Schools: The Missing Link in Promoting Healthy Children

On May 9^th, 2012, Healthy Schools Campaign and Trust for America’s Health, along with a group of partner organizations (including Health & Disability Advocates), released policy recommendations to Secretary of EducationArne Duncan and Secretary of Health and Human Services Kathleen Sebelius. The recommendations called on the departments to “further support the critical connection between health and learning, and build this priority into the Department’s infrastructure and leadership.”

A strong connection exists between children’s health and education. A child who is healthy is more likely to attend school and engage in learning. However, many schools lack things necessary to promoting health, such as access to clean air and water, nutritious food and school nurses; and do not provide an opportunity for students to be active throughout the day.  

School’s lack of emphasis on health comes at a time when promoting health is of the utmost importance. Rates of chronic diseases, such as asthma, diabetes or obesity, have doubled among kids in the last several decades. Students with a chronic condition often need extra care to manage their condition, and school—a place where many kids spend most of their time—could play an important role in their health.

Our nation faces a growing achievement gap in our nation’s students—which recent studies have shown to be linked to health issues. Low-income minority students are more likely to suffer from health issues, as well as more likely to attend a school without a healthy environment.

Healthy Schools Campaign, Trust for America’s Health and their partner organizations crafted their recommendations with these strong connections between health and learning in mind. The recommendations focus on actions that are within the government’s role to make and can have an immediate impact on the health of students and the achievement gap:

Recommendations to the Department of Education:

1. Expanding the mandate of the Office of Safe and Healthy Students (OSHS) and appointing a Deputy Assistant Secretary to the office in order to build up the office’s capacity for leadership.
2. Support pre-service and professional development programs for teachers and principals by making health a priority in grants and other training programs.
3. Make health an important factor of the standard of excellence for the Blue Ribbon Program.
4. Developing and disseminating best practices for colleges and universities to support teachers’ and school leaders’ abilities to address student health needs
5. Support the development of resources for schools to effectively engage parents around school health and wellness issues.
6. Support the development of educational data systems and school accountability programs that incorporate student health.

Recommendation to the Department of Health and Human Services:

1. Reduce barriers schools face in providing health care to students: Currently, restrictive regulations limit the reimbursements schools can receive from Medicaid. Removing these restrictions, which HHS itself deemed “unenforceable,” would allow schools to expand the health care schools can afford to provide to students.
2.   Include Schools in the National Prevention Strategy: The strategy emphasized the importance of making good health a priority in all areas of life, not just within a health care setting. It is important for HHS to acknowledge how important schools are to an effective prevention strategy, and to fully investigate the role schools may be able to play in promoting health.

At the event, Secretary of Health and Human Services Kathleen Sebelius announced a $75 million investment in the establishment of school health centers, as a part of the School-Based Health Center Capital (SBHCC) Program, created by the Affordable Care Act. These health centers offer disease prevention and health screenings to students. This announcement marks one of many necessary steps in the right direction towards the integration of health and education.

Stephanie Altman

Health & Disability Advocates; Program and Policy Director

Check back with Illinois Health Matters for more info on how the Department of Education and the Department of Health and Human Services integrate health into the nation’s schools. 

Using Technology to Connect in New Ways in Illinois

According to the Pew Internet & American Life Project, 85% of all Americans 18 years and older own a cell phone; of these users, nearly a quarter (72%) of them “text”. A July 2011 report shows that nearly one-third of all adults are “smart phone” users.

Given that these statistics are only likely to increase as technology becomes more advanced and allows us to get information in even smaller and more portable devices, it’s important to consider how technology help in efforts to share important and relevant information, as well as connect individuals with services that fit their needs.

For the past two years, Text4baby, the first ever FREE mobile health service, has been using cell phones to share health tips with pregnant women and new moms. Moms sign up by texting BABY to 511411 (or BEBE to 511411 to receive messages in Spanish) to receive helpful messages that are timed to their due date or baby’s first birthday. These messages include reminders about check-ups, immunizations, oral health, and tips for good nutrition.

We here at the Illinois Maternal and Child Health Coalition serve as the statewide coordinator  and have been working with health departments, community clinics, doctors’ offices, as well as local businesses to promote text4baby. To date, we’ve helped enroll nearly 13,000 users into text4baby and have made FREE outreach materials available for order from our website. We’ve heard firsthand from text4baby users about how direct and simple the messages are and how helpful they can be, especially for first-time parents.

Of the many useful messages provided by text4baby, several of them provide users with information about how they can get no-cost or low-cost health insurance for their children by providing them with the toll-free hotline 1-877-KIDS-NOW (1-877-543-7669).

Parents who call the 1-877-KIDS-NOW number in Illinois will be connected with the All Kids program, which provides affordable health insurance to children who live in Illinois and meet income requirements. Parents can request an All Kids paper application to be sent to their address or they can fill out the online application.

Nearly 1.7 million children in Illinois benefit from the All Kids program, which covers doctor visits, prescription drugs, hospital and emergency services, dental and vision care, and more. Some parents may qualify for FamilyCare coverage for themselves and pregnant women may be able to get benefits from the Moms & Babies program.

Even if text4baby or the All Kids or other health insurance programs may not be something that you need, consider sharing these resources on your Facebook page or sending out a Tweet to your followers about the benefits of these programs. With your help, we can ensure that more women, children, and their families have the best opportunity to lead healthy and productive lives.

