School centers can transform healthcare for California’s children

Courtesy of: California School-Based Health Alliance

“SHOP 55” is a school health center at Oakland High School in Oakland.

School-based health centers are essential to supporting child and adolescent health and student success. But, unlike many other states, California has never provided public funding for this proven model, which could bring effective integrated physical and behavioral health care to many more students.

School Health Centers are health clinics located on or near school campuses where children can get immediate help for acute and chronic illnesses as well as preventative care. They increase :

  • Health care access.
  • Use of preventive services.
  • Use of early mental health intervention services.
  • Healthy behaviors, especially among marginalized student populations.

In California, School Health Centers are located in schools and communities with disproportionate incomes, where they help create a more equitable learning environment by improving attendance, school climate and academic achievement.

The LA Trust for Children’s Health conducted a 2015-2021 study of 16,462 middle and high school students in the Los Angeles Unified School District that showed visiting a school-based health center was associated with an increase in student attendance.

The study found, on average, that the proportion of full days at school decreased for students before their first visit to the school health center, but began to improve after their visit. Student attendance increased by 5.4 school days per year after any type of visit to a school health center and increased even more – by seven school days per year – after a visit for a mental health support.

The best school-based health centers are those offered to LAUSD students – comprehensive health homes for children and youth that include primary care, behavioral health, and services needed locally by children, such as health education, oral health and eye care. . They are open most school days, often open during the summer, and are constantly staffed by child and adolescent health care providers. They are closely integrated into the community and have ongoing opportunities to coordinate awareness, prevention and care. They can also serve as a hub for youth engagement, leadership and peer support models.

Unfortunately, because there is no ongoing source of funding for school health centers in California, many do not realize this comprehensive vision.

But California is investing heavily in the community schools model, and school health centers complement community schools by meeting the needs of all children and providing reliable, affordable, quality health services to students and their families. in an accessible and coordinated manner.

In 2021, California passed a state budget with unprecedented investments in child and youth behavioral health, with a focus on school-based services and supports, and those investments are becoming available this year. All of these investments are one-time funding, so they should be leveraged to build new infrastructure and partnerships with a focus on sustaining investments after funding ends.

Since school health centers often leverage health care reimbursement for services, we believe these funding resources are great ways to start new programs and expand existing ones.

These funds include billions of dollars in statewide grants for the following:

  • Full Service Community Schools, that take an integrated approach to the academic, health, and social-emotional needs of students by linking with a range of government and community services.
  • The Student Behavioral Health Incentive Program, a new program that aims to increase access to prevention, early intervention and behavioral health services by school-affiliated behavioral health providers for public school children.
  • Behavioral Health Continuum Infrastructure Program, a new program to build capacity across the continuum of public and private behavioral health facilities for children and youth.
  • Federal COVID Aid – Emergency Aid for Elementary and Secondary Schools, which provides local education agencies with emergency relief funds to address the impact that COVID-19 has had, and continues to have, on elementary and secondary schools.

Many schools have adopted school wellness programs, including popular “quiet rooms” that provide a safe space for students struggling with increased anxiety, stress and depression.

While a good start, programs that separate behavioral health from primary health risk leaving many students with only part of the care they need. Often there is a complex primary health and behavioral cause in student behavior that can go unnoticed when services are not integrated. A student with diabetes may find it difficult to concentrate in class, for example. This student may also be suffering from depression and anxiety, but without investigating other underlying health conditions, this student will never receive the care needed to feel truly well.

These billions of dollars in new funding streams are a golden opportunity for California schools offering behavioral health and wellness services to pivot toward a full-service school health center that provides integrated health services to the entire student body – especially for students who might not otherwise identify as having a health need – behavioral or otherwise.

Let’s partner to bring the exceptional model of care that School Health Centers provide to all students in California!


Sergio J. Morales, MPA, is the executive director of the California School-Based Health Alliance, the statewide nonprofit organization that advances school health centers and helps put more health services in schools .

Maryjane Puffer, BSN, MPA, is the chair of the board of trustees of the California School-Based Health Alliance and the executive director of the Los Angeles Trust for Children’s Health, which connects health and education to ensure student well-being for children. children and youth of Los Angeles.

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