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[Editor's note: This is the second in a series of three posts on school-based health centers. Yesterday we briefly reviewed evidence supporting the use of these clinics. Today, Linda Gann talks about how her district founded two such centers. Soon Jennifer Danielson will take us through a day in the life of a nurse practitioner and tell us how her school-based health center has impacted kids.]

School-based health clinics have shown a great deal of promise in improving health outcomes for students, decreasing Medicaid costs at a time when every penny counts and even in potentially raising academic outcomes for low-income students. But yet there are only about 2,000 school-based health clinics (SBHCs) in the United States. Why don’t more districts take this approach? Does it seem too expensive? Too risky? Too separate from the district’s academic mission?

We recently spoke to Linda Gann, Communications and Special Project Coordinator in Colorado’s Montrose County School District RE-1J, to learn more about how her district came to embrace SBHCs. She also told us about her experience planning and implementing the district’s first school-based health clinic three years ago and its second a few months ago. Some keys to their success? The clinics get all their funding outside the general fund. They keep the community engaged in and informed about these efforts. And they consider not only the physical but also the mental health needs of students.

SBHCs alone will not close the achievement gap. But in Montrose, they are part of a broad strategy to address the needs of its growing Hispanic community. And that strategy appears to be working—for example, the district has a 20% higher graduation rate for Hispanic students than the state does.

Here's the story as Gann told it to us in a recent phone conversation.

About Montrose County School District RE-1J

I think from a researcher’s standpoint our district is almost a perfect universe, as far as data analysis goes. We are located in west central Colorado. We are five hours away from Denver. We are about 1,100 square miles, with two distinct communities. Montrose is about 30,000 people. Olathe is probably about 8,000 people. So we are not very large. And we are separated from our neighboring districts by open space, so it is really easy to tell where our school district stops and another one starts.

In our district, we have 6,500 students. District-wide, 54% receive a free or reduced price lunch. But on the south end of our district, which is close to the ski resort of Telluride, the houses are larger, and there are more families considered upper middle class.  The free and reduced price lunch population at the elementary school in that area is about 11%. On the north end of our district, the free and reduced price lunch population is 80%. ...

It has long been suggested that health disparities between low-income kids and their peers contribute to the academic achievement gap. If you are looking for evidence to support that theory, a recent research review by Charles E. Basch—Healthier Students are Better Learners: A Missing Link in School Reforms to Close the Achievement Gap—offers it.

Long story short (and it is a long report), Basch describes the evidence showing how groups of children differ in the incidence of (and access to care for) each of seven “educationally relevant health disparities”: vision, asthma, teen pregnancy, aggression and violence, physical activity, breakfast, and inattention and hyperactivity. He also reviews evidence on the “causal pathways affecting educational outcomes” (I think that means he shows that not only are there disparities, but that these disparities actually do affect achievement).

One brief, and extremely simplified, example: Children with asthma sleep less. Children who sleep less tend to have worse academic performance than those who sleep more, because sleep influences cognitive function. Low-income children, for a variety of reasons, have asthma at higher rates than middle- and upper-income children. So even assuming ...

The dream of college for all is one of the first casualties when jobs dry up and the future looks bleak. More and more people are questioning the wisdom of paying big tuition for what could be a small return. Technical school may be a better bet, they say, especially for poor youth who can't afford to get into debt.

They may have a point. But I think it's a very bad idea to retreat from our commitment to get many, many more poor students through college. At the same time, it's unwise to assume that education alone will solve our economic woes.

The "college for all" argument is important, because it offers a vision for overcoming stubborn class inequities. Let's face it, the vast majority of wealthy parents expect their kids to go to college. Even some of those pundits who pooh pooh college in the pages of the Times or The Wall Street Journal would likely pitch a fit if their own children decided to go the voc-ed route. Poor children face a very different reality.

It may be true that college isn't for everyone. But until student inclination--and not income--becomes the major sorting mechanism for college, I'm not ready to abandon the focus on college. After all, those who never went to college are ...

We in education could learn a lot from the US military. That's the major message of the new State Education Standard. This remarkable issue of NASBE's quarterly magazine is well worth a read.

People in schools don't naturally look to the military for advice. When they hear "military," many think "rigid," "stern" or "traditional." A story in Wednesday's New York Times shows just how damaging such perceptions can be. It charts the decline of private military academies that long ago billed themselves as reform schools--hardly the best way to market private schools these days. The schools may have changed, but the reputation lingers.

The State Education Standard offers a very different view of what the military brings to the table. Many decidedly un-military educators will no doubt like what they see there. In some respects, there's nothing at all military about the military. Here's a brief sampling of ideas I took away from the magazine:

Nurture your talent. This passage from a story on leadership stopped me in my tracks: "Typically, officers spend between one-quarter and one-third of their time in schools, either as students or as instructors!" Yes, the military does a great deal to steer its best people into leadership tracks. But once leaders are in those tracks, they receive sustained, job-embedded staff development. It's ironic that the ...

I continue to be amazed by the fact that it has become taboo in some school reform circles to talk about strategies for clearing away non-academic barriers to student learning. Calls to address problems like hunger or poor health are often seen as excuses for poor schooling rather than as concrete strategies to improve the lot of children. This tendency strikes me as very counterproductive.

It's not the job of schools to ensure medical care and proper nutrition, we're told. It's not the job of schools to do what parents should be doing. Those are lovely sentiments. Many teachers and other school staff would probably agree that the job they thought they signed up for didn't involve finding health care for children, getting them warm clothing in the winter, or offering them breakfast when they're hungry.

