values of school-based health care, and partnered with Kaiser Permanente, Clinica Sierra Vista, and Valley Children’s Healthcare on planning the new sites.

Valley Children’s Healthcare CEO Todd Suntrapak outlined the fiscal and public health benefits of putting health care directly into Fresno’s schools:

Fresno Unified School District“Last year, we took care of 37,599 kids that were located within three miles of each one of these six clinics. We believe in partnering with Clinica Sierra Vista and Fresno Unified, we won’t just be committed to addressing episodic acute health care needs of kids, but we will be able to … improve and sustain the health and wellbeing of kids.”

See more in a video of the press event and on the Fresno Bee website.

School Health Care Remains Popular in CA

School-based health care is growing in California and providing more services and health care access for students.  There are now 246 school-based health centers (SBHCs) providing high-quality health care to students. Across California, more than 265,000 students attend a school that has a health center, and many more have access to other types of school health services.

This is more than double the number a decade ago. Of the 246 SBHCs, 159 offer mental health care, 69 offer dental treatment, and 129 offer youth engagement programs that keep kids engaged in school and thinking about their future.

SBHCs are so popular because they offer convenient health care for kids in a setting families already know and trust.

Students who utilize SBHCs are less likely to go to the emergency room or be hospitalized, keeping costs down. SBHCs also improve attendance, reduce dropout rates, improve school climate, and support students’ academic achievement. Schools and school districts partner with health service providers to finance SBHCs.

More Information on California’s SBHCs

There are 246 SBHCs serving more than 265,000 students across California. SBHCs are usually located directly on a school campus and provide primary care like any health clinic. Staff vary in size, and typically includes nurse practitioners, nurses, mental health providers, as well as part-time physicians and medical students. Services are provided at no or low cost. No one is refused service for inability to pay.

Services Offered

Service Number Percentage
Medical 213
Health Education 175 71%
Mental Health
159 64%
Reproductive Health – Screening & Education
150 60%
Reproductive Health – Clinical Care 140 56%
Youth Engagement 129 52%
Dental Prevention 123
Dental Treatment


Sponsoring Org Types

Type of Sponsoring Organization Number Percentage
Community Clinic 137 57%
School District 65 27%
Local Health Department 11 5%
Hospital 9 4%
Nonprofit Organization 7 2%
Mental Health Agency 8 3%
Tribal Government 1 .5%
Other 4 1.5%


Onsite SBHC Location Level 

School Level Number Percentage
High School  120  49%
Elementary School  60  24%
Middle School  27  11%
Other (school-linked/mobile/combined levels)  39  16%



Moving Forward, No Matter What

School-based health care providers and those who advocate for the well-being of children and teens help hold our community.

This election has been a particularly divisive time, and as you work to care for students and their families, we will continue to support you and your work. We will work hard to uphold the gains we have made and build on them.

There is some really good news to share: the following key ballot measures passed that will provide critical support to our school children.

  • Proposition 55 will raise billions every year to fund K-12 schools.
  • Proposition 51 will bring in billions to fund school renovations and facilities upgrades.
  • Proposition 56 will tax tobacco sales and bring in extra revenue for Medi-Cal.
  • Proposition 57 will decrease the ability to try juveniles as adults in court.
  • Local soda tax measures prevailed in communities in the San Francisco Bay Area.

These are all wins for promoting student health and success in our state and we are hopeful that school-based health services will benefit from these new sources of funding.

We still don’t know what this week’s presidential election will mean for the federal policies that have improved the lives of children and families in our state.

Let’s remember that emotions may be running high among families of the children whose lives are changed by school-based health services. Students in our schools are fortunate to have you to help them address any possible stress. And again, as you support them, we are here to support you.

We will not back down from our commitment to helping communities across California bring access to mental and physical health care for all students at school, no matter what.

#Health4All Brings Us Closer to Health Equity

By Lourdes Bernal
Lourdes at work

Lourdes helps parents understand eligibility for expanded Medi-Cal.

Getting health care has always been a battle for undocumented, low-income Californians. It has always meant waiting until the last minute to visit a provider, and trying to downplay pain and discomfort from illness or injuries.

The parents of undocumented children work extra hard to pay bills and put food on the table, and many young people are conscious of the added stress of paying for health care. Many undocumented children minimize care to maximize their family’s security.

Thanks to legislation enacted in 2012, many young people have become eligible for Deferred Action for Childhood Arrivals (DACA), which is a program that allows undocumented young people to be employed legally and be eligible to receive Medi-Cal, our state’s Medicaid assistance program for low-income Californians.  This helped a lot, but many young people who were ineligible for DACA were still left out.

This year Medi-Cal expanded to include all income-eligible children and youth under 19, regardless of immigration status. This historic expansion provides thousands of kids in California with access to previously restricted care. 

