1. Beyond Mom and Pop: A New Vision for School-Based Health Centers The National Assembly on School-Based Health Care June 26, Julia Graham Lear, PhD, Director, Center for Health and Health Care in Schools, School of Public Health and Health Services, The George Washington University
The Center for
Health and Health Care in Schools

2. Beyond Mom and Pop: An Overview
The Take-Home Message
A New Vision for SBHCs
Opportunities and Threats
Don’t Look Back: The Future is Gaining on Us

3. Tale of Two Cities The Bronx and Montefiore Medical Center
Denver and Denver Health

4. The Take-Home Message
A new vision: A shift from ‘small is beautiful’ to ‘big is better’
Program stability may be easier to achieve through bigger budgets and larger programs
Pursuit of larger SBHC programs will require new ways of doing business

5. A New Vision for SBHCs: Program Purpose & Characteristics
Purpose: a safety net for the community’s children
Multi-site, serving significant numbers of high-need children
Primary care and mental health services that meet standards of care for safety and quality
Integrated into mainstream payment and service delivery systems
Eg: Portland,OR, NYC-Columbia SPH, Denver

6. Arguments in Favor of a New Vision for SBHCs 
Moral obligation: The right thing to do, eg. public consensus that access to primary care for underserved populations is important
Persistent unmet need in many communities
Self-interest: Will benefit SBHCs in long run

7. Arguments Opposed to This New Vision
Departure from SBHC history emphasis on “getting the model right”
-- community/grassroots tradition, desire to be separate from mainstream healthcare; resulting disconnect with sponsor agency and mainstream healthcare providers
Emphasizes health service delivery over public health/preventive care priorities
Inconsistent with personal visions and skill sets of SBHC staff & leadership

8. The Future is Upon Us
Budgetary realities; federal & state funding cuts affecting SBHC sponsors; reduction in state grants for SBHCs, some SBHCs closing
Continued opposition to federal support in U.S. House of Representatives
A response is required

9. The Future is Upon Us, #2
For established programs -- a time to choose. What is your purpose? Can you demonstrate effectiveness in meeting that purpose? Is that purpose congruent with public goals?
Rural programs may require different strategies, eg. A network of SBHC that function both as a local entity and a state-wide network.

10. What we have before us are some breathtaking opportunities disguised as insoluble problems John W. Gardner, 1965

11. Contact Information
The Center for Health and Health Care in Schools
1350 Connecticut Avenue, NW Suite 505
Washington, DC 20036
fax
The Center for
Health and Health Care in Schools