This post, by Kathy Chan of the Illinois Maternal and Child Health Coalition, was originally posted on the MomsRising,org blog, here. 

Health Reform's Best-Kept Secret

The Basic Health Program could bring more affordable, more reliable coverage to millions of adults--and improve access to care for children, too.

For all the attention devoted to the Affordable Care Act, scant consideration has been paid to a little-known part of it called the Basic Health Program. It's an option for states that could, if implemented nationwide, make health care coverage more affordable and accessible for more than 5 million adults and bring health coverage to more than 600,000 who would not otherwise have it.  Because many of these adults are likely parents of Medicaid- and CHIP-eligible children, the Basic Health Program could improve coverage and access to care for low-income children as well.

Most Say Ahhh! readers likely know how it works, but here's a quick recap of the Basic Health Program: under health reform, low-income people without health coverage will receive federal subsidies starting in 2014 to buy health insurance through Exchanges. States that implement the Basic Health Program in addition to an Exchange would contract with health plans or networks of doctors and hospitals to provide health care to people with incomes up to twice the Federal poverty line--just under $22,000 for a single adult--who don't qualify for publicly-financed programs such as Medicare or Medicaid. The Basic Health Program would replace subsidized coverage through Exchanges for this lower-income population. Washington would pitch in by providing states with 95 percent of the tax credits and subsidies that would have otherwise been provided through health reform.

According to an Urban Institute paper commissioned by our organization, the Association for Community Affiliated Plans, costs for subsidized health coverage through the Exchange are projected to cost low-income individuals more than $1,650 per year in premiums, copays and deductibles. For most people, that's a terrific deal. But for someone making $22,000 a year, $1,650 is nearly a month's pay. Many could well forgo coverage through the Exchange, pay a tax penalty of up to $700 and apply the difference to food, rent, or electricity. While health reform goes a long way towards making coverage more affordable through Exchanges and subsidies, health coverage may remain out of reach for some people with low incomes.

But if states were to implement the Basic Health Program to provide coverage modeled on Medicaid and CHIP, the Urban Institute estimates that annual premiums and out-of-pocket costs for adults would drop from a combined $1,650 to just under $200. At that level of affordability, paying the tax penalty makes no sense. The Urban Institute estimates that 600,000 people who would otherwise not purchase insurance would do so if all states ran a Basic Health Program. That's reason for cheer on its own.

Better still, the Basic Health Program could help more children access coverage and care in two ways. First, covering more adults will help children. While the Basic Health program would primarily cover adults in 2014 (Medicaid and CHIP handle low-income children), the lower premiums and reduced cost-sharing that could happen under BHP for adults would help children, as research has suggested a link between parents' insurance status and their children's access to care.

It could also serve as a backstop: should Congress not authorize new funding for CHIP in 2015, the Basic Health Program could serve as a bridge program for children, providing them with CHIP-like coverage rather than coverage through an Exchange. Finally, children who are prohibited from receiving Medicaid or CHIP coverage because of the 'five year bar' could be covered by the Basic Health Program. CHIPRA in 2009 gave states the option of covering these kids, but only six states had done so as of January 2011.

The Basic Health Program remains a work in progress, and there's work yet to be done: the Department of Health and Human Services must provide states guidance on several issues that will affect how states tailor their Basic Health Programs--notably, clarification of the mechanisms for calculating and delivering Federal funds. States must ensure that reimbursement levels for health plans and providers are high enough to attract an adequate number of participating physicians to meet demand for services generated by the program. While some analysts have questioned whether the Basic Health Program could adversely impact Exchanges, policy solutions could be found to address these impacts if they do occur.

The Basic Health Program represents the best health reform has to offer: more affordable and accessible care for millions of Americans, including parents and their children, and up to 600,000 fewer uninsured.

Given the financial pressures felt in statehouses across the country--and the professed desire by leaders on both sides of the aisle for affordable health options--the Basic Health Program deserves a long, close look. Governors, Medicaid directors and state legislatures across the country owe it to the people they serve to give Basic Health Program serious consideration.

Because this program is simply too promising to be kept a secret.

By Meg Murray and Jenny Babcock,Association for Community Affiliated Plans

This post originally appeared in Say Ahhh! A Children’s Health Policy Blog.

A Birthday for America's Children's Health Law - With the Gift of Health for Illinois's Kids

It’s been two years since Congress and President Obama enacted legislation to strengthen the Children’s Health Insurance Program, known here in Illinois as All Kids. And at this birthday party, Illinois’s families no longer have to wish and hold their breath when they blow out the candles.

The children’s health law has helped Illinois cover more uninsured children through All Kids. As a result, 1.6 million children can get the checkups and preventive care they need to stay healthy and see the doctor when they get sick or injured.

That means parents struggling to keep their families afloat during tough economic times can have peace of mind that a playground injury or flu outbreak won’t drive the family deeper into debt. It means Illinois uses health dollars wisely – keeping kids healthy, rather than spending more on emergency room care for problems we should have prevented. And it means Illinois’s federal tax dollars come back into our economy, to protect local health care jobs.

Help us to celebrate this important anniversary. Thank your representatives in the General Assembly in Springfield for their continued support of All Kids and let them know that maintaining coverage for children should continue to be a top priority this year. Spread the word to parents and others in your community about All Kids, so we can help even more uninsured children to get the care they need to grow and thrive.

Andrea Kovach
Sargent Shriver National Center on Poverty Law 
(Originally posted in the Shriver Brief  on Feb. 4, 2011)