At the California School-Based Health Alliance, I work closely with schools in the Bay Area to spread awareness about this opportunity so more parents can enroll their kids in coverage. My goal is to create a pathway to access for the many students who feel  that health care is not an option for them because of the cost and because of where they were born.

I am proud I can help parents understand there are options for their children to access health care, and that doing so does not come at the risk of financial burdens, or worse, separation and deportation. I take pride in sharing new options for coverage with parents who are sacrificing so much so their children can thrive. 

Free resources on expanded Medi-Cal:

This outreach is personal to me because I understand the vital importance of having access to care. I’ve seen how access provides you with the opportunity to live better in this place we call home.

I am also proud to be working in partnership with school-based health centers because, in addition to providing vital access to care, they give children and youth a safe space to be themselves without fear. School-based health centers are an important part of an education system that makes it possible for young people to dream, thrive, and succeed.

I believe in expanded Medi-Cal and #Health4All because I know that California is stronger when we are all healthy.

Lourdes Bernal is the Communications Program Assistant at the California School-Based Health Alliance and is helping schools educate parents and students about expanded Medi-Cal for all kids.

State to Change School Medi-Cal Billing Program

We have very exciting news to share about the “free care rule” reversal that reopens a critical avenue of reimbursement for Local Education Agency (LEA) school health providers.

Learn More About the Free Care Rule

The Department of Health Care Services (DHCS) announced on August 29 that changes to the provider manual for the LEA Billing Option Program will reflect the most recent policy direction from the Centers for Medicare & Medicaid Services (CMS) regarding “free care.” The draft changes to the manual are available for review and should be officially published later in September.

This exciting anticipated change to the LEA Billing Option program ensures that Medi-Cal may reimburse LEA providers for services provided to Medi-Cal eligible students, even if they are not in special education.

We hope that everyone providing health services in schools will learn about this opportunity to draw down more revenue to create robust school health systems that include both school districts and community providers.

You can learn more about the “free care” policy, the LEA Billing Option program, and CMS’s policy change on our Free Care Rule page. We have been working closely with DHCS, LEAs, the California School Nurses Organization, and other advocates to make sure that our state makes changes to the LEA program to strengthen school-based health care.

Judy Appel Named Executive Director

Judy AppelThe California School-Based Health Alliance Board of Directors has named Judy Appel as the new executive director to lead our organization.

Judy starts on September 19 and is excited to join us at a moment of incredible opportunity to build more support for school-based health care. Our Board of Directors chose Judy after a comprehensive search process because of her strong experience leading a regional nonprofit to statewide and national prominence.

Judy has served since 2005 as the executive director of Our Family Coalition, which is based in the Bay Area and advances equity for lesbian, gay, bisexual, transgender, and queer (LGBTQ) families with children through support, education, and advocacy.

She has led policy victories for Our Family Coalition, including the Welcoming and Inclusive Schools Program that guides schools to create more welcoming environments for LGBTQ families, and LGBTQ inclusion in the new history-social science curriculum framework recently adopted by the State Board of Education. She is also involved in statewide policy efforts on ending the school-to-prison pipeline.

Judy serves on the Board of Education for the Berkeley Unified School District, where she oversees a complex budget of $135 million; guides policy direction for instruction and programs; supports physical and mental health services for students; and leads Board efforts to implement restorative justice, social emotional learning, and trauma-informed practices at school sites.

In addition, she is involved with numerous initiatives aimed at improving education and health equity for all students, including the Restorative Practices Advisory Committee, the Berkeley Unified 2020 Vision Leadership Team, and the Fix School Discipline Policy Coalition.

We are pleased to welcome Judy as we begin a new phase of growth for the California School-Based Health Alliance and school-based health care in California!

How Supreme Court Ruling Affects Health for All Kids

Health4AllKids-HHH-SBHCs-largeThe United States Supreme Court on June 23, 2016, issued a 4-4 split decision on President Obama’s executive immigration actions known as Deferred Action for Parental Accountability (DAPA) and the expansion of Deferred Action for Childhood Arrivals (DACA).

This leaves in place a lower court decision that blocks the implementation of these executive orders.You can read more about what this ruling means by reading statements from The California Endowment and the National Immigration Law Center.

School-based health centers have always been committed to providing health care for all students, regardless of immigration status. The California School-Based Health Alliance stands behind the work that all of you do to keep everyone in our state healthy and ready to learn. We will continue to advocate for health security for all children and families in California.

Today’s ruling does not affect the 2012 DACA program or California’s recent Medi-Cal expansion to undocumented children. We continue to ask schools and school-based health care partners to join us in sharing information on Medi-Cal for all kids in California.

  • You can download customizable flyers that you can print or post on your school’s website here. These flyers meet the state’s requirements for AB 2706, which requires schools to include information about health coverage at registration.
  • You can get more information and resources here.

You can see our health coverage outreach resources here.