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 Opportunities
Local Funding and Accountability
California made 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. 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.
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. Currently, the state administration is in the final stages of the approval of a state plan amendment (SPA) that will implement the changes to free care.
High quality facilities are critical to the success of SBHCs. 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. 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.