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Jolene Joseph is chief executive officer of The HealthCare Connection, which provides primary health, dental and behavioral health services to the medically underserved, underinsured and uninsured in northern Hamilton County and surrounding areas. Each year The HealthCare Connection, which operates the Viking School-Based Health Center in the Princeton City School District; neighborhood health centers in Lincoln Heights, Mount Healthy and Forest Park; and two co-located behavioral health centers, provides services to more than 17,000 unique patients.
Interact for Health: You joined The HealthCare Connection last November having previously served as chief operations officer and director of behavioral health at a federally qualified health center in Grand Junction, Colorado. How do policies that support SBHCs differ in Colorado and Ohio?
Joseph: The policies or procedures that direct the operation of SBHCs in Colorado versus Ohio do not necessarily differ but how they are enforced or carried out may look slightly different. Colorado has outlined a detailed description of minor consent laws and the required services at a school-based health center, which must include reproductive health and is understood by the medical provider and school district. In addition, a heavy emphasis is placed on quality with reporting requirements necessary for performance measures identified by the Colorado Department of Public Health & Environment. In Colorado, there is a great deal of research conducted by the Colorado Health Institute to provide data and information that supports the importance of SBHCs, locations with highest need or disparities and performance (quality metrics) that describe the impact SBHCs have on the health care system, which is shared with policymakers regularly.
Interact for Health: What about funding models for SBHCs? How do they differ in Colorado and Ohio?
Joseph: Colorado has a very active school-based health association that has been in existence for over 25 years and is often instrumental in assisting new start ups with planning and funding sources, supporting existing SBHCs through change efforts, and advocating at the state level for funding and policies. In addition, the Colorado Department of Public Health & Environment's School-based Health Centers division and the Colorado Department of Education, Health and Wellness division have helped to fundamentally change the view of the importance and impact school-based health centers can have on academic success and the long-term health benefits. CDPHE has built into the state budget funding to support planning and ongoing operational dollars for school-based health center programs. The state budget is typically set for five years. In addition, community health centers and SBHCs whose patient populations are predominately uninsured or medically indigent have access to the Primary Care Fund, which is funded by tobacco taxes.
Interact for Health: Are there any things that Colorado and Ohio SBHC models do well that could benefit SBHCs in other states?
Joseph: Collaboration is apparent across both states. The need for the health center (medical sponsor) and the school district to build a partnership that supports sustainability through integrative practices is critical.
Interact for Health: Last year COVID-19 forced students to learn remotely. How did that affect operation of school-based centers such as Viking?
Joseph: The COVID-19 pandemic has put both the health care system and education system under unprecedented stress, and SBHCs sit at the intersection of those challenges. SBHCs have been hard at work navigating school closures, standing up telehealth programs, conducting outreach to families and responding to changing community needs. Viking is no different. The pandemic has shined a light on the essential role SBHCs play in the health care landscape and the critical services provided to children and families with limited access to care. Viking SBHC remained open throughout the pandemic offering care, which included COVID-19 testing, telehealth visits for students working from home and opening up services to siblings.
Interact for Health: With school reopening, how does The HealthCare Connection plan to increase awareness and consents to use Viking SBHC?
Joseph: The HealthCare Connection has worked to increase awareness and improve the number of consents obtained over the summer months in anticipation of a new school year that could look very different from previous years. We have updated our SBHC informational packet with new consent forms to include oral/dental and behavioral health services to be added this fall and all forms are now included in the Final Forms system for Princeton City School District. We have been working with the communications director at Princeton on ways to promote Viking SBHC differently, and we have had meetings with the school nurses to educate and inform them of services and the process for referral.
Interact for Health: What is The HealthCare Connection doing to promote vaccination efforts?
Joseph: The HealthCare Connection has held four COVID-19 vaccination events at Princeton High School this summer and will hold another one there on Aug. 21. In addition, the vaccine will be available for any student or staff person who chooses to access it at Viking SBHC throughout the school year. We have included COVID-19 vaccine availability in all of our literature and will continue to promote vaccination via social media and written materials. Note: Interact for Health has provided funding to support HealthCare Connections school-based and other COVID-19 vaccination efforts.
Interact for Health: Has the pandemic forced you to set aside long-term planning and focus on the crisis at hand or are you still looking to the future? If so, what lies ahead?
Joseph: The pandemic has not forced The HealthCare Connection to pause. In fact, it has launched our efforts to plan for the future much faster. We decided to add dental and behavioral health services to Viking in response to the feedback we have received from the faculty of Princeton and the unmet needs they have identified with the youth. The HealthCare Connection will also add a fully integrated SBHC to the Mount Healthy School District in late 2021 that will immediately offer medical, dental and behavioral health services. The center will be situated inside the high school and available to the entire district.
Both of the SBHCs will begin assessing social determinants of health and increase screening efforts for mental health and substance use. We have started conversations with other area school districts with the intent of continuing to address the unmet needs of our youth across northern Hamilton County and promote the benefits of school-based health centers. In addition, we are in the planning phase of adding vision and on-site pharmacy services within two of our sites situated in Lincoln Heights and Mount Healthy by fall 2022.
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