School-based Health Centers: Increasing Health Care Access for Local students.

Pictured above: Bringing healthcare to non-traditional locations.

At his annual physical last year, a Washington, D.C., teenager received much more than a clean bill of health.

During this routine visit, the Roosevelt High School student revealed to his healthcare provider that his home had been without heat or electricity for four months during the peak of winter. He said his family had no way of restoring power to their home because illness prevented his grandmother, his primary caregiver, from working.

With this information, his healthcare team reached out to partners with Georgetown University’s Health Justice Alliance, who worked on the family’s behalf to get their utilities restored, reduce their debt and enroll in public programs to help fill gaps in social needs.

“We were able to use our resources to help turn things around for his family,” says Ana Caskin, MD, associate medical director of Community Pediatrics, MedStar Health.

This unique, life-changing appointment was not conducted at a traditional hospital or health clinic. Instead, it took place just a few steps from the student’s classroom.

In partnership with the District of Columbia Department of Health, the Division of Community Pediatrics at MedStar Health operates two school-based health centers at D.C. Public Schools—one at Anacostia High School in Ward 8 and the other at Roosevelt High School in Ward 4.

The health centers allow students convenient access to high-quality care without worrying about finding transportation to an appointment, missing school or lacking insurance. Each school-based health center offers various services for medical, oral health, mental health, and social needs, as well as referrals for additional community-based resources.

Families are not billed for care, and if they do not have insurance, a case manager is available to help students apply. “The goal is to improve access to healthcare for students,” says Dr. Caskin. “We want to remove barriers for the kids in our community who face the most challenges to getting care.”

A patient services coordinator, nurse, and primary care provider (pediatrician, nurse practitioner, or physician assistant) are on hand full-time at each center every school day throughout the year. The social worker divides their time between school locations, and a nurse midwife visits each school twice a month to provide prenatal and reproductive health care.

Dr. Caskin says this convenient accessibility helps foster stronger connections between students and their healthcare providers, a connection that might not occur as often in traditional hospitals or clinics.

“The students see us on a regular basis every day—in the hallways, in the parking lot, around the school—so there are more opportunities for us to build trust,” says Dr. Caskin, who estimates the centers serve about 12 students each school day.

Though students do not need a parent present to receive care, a signed consent form from a parent or legal guardian is required to access the full spectrum of services. Dr. Caskin says children under 18 can consent to their own health care if it relates to reproductive health, mental health or substance abuse counseling.

“Our families are very grateful to have this valuable resource available to them,” Dr. Caskin says. “We’re hoping to change the way medicine looks in the future.”