School-Based Health Centers: Trusted Lifelines in a Time of Crisis
This post is part of LPI's Learning in the Time of COVID-19 blog series, which explores evidence-based and equity-focused strategies and investments to address the current crisis and build long-term systems capacity.
Just a few weeks before schools closed for the shelter-in-place order, an Oakland Unified student I’ll call Chris visited La Clinica, one of the district’s school-based health centers (SBHCs), due to a serious escalation of mental health issues. The clinic’s medical director evaluated Chris and immediately placed him on psychiatric medication to stabilize his condition. She also arranged for a psychiatric evaluation at Casa del Sol, another local clinic, in order to connect Chris with long-term therapy.
Unfortunately, Chris’s appointment at Casa del Sol was postponed due to COVID-19. While Chris awaited further psychiatric evaluation, staff from La Clinica called him frequently to assess his suicide risk and to provide therapy by phone. Additionally, the clinic’s medical director arranged regular phone appointments with Chris’ mother to explain his need for more intensive treatment and to support her as she coped with her son’s new diagnosis.
Chris is now connected with Casa de Sol and is receiving long-term psychiatric care. Most importantly, he is alive and supported with the services he needs to pursue his learning and life aspirations.
School-Based Health Centers in Oakland
Chris is one of thousands of students who have benefited from the extraordinary health care provided by Oakland’s SBHCs, which are designed to meet the needs of our most underserved students and families, many of whom are without health insurance or a primary care provider.
Oakland’s SBHCs are a foundational component of our full-service community schools strategy, a districtwide approach to serve the whole child and to address unacceptable disparities in education, health, and life outcomes for our students. There are 16 SBHCs in Oakland, which are accessible to nearly all of our secondary students.
Oakland’s SBHCs provide medical, mental health, health education, youth development, and dental services. Additionally, one of our SBHCs has a full optometry clinic. The majority of SBHCs in Oakland are operated and staffed by federally qualified health centers (FQHCs), designated health centers for medically underserved areas or populations. Community partners—East Bay Asian Youth Center (EBAYC), Fred Finch Youth and Family Services, and East Bay Agency for Children (EBAC)—operate three of our SBHCs in conjunction with an FQHC.
Our SBHCs are supported by a long-standing partnership between Oakland Unified School District and Alameda County’s Health Care Services Agency, which allows for the blending and braiding of multiple funding sources. Base funding is provided through a combination of County Measure A (a half-cent sales tax that supports emergency medical services for low-income and uninsured county residents), Tobacco Master Settlement funds (a stable funding source that emerged in 2000, pursuant to litigation against four major tobacco companies), a grant from Kaiser Permanente, and local educational agency (LEA) reinvestment dollars (a state program that reimburses school districts for Medi-Cal–related expenses). Additionally, the SBHC lead agencies reinvest Medi-Cal and other billing revenue into operations and apply for grants to augment services. For example, EBAC has a trauma-informed care grant through Kaiser that funds a staff wellness consultant, and other sites have acquired grants to expand health education programming.
Blog Series: Learning in the Time of COVID-19
This blog series explores strategies and investments to address the current crisis and build long-term systems capacity. View all blogs >
Responding to COVID-19
Nearly all of the SBHCs in Oakland have continued to provide telehealth care for existing patients. Remarkably, La Clinica has also created a phone line to triage services for any youth in Oakland who does not have a medical home. Three SBHCs, in different areas of the city, have remained open in order to provide a combination of in-person and telehealth services.
These SBHCs have community entrances (in addition to school-side entrances) and have therefore always provided services to both students attending the school in which the clinic is housed, as well as those from the neighborhood. They have sustained this model during the COVID-19-related school closures.
Since the shelter-in-place order, these three SBHCs have conducted more than 2,000 in-person medical and mental health visits as well as care via video, phone, and text. They have also provided trauma-informed training for teachers, so that they can better support families and students in crisis. In addition to providing high-quality health care, the SBHCs have surfaced student and family needs that have informed Oakland Unified’s overall COVID-19 response. This has led to the dispensing of feminine hygiene products, alongside food and other basic-needs products at distribution sites, as well as scheduling of drive-through COVID-19 testing for students and families identified through their exposure and other risk factors (e.g., crowded living conditions, high-risk medical conditions, and possible virus exposure due to family members continuing to do essential work).
Additionally, the centers continue to provide reproductive health services (birth control, pregnancy tests, and STI testing and treatment); phone appointments for patients with chronic conditions (e.g., asthma, allergies, and acne); prescription refills; and basic needs assessments for food, housing, and access to technology for online learning. These clinical services are enhanced by health education groups for students, which are currently provided via online platforms. In keeping with the SBHC model of serving the whole child, SBHC staff have also led virtual college tours and yoga classes for our students.
Our SBHC staff have developed a rare institutional trust with students, families, and community members, which is essential for providing care. During shelter-in-place, our SBHCs and health partners have been able to lean into these existing relationships with our students and families. Without these connections, students and families are likely to seek health care in emergency rooms—a much more costly alternative, in terms of both dollars and the health and well-being of our community. The bottom line is that SBHCs provide essential health care in Oakland’s most high-need neighborhoods. As Chris’ story indicates, their work is truly a matter of life itself.
Curtiss Sarikey is currently Chief of Staff with the Oakland Unified School District (OUSD) and brings more than 30 years of experience in social work and education to his current position. From 2011 to 2016 he served as the district’s Deputy Chief of Community Schools and Student Services. In 2016 Curtiss was awarded the Community Schools Initiative Leadership Award from the National Coalition for Community Schools.