Henry Ford Health System offers three models of health care to schools:
School-based, with clinics located in school buildings
School-linked, with services offered to schools via school health program staff
Mobile services, with services offered in mobile vans brought into the schools and community
2005 Health Status Needs Assessment Henry Ford Health System School-Based Health Centers
In keeping with their educational settings, all three models of care focus on health education as their priority.
The first School-Based Health Center in Detroit opened in 1991 with a grant from the W.K. Kellogg Foundation and was operated by Henry Ford Hospital. By 2005, Henry Ford operated 14 sites and two mobile vans. Collaboration between Henry Ford, Michigan State University and Molina Healthcare of Michigan, Detroit's largest Medicaid health plan, continues to assure a bright future for the School-Based and Community Health Program.
Henry Ford Hospital's Mobile Van
In all three models of care, a board-certified pediatrician directs the services provided, assuring the most appropriate and top quality care. In addition to the care and supervision of those pediatricians, a variety of additional professionals, including nurse practitioners, nurses, physician assistants and social workers also provide health care and mental health services.
Such care includes diagnosis and treatment of minor illness and injury; management of chronic conditions; preventive services such as immunizations, physicals and screenings; and a variety of mental health services such as crisis intervention and counseling. Pregnancy testing, sexually transmitted disease testing, and birth control are also offered (the latter only in school-linked settings). Laboratory services also are provided.
While the health care sites can bill for insurance, no child is ever turned away for lack of insurance. More than 15,000 visits were recorded in 2005.
One study (1999) showed increased state standardized educational test scores and close to 100 percent immunization rates at schools with school-based health clinics.
These metrics represent a 1999 Henry Ford Health Systems study
Thus, in many ways, the School-Based Health Initiative has been quite successful. However, school-based health care faces several challenges:
They need to continue to evaluate and demonstrate improved health in students. This health care must be provided in ways that do not reduce cost-effectiveness and efficiency of the health care system.
Ensuring stable sources of funds. While no student will be turned away for lack of funds, using commonly-accepted billing systems and sliding fee scales when appropriate, will allow health care to be given to the largest number of students possible.
Maintaining the financial security of behavioral health services. Almost 20 percent of visits to the school-based and school-linked sites are for social work services, but these cannot be billed. Such services are only funded by grants or are not compensated. Clearly, these are important and necessary services, based on the demand, but they are threatened by a lack of funds.
Successfully expanding the model of care across the Detroit Public Schools and beyond to improve the health of a larger portion of students.
Increase the rates of consent-to-treat from parents and so that all students can seek care if necessary and improve the health of a larger portion of students.
Increase prevention and health promotion services at current sites to reduce the need for more-expensive health care and improve the health status of students.
Integrate school-based care into other health systems of care to improve access to health information and efficiency, such as electronic medical records.
Henry Ford's School-Based Health Initiative has come a long way in its 15 years of service, and it continues to move forward in addressing these issues along with others in the state and nation.
W.K. Kellogg's recent grants totaling $16.3 million toward this effort, including grants made to Henry Ford, were made so that "school-based health care will be financially stable, available, and accessible to children and families, and supported as a consumer-centered model of quality care throughout the United States."
Projected Income 2005
Projected Budget 2006
In sum, School-Based Health Care:
Supports schools
Responds to the community
Focuses on the student
Delivers comprehensive care
Advances health promotion activities
Implements effective systems
Provides leadership in adolescent and child health
If you'd like more information, please contact:
Kathleen Conway
Director, School-Based & Community Health Program
Administrator, Pediatrics
(313) 874-5426 school-based@hfhs.org
