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Q&A with Tammy Alexander, director of state relations at the School-Based Health Alliance

Tammy Alexander is the director of state relations at the School-Based Health Alliance, a Washington, D.C.-based nonprofit founded in 1995 to serve as the national voice for school-based health care. Alexander oversees state leadership and state affiliation relations and provides training and technical assistance on school health program development and implementation. In addition, she leads a national grant project to increase students' access to oral health services in schools and collaborates with national, state and local partners to to advance school oral health programs.

Interact for Health: How has COVID-19 impacted your member organizations and the School-Based Health Alliance's mission? 

Alexander: Each day, we continue to work to improve the health of children and youth by advancing and advocating for school-based health care. COVID-19 presented everyone, at every level, with the challenge of reimagining how we do the work. The "why" remains the same and becomes more compelling because--as many schools and SBHCs closed--kids are not receiving the care they need and count on to stay well and safe. Kids are hurting and going without the support they need.

Interact for Health: In pivoting to address the pandemic, what has been the biggest challenge for the alliance? 

Alexander: The pandemic presented the alliance with more opportunities than challenges, as we were well situated for remote work, had the technology already in place, and the expertise to quickly respond to the needs of the field. In the early days of the pandemic, we held Listen and Learn sessions for the SBHC field, allowing people to share their responses to the pandemic, and create a large community of people sharing how they continued the work to the best of their abilities.

Interact for Health: Among your many responsibilities, you spearhead the alliance's work to increase students' access to oral health services in schools. What have you found to be key for achieving that goal? 

Alexander: The key is helping people understand the significant connection between oral health disease and the impacts on overall health and how oral health disease impacts students' ability to stay in school and learn. Once that connection is made, especially with the educational partners, people will begin prioritizing getting oral health education, prevention and care for students.

Interact for Health: You began working in school-based health care in Oregon in 1993. After nearly 30 years working with school-based programs, what makes you hopeful? 

Alexander: My hope comes from knowing there is an army of dedicated individuals at the local, state and national levels, as well as funders, who understand the need for school-based health care. The stories from the front line inspire me daily to "keep on keeping on."  

Interact for Health: In your opinion, what are the most significant contributions that Ohio school-based health centers have made to the field?

Alexander: Ohio has been at the forefront of school-based health care for decades. You have had visionary funders, brilliant minds that developed technical assistance and tools, rabidly passionate SBHC providers, and leaders who work together to make great things happen for Ohio students. Growing Well continues to lead selflessly, volunteering its resources and expertise whenever asked. From the national SBHA perspective, we can always count on Ohio to provide cutting-edge experience in school-based health care and you are responsive to trying new initiatives and piloting new ideas.

Interact for Health: What are the greatest challenges and greatest opportunities facing school-based health programs in the next year?

Alexander: Since the pandemic disrupted lives in all kinds of ways, one of the challenges is getting back to "normal." That means restaffing, increasing hours, assuring funding, and all the components that make school-based health care work and work well. We need to be asking all sorts of questions, and not assume we will always operate in the same way, prepandemic. What have we learned from the innovations developed as we continued to provide care when schools were closed? How can we expand care to more students and families with new care models and still be sustainable? How do we respond to the increased mental health needs of the students, teachers and community members? SBHCs cannot do it all, and this presents the greatest opportunity: new partnerships.

Interact for Health: What lessons have you learned through your work? 

Alexander: There are so many. We always need to put the students at the center of the work, and include them in identifying the challenges and the solutions. We do not need to reinvent the wheel. We need to "steal shamelessly and share seamlessly." The work is a marathon, not a sprint. In addition, we are still the best-kept secret, which we are changing. SBHCs make a difference every day.

Interact for Health: What motivates you to come to work every day?

Alexander: Each day I learn something new, and I have the opportunity and a platform to share with the school-based health care community; I connect with other school-based health care people who inspire me with their dedication and expertise; and I have dedicated and knowledgeable colleagues who are creative, responsive and some of the hardest-working colleagues I have worked with during my career. At the end of the day, I know that our work at the alliance provides support to the local, state and national partners who make a difference in the lives of our students, families and communities.

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