School-based health centers can deliver care to vulnerable populations during the COVID-19 pandemic

COVID-19Mar 17 2020

School-based health centers provide primary and preventative health care, chronic disease management, dental care, and mental health services to over 6 million students in over 10,000 schools in the United States. Unfortunately, as school closures spread across the United States due to coronavirus disease 2019 (COVID-19), students could miss out on these needed services.

School districts that have already (or plan to) shut down should coordinate with their school-based health center’s sponsoring agency to understand how students will be affected and learn how to best serve students when school is not in session. Districts that remain open can take steps to ensure that students are served in the event of a closing.

School-based health centers are typically operated by community-based sponsoring agencies, such as federally qualified health centers, hospitals, or health departments. While most of these health centers only allow students and school staff to access services, some also serve the broader community. And because school-based health centers are located within schools, if schools close, so do the centers.

Furthermore, school-based health centers disproportionately reach low-income students and those living in rural areas. Health care deserts are common in these areas, particularly for children, and the closure of school-based health centers could be especially detrimental to these students. For many, such services represent their only access to health care—at a time when they may need care the most.

For school districts that have closed, the following recommendations may further support the health and well-being of students:

  • Coordinate with health center providers and administrators to ensure that children with physical and mental health needs can access appropriate services. Access to health care may be via a school-based health center, other resources in the community, or online.
  • Communicate with parents and students about how to access health care services, particularly in isolated areas that lack an accessible clinic. This may involve using messaging systems, such as texts or emails, and other district resources to communicate ways to access telehealth or related services.
  • Consider permitting school-based health centers to remain open if schools themselves are minimally staffed.
  • Allow school-based health centers to pivot to a telehealth model and communicate the new protocols and procedures with students and staff.
  • Because of HIPAA regulations, health center staff will need to reach out to students and families who use the center regarding alternative health care options.

For school districts that are closing soon, here are some tips to prepare for a school closure:

  • Districts should coordinate with the health center’s sponsoring agency to ensure that material records, such as journals or medical notes, are transferred to the sponsoring agency.
  • School-based health centers should ensure that students have sufficient refills of prescriptions to get through a potential prolonged school closure.
  • The district and center staff should consider keeping the center open for limited hours.
  • Districts and school-based health centers should inform parents about the center’s sponsoring agency so they can plan for continuity of care. A notification via email, in written form, or text can inform parents how they can still access services.
  • School districts should include health center administrators in meetings related to the closure so that center staff can facilitate continuity of care.

School-based health center staff and other school employees must take all appropriate precautions to ensure their safety during the COVID-19 pandemic. Some of our recommendations assume that in-person visits will remain necessary; indeed, children will continue to have health care needs. Throughout such visits, all social distancing measures should be employed as directed by the CDC. Additional protocols, such as limiting the use of waiting rooms, should be considered.

It is necessary to ensure the health and safety of all medical staff during this time; if appropriate and necessary, the best course of action may be to close school-based health centers for an extended period. However, students and parents will face considerable hardships when schools shut down, and school-based health centers can help ensure that critical health services remain accessible.

Kelli Caseman is the executive director of Think Kids.

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