Deborah A. MontillaDistrict DirectorMiami-Dade County Public Schools

MIAMI-DADE COUNTY PUBLIC SCHOOLS

MIAMI-DADE COUNTY HEALTH DEPARTMENT

CHILDREN’S TRUST

Forging Effective Community Partnerships to Promote Student Wellness & Achievement

73% of students eligible for free and reduced price lunch

91% of all Miami-Dade students are minority children

50% of all families are foreign born

More than 12% of households are headed by a family member with less than a

9th grade education

75% of families speak a language other than English at home

Miami-Dade entered the 21st century with graduation rates barely 55%

The Status of Children’s Health in 2005

Nearly 100,000 uninsured children attended our schools

50% of all families are foreign born

Less than 8% of schools had some form of a health clinic

More than 350,000 students were being served by 24 nurses

(A ratio of .00007 nurses per student)

Poor health status and lack of care leads to higher absenteeism rates and poor educational performance

An innovative school-based prevention and intervention model targeting student health

to promote academic achievement

The Vision for HCiOS

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Required an unprecedented collaboration

Creates a standard and comprehensive approach to health service provision in public schools

Provides primary health services to all students regardless of economic eligibility

Establishes student and family links to medical homes

Required an unprecedented collaboration

Creates a standard and comprehensive approach to health service provision in public schools

Provides primary health services to all students regardless of economic eligibility

Establishes student and family links to medical homes

Implementation Partners

M-DCPSTOTAL : $11.9 million

(including in-kind)• $2.5 million in School

Social Worker positions and• In-kind contributions in the form

of $9.4 million for use ofexisting school space for each

of the current 100 health suites

M-DCHDTOTAL : $3 million

•via Florida Legislature funding forSchool Health Services Program

health team positions

The Children’s TrustTOTAL : $11.4 million

• Administrative staff to supportinitiative and funding to providers

to staff school health teams

Community ProvidersTOTAL : $2.8 million

• 25% match of resources tofully staff HCiOS health teams

(Health Choice Network, University of Miami,Public Health Trust, Miami Children’s Hospital)

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Implementation TimelineSep-05

School Board endorses the conceptual proposal for HCiOS and authorizes the Superintendent to begin work with the Children's Trust and Miami-Dade County Health Department (M-DCHD) to develop final proposal for HCiOS (Item A7)

Feb-06

HCiOS Business Plan is endorsed by the School Board (Item A4)

 

Mar-06

An initial 38 schools to comprise Phase 1 of HCiOS are identified. These schools encompass 19 prior comprehensive school-based health centers

38 Schools

May-06

School Board approves the request to adopt a School Wellness Policy aligned with the District’s system of health and Child Nutrition and WIC Reauthorization Act of 2004 (E-37)

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Aug-06

An additional 62 schools (for a total of 100 schools) are added to complete the first roll-out of HCiOS

100 Schools

Nov-05

School Board introduces components for a System of Health and Wellness •Nutrition•Physical Activity•Health Literacy•School-based Healthcare(Item A3)

 

Implementation Timeline: Continued

Implementation Timeline: Continued

Aug-11

M-DCPS will implement second phase of HCiOS in an additional 50 schools

151 Schools

TBD

HCiOS proposed in 2008 to implement health teams in all PK-12 schools

All Schools

Oct-07

The Board of The Children's Trust authorizes the second phase expansion of HCiOS to an additional 50 schools

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HCiOSHEALTHSUITE

HCiOSHEALTHSUITE

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What We Do…What We Do…I’d like to welcome all of

you to our Health Connect in Our Schools “health suite”, I am the school principal…who are you and what do you do?

And I’m your school’s health aide. I will be

assisting both the nurse and social worker and I am

trained in basic health service provision. I

also help link parents to health services.

I’m your school social worker. I will be providing counseling services, social

service referrals, attendance intervention,

and psycho-social assessments for your

students.

I’m your school nurse. I will be providing basic health services which include: emergency first aid/CPR, grade

appropriate vision/hearing

screenings, and health education.

“The rung of a ladder was never meant to rest upon, but only to hold a man's foot long enough to enable him to put the other somewhat higher.”

