November 2011 Newsletter: Charter Schools Pursue School-Based Health Care Programs

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Charter Schools Pursue School-Based Health Care Programs

A charter school in Albuquerque, New Mexico, has received a $500,000 federal grant to build a school-based health center. Charter schools typically struggle to find facilities for their academic programs, let alone accommodations to provide health services. But the grant, among $95 million in awards announced in July 2011 by the U.S. Department of Health and Human Services (HHS), will support Native American Community Academy's (NACA) construction of a 2,685-square-foot health center as part of a new school that is to be built for NACA within the next year. Charter school leaders are developing projects on a variety of levels to integrate health care into their school programs, recognizing that healthy students make better students. This monthly newsletter of the National Charter School Resource Center (Resource Center) provides information about federal programs that support health care in schools, details about the New Mexico school's project, a charter school leader's efforts to provide health services in New Orleans, and additional healthcare resources for those pursuing a deeper understanding.

The school-based health center awards from HHS were funded through the Affordable Care Act, which appropriated $200 million for 2010 through 2013 to address capital needs in school-based health centers. The Health Resources and Services Administration (HRSA) oversees the program and provides information on grant opportunities. In fiscal year 2013, the agency plans to make available about $75 million to support 150 grantees. HHS grants cover a wide range of activities, including oral and mental health. HHS regularly updates forecasts of its grant opportunities.

The U.S. Department of Education is establishing the Office of Safe and Healthy Students, which will house programs that remain after the closure of the Office of Safe and Drug-Free Schools. The department has operated a variety of grant programs related to health, including the and Elementary and Secondary School Counseling Programs. Charter schools have received grants through both programs. Funding for the programs for the coming year will be based on the federal budget, which remains under review.

Regulations Affecting Health Care Services at Charter Schools Vary Across the Country

Laws and regulations affecting school health care services vary across the country, including about such issues as who is allowed to administer medications at school. "Some states are very open about delegation so lay people can assume the duties of a nurse," Linda C. Wolfe, a registered nurse and past president of the National Association of School Nurses, said in an interview with the Resource Center. "In some states it is legal for the secretary to give medications. In some states they don't even have to be trained by anyone." It is important for school operators to understand the regulations.

In Delaware, for example, charter schools "must either agree and certify that the services of at least one (1) full-time nurse will be provided for each facility in which students regularly attend classes, or demonstrate that it has an adequate and comparable plan for providing for the health and safety of its students," according to subsection 4.5.3 of the charter school section of the state's administrative code. Wolfe, currently director of School Support Services at the Delaware Department of Education, said charter school nurses in the state participate in training offered by her department.

School leaders should assess the health needs of the students they serve and determine the capacity and resources available to provide the services. "The models are going to look different across the nation, different even within school districts," Wolfe said. "Depending on the families in a given neighborhood, they may have different needs and different resources than families in another neighborhood."

Federal Grant Will Support Health Center at Charter School's New Campus

Native American Community Academy (NACA) in Albuquerque, New Mexico, a 6-12 charter school serving about 400 students, has had a school-based health center since it was founded in 2005. Health education and improving wellness are core elements of the school's mission, according to Kara Bobroff, NACA founder and principal. The current health center provides a variety of services, including counseling and weekly access to a primary care physician. The services are provided through partnerships with local organizations, including the University of New Mexico and First Nations Community Healthsource. Ninety-eight percent of the students are Native Americans and 82 percent qualify for the federal free or reduced-price lunch program. "We really did a lot of community engagement with other people who were serving Native American students and families prior to starting the school," Bobroff said in an interview with the Resource Center. "We were looking for organizations that serve Native students and families and trying to incorporate them into the school."

NACA currently shares its campus and health center with an Albuquerque district school. Bobroff said she expects NACA to move to a new school facility within the next year. The new school is to be constructed as part of an Albuquerque districtwide school bond issue, which passed in 2010 and included funding for charter schools. Bobroff said the federal health center grant made sense to pursue because it will enable the school to provide space to continue offering health services at its new school facility. The school-based health center is expected to include an administrative and waiting area, three offices, two examination rooms, a conference room, a pharmacy area, a laboratory area, storage areas, a restroom, a dental examination room, a dental X-ray room, a behavioral health care area, a kitchenette, a meeting area, and a health resource room, according to a project summary provided by HRSA. Equipment also will be purchased.

New Orleans Charter School Leader Pushes for Health Services Collaborations

Andrew Shahan, founder and principal of ARISE Academy in New Orleans, Louisiana, has been working to develop partnerships to provide health care services. ARISE is a PK-4 charter school in the city's upper Ninth Ward, and all 351 of its students qualify for the free lunch program. Shahan said in an interview with the Resource Center that the health care services at the school are piecemeal and he wants to develop a comprehensive, "one-stop shop" program that includes a pediatrician with an office at the school.

