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SBHC Innovations: The Intersection of Public Health and Education

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Sharing strategies and plans for the re-entry of school-based health

July 30, 2020

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SBHC Innovations: The Intersection of Public Health and Education

  1. 1. School-Based Health Center Innovations The Intersection of Public Health and Education; Sharing strategies and plans for the re-entry of school-based health July 30, 2020 Brought to you by:
  2. 2. Important Take-Aways:  Understand multiple aspects to consider when planning each type of re-entry plan  Consider how to further support school-based medical, behavioral health providers and program directors in these new models  Hear how other school-based teams are supporting students and addressing needs
  3. 3. Today’s Faculty Panel Yvette Highsmith–Francis, MM; Vice President, Eastern Region, Community Health Center, Inc. Seleena E. Moore, MPH; Senior Program Manager, School-Based Health Alliance Dr. Rob Dudley, MD, MEd, FAAP; Pediatric Physician, Community Health Center, Inc. Georgette Harrison, LPC, NCC; Director of Clinical and Community Partnerships, Child Guidance Center of Southern Connecticut Molly Ticknor, MA, ATR, LPC; Executive Director, Show-Me School-Based Health Alliance of MO
  4. 4. Transitioning Out of Isolation Living with SARS-COV-2 in an Educational Environment Rob Dudley, MD, MEd, FAAP
  5. 5. Considerations in Reopening Schools Many factors to consider including  Physical Safety  Social distancing  Cleaning and disinfecting  Altered schedules/Phased reopening  Local spread, testing capacity, school’s ability to limit spread  Conversation between BOE/DPH (state and local)/local health organizations How can a SBHC participate in planning school reopening?
  6. 6. Considerations in Reopening Schools Educational Concerns  Students will have had a variety of experiences with virtual learning  Children with disabilities may have had greater impacts from loss of therapies as well as instructional time  IEPs may need updating  Students may have troubles adjusting to new routines and uncertainty in routines How can SBHCs support educators and students as they reenter school?
  7. 7. Considerations in Reopening Schools Health Concerns  Planning for exposures in school  Clearance for children with special healthcare needs  Health forms, immunizations, sports participation clearance How do SBHCs collaborate with school nurses, primary care providers and educators to promote the health of students, staff, and families?
  8. 8. Considerations in Reopening Schools Mental Health Concerns  Broader social and family stressors may affect student’s ability to attend school or be ready to learn  Students will have experienced different levels of stressors  Those with preexisting mental health conditions may have fallen out of care or suffered exacerbations  Risks of child abuse or neglect  In-person classes may be interrupted by another wave of the virus What mental health resources can SBHC staff bring to the table?
  9. 9. Resources • Centers for Disease Control (CDC) – https://www.cdc.gov/coronavirus/2019-ncov/community/schools- childcare/index.html • American Academy of Pediatrics (AAP) – https://www.aappublications.org/news/2020/05/05/covid19schoolopening050 520 – https://www.healthychildren.org/English/health-issues/conditions/chest- lungs/Pages/COVID-19-Information-for-Families-of-Children-and-Youth-with- Special-Health-Care-Needs.aspx – https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19- infections/covid-19-planning-considerations-return-to-in-person-education-in- schools/ • American Academy of Child and Adolescent Psychiatry – https://www.aacap.org/AACAP/Families_and_Youth/Resource_Libraries/covid- 19/resources_helping_kids_parents_cope.aspx
  10. 10. Reopening Format Matters In-Person vs. Hybrid vs. Distance Learning Daily mental health needs of children will vary based on format School Re-Entry Behavioral Health Considerations Supporting Students, Caregivers and Staff
  11. 11. In-Person Learning  Increase in school avoidance behavior  Increase in pre-existing OCD symptoms, emergence of contamination fears  Academic performance anxiety  Difficulties wearing masks for extended periods  Fantasy about “returning to normal”  Presence and intensity of anxiety will impact child’s ability to learn  Anxiety about returning to the home (interpersonal violence, abuse, neglect)
  12. 12. In-Person Re-entry Considerations  Collaboration with school staff to address school avoidance  Anxiety-reduction strategies  Normalization of the desire to “return to normal”  Possibility for mask breaks  Supporting students and staff in identifying individual zone for optimal learning  Collaboration and plan with school staff and colleagues upon suspicion of IPV or abuse
  13. 13. All Distance Learning  May be a continuation or fine-tuning of procedures in place in Spring 2020  Student and caregiver frustration about being unable to “return to normal”  Academic performance anxiety  Students who are not logging on for sessions or classes  Caregivers who struggle helping children complete academic work  Lack of contact with children who are at-risk for abuse, neglect  Exacerbation of social skill challenges
  14. 14. Distance Learning Re-Entry Considerations  Critical assessments of procedures implemented in Spring 2020  Validation of caregiver and student frustration  Close collaboration with school staff for early identification of children who are starting to struggle/caregivers who say they don’t know how to support child/student no longer logging on  Structured opportunities for real-time virtual contact with children who are at risk for abuse, neglect  Facilitation of social skills virtual groups
  15. 15. Considerations For All Formats  Identifying relationships that need bolstering  Re-entry support groups  (Re) Establishing a therapeutic alliance with caregivers  Identification of case management needs  The way we listen to children, caregivers, staff hasn’t changed
  16. 16. School Re-Entry / Role of SBH with COVID-19 Molly Ticknor, MA, ATR, LPC Executive Director
  17. 17. Considerations for School Re-Entry Operations & Physical Space Community Partnerships Support & Collaboration with School District Partners Health Education Addressing Student Needs Socio-Emotional Health of Staff Infection Control HIPAA/FERPA Guidelines
  18. 18. Role of SBH Programs to Support School Re-Entry Closing the immunization gap critical to re-opening schools Providing COVID testing if approved (or any other diagnostic testing) Supporting tracking cases & quarantine efforts to reduce exposure & spread Providing preventative & urgent care & behavioral/mental health services to address gaps & reduce ED visits Providing medical supplies (i.e. PPEs, thermometers, etc.) that schools/school nurses may not be able to access Supporting the establishment of school cleaning & sanitizing procedures Educating staff on the symptoms of COVID-19, helping to establish protocols for screening, assessing symptoms, and providing basic health education
  19. 19. Considerations for Schools & SBH Programs: Partnership / Collaboration • Collaborate early and often with school administrators and school nurses • Schedule periodic meetings throughout the summer • Identify roles and responsibilities • Make decisions jointly based on school re-entry planning decisions • Determine health priorities to address student needs • Partner to prepare education on trauma informed practices and resiliency for teachers and SBH program staff • Collaborate with school social workers / case managers to address social determinants and outreach efforts
  20. 20. Advocacy Efforts • Support the growth and sustainability of School-Based Health Programs as funding is made available • Advocate for children’s health coverage and care - • Advocate for additional and continued reimbursement for virtual visits • Advocate for reimbursement of case management / wraparound supports for families related in addressing social determinants of health 20
  21. 21. Resources • https://moschoolhealth.org/ • https://moschoolhealth.org/wp-content/uploads/2020/07/Draft- Guidance-for-Reopening-SBH- Programs_7.20.2020_CURRENTDRAFT.pdf • https://www.mosba.org/2020/04/05/msba-resources-for-the- covid-19-pandemic-2/ • https://www.cchpca.org/ • https://www.cdc.gov/coronavirus/2019- ncov/community/schools-childcare/Schools-Decision-Tree.pdf
  22. 22. Thank You! Please contact us with your questions. WeitzmanLearning@chc1.com For more information, visit our websites: www.sbh4all.org www.weitzmaninstitute.org/coronavirus