But such expectations don't mean a whole lot when a child in your classroom can't concentrate because she has a tooth ache, can't see the board because she needs eye glasses, or is hungry because she went without breakfast. High-sounding talk about what a school's "mission" should or shouldn't be must ...

I'm hearing concerns that too much power over schools is passing into the hands of people who have not been elected by the public to serve the public interest. What a thorny issue.

An article in yesterday's Washington Post offers a case in point. A group of foundations warned that they might not keep the money flowing into Washington DC's school reform efforts if the district's leadership changes. In other words, the funds may dry up if a new mayor takes the reins. Not surprisingly, this warning has caused an outcry over the influence of foundations on the mayoral race.

A new commentary in Edweek raises similar concerns about the concentration of power. Russ Whitehurst, the founding director of IES, writes that Race to the Top (RTTT) was an end-run around Congress. "Based on the ARRA itself, he writes, "I don’t think Congress intended to give Secretary Duncan the carte blanche he took."

The legislative process is messy, but we are better served in the long term by allowing our elected representatives to decide on the education policies we are to pursue as a nation, rather than having them dictated to us by the executive branch under the guise of a grant program to reward reform and innovation.

Duncan and the foundations may well counter that they can't very well dole out money without strings attached. But growing suspicion of government ...

At a time when most American industries have been struggling to find their footing, at least one has been experiencing a real boom: The public school horror film industry. The filmmakers and financiers behind these movies may see themselves as defenders of children. But some of them are just leading the charge out of public education and into--what?

They're aiming for outrage. But they're just as likely to create disaffection and disengagement. That's bad news for school reform.

Here's a little sampling from the new Tinseltown genre. Two Million Minutes portrayed our high schools as relaxing spas for idle youth. Then there's Race to Nowhere, which depicts our schools as cruel pressure cookers that drive children to suicide. And we mustn't forget The War on Kids (!), which argues that U.S. schools are really just prisons designed to crush our children's spirits.

It hardly matters that these horror stories contradict one another. The overriding message is clear and consistent: Get your kids out now!

The films generally offer simple solutions to the problems they present, and that lets viewers off the hook. Most examples of the genre point to charters and vouchers. Take, for example, The Cartel, which has just hit theaters. According to The Boston Globe, "'The Cartel' leads its audience to what Bowdon [the filmmaker] sees as a promised land of better American education, populated by vouchers and ...

Mike Town is a man with a mission. This Washington state environmental science teacher has spent the past 25 years educating students on environmental issues. His students do real-world projects designed to show the relevance of science, get them thinking about the environmental impact of their actions, and introduce them to the emerging green job sector.

One such project is the Cool School Challenge, a model he helped develop that engages students and teachers in reducing their school's greenhouse gas emissions. Now available for free on the web, this approach has saved over 1.6 million pounds of CO2 nationwide (and saved Redmond High School more than $100,000 over the past three years). And he and his students are scaling up the concept in their community, joining forces with the local government for the “Eco-Office Challenge.” ...

When the President's Blueprint for Reauthorization of the Elementary and Secondary Education Act appeared last month, Chuck Saylors was struck by what he didn't see: much attention to parent engagement. The President's budget proposal had already seemed to eliminate the Parent Information and Resource Centers (PIRCs), the only federal program devoted solely to parent engagement in schools. (The Learning First Alliance just released a statement urging a much stronger federal focus on parent engagement.)

Saylors recently told us about the National PTA's work to make parent and family enagement a national priority. Despite his disappointment with the Blueprint, Saylors is optimistic. The administration seems ready to listen, he told us, and the PTA is not about to let up on its fight for parents.

Public School Insights: What are the biggest legislative priorities this year at PTA?

Saylors: There are several things on the agenda, but I am going to say that the reauthorization of ESEA is probably the issue of the day for us. We want to make sure that ESEA is reauthorized in a timely manner and we want to do everything that we can to get parents involved in the process. There are a lot of components to the legislation that need to be addressed, and we want to make sure that a parent voice is at the table.

Public School Insights: Is your sense that the blueprint the Obama administration offered for this reauthorization included the parent voice?

Saylors: I have to admit that I'm very disappointed that it was not more direct in including parental engagement. There are some brief references, but as the leader of the PTA I can tell you that I am very disappointed in the fact that there's not more concrete reference to parental engagement in the blueprint.

That being said, I have to publicly admit that PTA does have a good working relationship with the administration and we are very thankful for that. But this is ...

I was wrong. I thought the debate between the value of schools and the value of community support for children was winding down, but it seems the debate is alive and well in the pages of the Washington Post.

Joel Klein, Michael Lomax, and Janet Murguia resurrected it in an op-ed last Friday. Their opening strikes me as a bit of a strawman:

In the debate over how to fix American public education, many believe that schools alone cannot overcome the impact that economic disadvantage has on a child, that life outcomes are fixed by poverty and family circumstances, and that education doesn't work until other problems are solved.

I don't know many people who believe that education won't work "until" we fix all the other problems. Groups like the Broader, Bolder Approach (which is a likely target of the op-ed) call for robust work to improve schools and address those factors outside of schools that can hinder students' learning.

The op-ed's following sentences might be jarring to people who work in and for schools: "This theory [that life outcomes are fixed] is, in some ways, comforting for educators. After all, if schools make only a marginal difference, we can stop faulting ourselves for failing to make them work well for millions of children."

Few educators would be "comforted" to think they can make only a "marginal difference." Why go into a line of work that yields such small financial ...

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