Thomas Henry Huxley

HealthConnect in Our Schools Formative Evaluation: Findings and Recommendations

Deborah Klein Walker EdD Margaret Hargreaves PhDCarladenise Edwards PhD August, 2007

HCiOS Formative Evaluation

Evaluation conducted by contract to Abt Associates with The BAE Company and Child Trends as partners

Evaluation focused on Phase 1 operationsMethods used include:

Environmental scan (1/07)Focus groups (4/07)Site visits (4/7)On-line staff survey (5/07)Encounter data (6/06 to 6/07)

Summary of FindingsHiring problems delayed school start-ups; Program

staff missing at all levels

Staff requested more cross district meetings with members of all HCiOS teams – by discipline or all together

Site visits and survey data reveal inconsistencies in services provided across schools

Although the majority had the necessary equipment and supplies needed, the minority that did not faced major challenges in implementing HCiOS

Perceived Program Benefits

Enthusiasm for program

Hope that early challenges in implementation would be resolved

Early successes on parent, school and student benefits

Professionals available for school health functions (e.g., less calls to 911 for emergencies)

School staff appreciated support from HCiOS team

Expanded Opportunities

• Each school year, nearly 8,000 students fail the school-based vision screenings.

• Many families cannot afford to visit a community eye doctor.

• The Miami Lighthouse operates three fully, equipped mobile optometric units staffed by ninety optometrists.

• Over 40,000 students since 1992 have received free comprehensive eye examinations and prescribed eyeglasses.

Impact of HCiOS on Schools

In addition to individual health services, the health teams provided a total of 4,864 preventative health education classes on topics such as general health, injury prevention, weight normalization, violence prevention, and HIV/AIDS serving over 68,000 students

More students are returning to class following a visit to the Health Suite (190,079 students-83% return rate)

More students are being referred for additional services as a result of Health Suite visits (75,000 KidCare, Oral Health, Mental Health, and Primary Care)

Increasing Graduation Rates

2009-2010 72.1%2008-2009 68.5%2007-2008 65.4%2006-2007 63.4%2005-2006 58.7%

Not done yet.

Next Steps…..As funding has decreased, there is a need to

think “out-of-the-box” to expand services

The HCiOS Telehealth Initiative will enable school-based health teams to use telemedicine equipment for consultations among schools and with medical providers based in hubs, community health centers and a hospital system.

Senior High SchoolMiami, FL 33127

Shared Registered NurseAdvanced Registered

Nurse Practitioner

Elementary SchoolMiami, FL 33136

Shared Registered Nurse

Middle SchoolMiami, FL 33127

Shared Registered Nurse

Elementary SchoolMiami, FL 33147

Shared Registered Nurse

Health Choice Network Health Connect in Our Schools Telehealth Initiative

GRANT10751450/EHB86426SAMPLE Implementation

Hub Community Health Center or Hospital Center

Implications for improving education in other cities……….“Partnering for Health” Adrienne Ammerman Principal Leadership

October 2011.

• School-Based Health Centers bolster academic achievement by reducing absenteeism and tardiness. (Gall, Pagano, Esmond, Perrin & Murphy, 2000; Walker, Kerns, Lyon, Burn & Cosgrove, 2010)

• School-Based Health Centers reduce dropout rates. (McCord, Klein, Fay & Fothergill, 1993)

• School-Based Health Centers reduce discipline referrals. (Jennings, Pearson, & Harris, 2000)

“We know that if kids aren’t healthy, then kids can’t learn.” Secretary of Education, Arne Duncan

$95 million - Unprecedented investment in school-based health care

Informing the public and policymaking bodies………..

http://www.studentservices.dadeschools.net and

http://www.thechildrenstrust.org

For additional information about Health Connect in Our Schools as

well as other programs and initiatives focusing on student

services, please visit us on the web at:

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Deborah A. MontillaDistrict DirectorMiami-Dade County Public Schools

MIAMI-DADE COUNTY PUBLIC SCHOOLS

MIAMI-DADE COUNTY HEALTH DEPARTMENT

CHILDREN’S TRUST

Forging Effective Community Partnerships to Promote Student Wellness & Achievement