1. 16th Annual Maternal and Child Health Coordinating Conference February 20, 2002 School-Based Health Centers As a Vehicle for Expanding Access for Adolescents Annette Ferebee, MPH Deputy Director The Center for Health and Health Care in Schools

2. 16th Annual Maternal and Child Health Coordinating Conference Session A3 The State of Adolescent Health in the District of Columbia: A Vision for the Future Wednesday, February 20, 2002 10:30 - 12 Noon

3. The Center for Health and Health Care in Schools l Funded by The Robert Wood Johnson Foundation l Established in February 2001 l Housed at The George Washington University

4. The Center for Health and Health Care in Schools What We Do: l Test model programs l Analyze options for organizing and financing school health l Research issues and publicize effective programs l Inform policymaker and the public

5. School-Based Health Centers(SBHC) Today l 1,400 SBHC nationwide l New York, Arizona and California l Urban, Rural, Suburban l Elementary, High School, Middle School

6. School-based Health Center Model l They are located in schools l Parents sign written consents l An advisory board of community representatives, parents, youth and family organizations l Clinical services are the responsibility of a qualified health provider

7. School-based Health Center Model l The health center works cooperatively with school nurses, coaches, counselors, classroom teachers, and school principals and their staff l A multidisciplinary team care for students (NP, MSWs, MD, HE) l The health center provides a comprehensive range of services

8. State of Adolescent Health Today l Adolescents (10-19) have the lowest utilization of health care services of any age group and are the least likely to seek care at a providers office. l Adolescents are less likely to have health insurance than other age groups l Risky behaviors are the leading threat to the health of adolescents

9. State of Adolescent Health Today l Leading causes of death for adolescents have changed from natural causes to unintentional and intentional injuries l Three quarters of those needing mental health services do not receive them.

10. State of Adolescent Health in the District of Columbia l 20% or approximately 115,000 are under the age of 18 l Infant mortality rate rose to 15 deaths per 1,000 more than twice the national average l 1.5 percent of children and youth under 20 were diagnosed with chlamydia, gonorrhea or syphilis -about 1 in 65

11. State of Adolescent Health in the District of Columbia l Percent of births to teenage mothers declined l New AIDS Cases diagnosed in children and teens declined l Violent deaths to teens decreased

12. SBHC Policy Issues in the District that Need to be Answered l It is not clear if SBHC personnel can legally diagnose and treat l Relationship between school nurses and school-based health center personnel needs to be addressed, and l How to measure performance and quality to enable political and community accountability

13. Resources l Center for Health and Health Care in Schools web site www.healthinschools.org l D. C. Children’s Trust Fund www.dcctf.org or www.aecf.org l RAND Health Highlights www.rand.org