"I've got an eye doctor-he's actually upstairs right now-and he gives examinations to every single child," Shahan said, adding that the doctor files the paperwork with Medicaid for reimbursement and the students receive glasses if they need them. Shahan said it is important to make it worthwhile for the doctor to come to the school and to maximize the value of the relationship. "This is where you get your advantage as a school," Shahan said. "When he comes, we've got it organized. All he has to do is just spend the day seeing kids," he said.

Shahan, who received his master's degree in interrelated special education, said eye examinations are basic, but providing assessments is critical. "You've got to check off those physical things first," he said. Proper eye examinations can help identify whether a student simply needs glasses or whether the student has a disability that special education can address. Making the right diagnosis helps students receive the services they need to succeed.

Creating the right space to provide health services is the biggest challenge, according to Shahan, who shares his building with another school. Shahan said he wants to "eliminate all the excuses and all the other reasons why we might not be achieving," inadequate health care among them. "It's really interesting. As we eliminate these things we are achieving."


33 States, D.C., Participating So Far in National Green Ribbon Schools Pilot Program

Charter schools are eligible for the U.S. Department of Education's pilot Green Ribbon Schools program, and 33 states and Washington, D.C., have indicated they will participate, according to the department. Read more.

Charter School Facilities Projects Backed by USDA Rural Development Loans

Charter schools received millions of dollars in loans in 2011 through the U.S. Department of Agriculture's (USDA) Rural Development Community Facilities Loans and Grants program, including about $3.8 million for projects in Hawaii, $2.8 million for a project in Delaware, and $2 million for a school in Massachusetts. Read more.

The Broad Prize for Public Charter Schools Focuses on CMOs, Offers $250,000

Twenty charter school management organizations (CMO) are eligible for the inaugural $250,000 Broad Prize for Public Charter Schools, which will be awarded annually to honor the CMO demonstrating the "most outstanding overall student performance and improvement among the country's largest urban charter management organizations in recent years while reducing achievement gaps for poor and minority students."

The Eli and Edythe Broad Foundation announced the new prize on November 1, 2011, and the first winner will be named at the June 2012 National Charter Schools Conference in Minneapolis, Minnesota. The winner will receive $250,000 for low-income student college-readiness efforts.

Organizations cannot apply or be nominated for the award, according to the announcement. CMOs that meet criteria such as the number of years in operation and enrollment profiles are automatically eligible. A review board will choose the winner of the award after an examination of publicly available student achievement data.

NAPCS Estimates 500 New Charters Opened for 2011-12, 150 Closed

More than 500 new charter schools opened across the country for the fall of 2011 and about 150 closed over the past year, with California leading in both categories, according to November 2011 estimates by the National Alliance for Public Charter Schools (NAPCS).

Back to School Tallies: Estimated Number of Public Charter Schools, 2011-2012 provides the top states for openings and closings of charter schools and a chart of the activity in each of the states where charter schools were operating in 2011.

Overall, NAPCS estimates there are now about 5,600 charter schools across the country, representing growth of about 7 percent. Four states showed declining numbers.

Minnesota Court Addresses Charter School's Challenge of Authorizer's Decision Not to Renew Contract

A 2011 Minnesota District Court order and an accompanying memorandum, now posted on the Resource Center's website, address a Rochester, Minnesota, charter school's challenge of a decision by its authorizer, Volunteers of America-Minnesota, not to renew its contract. The order denied Studio Academy's request that the court temporarily block closure of the school until a hearing of its plea to remain open. The memorandum compares the potential harm of allowing the school to close with the harm of requiring that it remain open. The memorandum also examines the role of state law and the contract between the school and the authorizer, as well as the implications for students and oversight of charter schools.

Volunteers of America-Minnesota received the National Association of Charter School Authorizer's 2011 Award for Excellence in Improving Practice.


February 27-29, 2012: The Second Annual Green Schools National Conference will be in Denver, Colorado.

June 19-22, 2012: The National Alliance for Public Charter Schools will hold the National Charter Schools Conference 2012 in Minneapolis, Minnesota.

June 24-27, 2012: National Assembly of School-Based Health Care will hold its annual National School-Based Health Care Convention in Albuquerque, New Mexico.


National Assembly on School-Based Health Care (NASBHC). NASBHC, which was founded in 1995, provides this website with a broad range of resources to support school-based health centers, including reports such as School-Based Health Centers: National Census, School Year 2007-2008, a list of state-based groups and information about grants. The 2007-08 census found that at least 26 of the 1,909 school-based clinics and programs that were identified were located at a charter school.

Division of Adolescent and School Health. This Web page of the federal Centers for Disease Control and Prevention provides resources and reports focused on youth health issues, including School Health Profiles that cover policies and practices and are based on surveys of principals and teachers.

The Center for Health Care and Health Care in Schools. The Center for Health and Health Care in Schools (CHHCS), based at George Washington University's School of Public Health and Health Services, offers resources and research to improve children's health care, including projects focused on immigrant and refugee children and school mental health programs.

School-Based Health Clinics. This report from the Robert Wood Johnson Foundation covers the foundation's experience over the past 25 years with projects focused on health care services in schools, including the impact of potentially controversial programs such as sex education.