School-based health clinics: models and implementation

Affordable Care

School-Based Health Clinics and Adolescents under the Affordable Care Act

School-based health clinics can have many advantages over traditional health care delivery methods. The primary advantage is that school-based health clinics can specialize in the individual needs of the adolescents while a primary care physician may have relatively little expertise in many of the conditions that might affect this demographic group. However, with the school-based clinics, the staff can be well versed in the specific challenges that these adolescents face and provide effective avenues to address these challenges.

Given the passage of the Affordable Care Act, the entire health care environment will be altered. Although adolescents will have increased access to more traditional challenges of health care delivery, there may be a trend in which adolescents are disadvantage in some manner because they will be less exposure to the school-clinics who specialize in many of the age specific challenges that affect these groups.

Affordable Care Act

Typically, a school-based clinic provides a combination of primary care, mental health care, substance abuse counseling, case management, dental health, nutrition education, health education and health promotion activities. Thanks to the Affordable Care Act, more than $14 million was awarded today to 45 school-based health centers across the country allowing the number of children served to increase by nearly 50%, HHS Secretary Kathleen Sebelius has announced (HRSA Press Office, 2011). Strengthening school-based clinics has been shown to be one of the most effective ways to respond to the unique challenges that face adolescents and can offer preventive, comprehensive, mental, and other sensitive care that has previously whereas there have been previous barriers in place (Brindis & Sanghvi, 1997).

Pros and Cons

There are many pros of maintaining strong school-based clinics is that they have unique abilities to combat specific conditions that are present in the demographic such as teenage pregnancy that can often end in poor pregnancy outcomes (Strunk, 2008). It has been shown that school-based clinics offer students more visits than students that do not have access to school-based care in urban centers (Rickert, Davis, Riley, & Ryan, 1997). It has also been shown to be an effective alternative model when factors such as rural residence, minority ethnicity, younger age, no driver's license, and other similar items are considered (Crosby & Lawrence, 2000). The cons that the evolving health care environment can be summarized by volatility in the system as the new platform evolves. Many children who have previously been uninsured may gain traditional access through the legislation. Therefore, it is possible that there will be a reduced emphasis on further the school-based clinic solution since other alternatives will now be available.