O2124: Navigating the Path to Education: School Based Health Center Interventions for New Americans

Background: School enrollment plays a crucial role in establishing families within communities and positively impacting long-term student health outcomes. The CDC and AAP emphasize the critical role of school attendance in promoting health, leading to better learning outcomes, and reducing poor health effects over the lifespan. Despite schools’ importance to student well-being, New American students face various barriers to successful enrollment, including language, transportation, and health literacy challenges. According to the U.S. Department of Education, approximately 4.7 million foreign-born individuals are enrolled in U.S. schools, representing six percent of the total student population. In this context, we describe how a School-Based Health Center (SBHC) revamped its practices to eliminate non-academic barriers for New Americans in Ohio’s largest school district, which enrolls an average of 200 foreign born students per month. SBHCs uniquely address systemic hurdles related to vaccination and testing requirements, medical care access, and resettlement paperwork.

Methods: To achieve this goal, a freestanding SBHC was established at the same site as district enrollment services. Our focus was on accessibility, community responsiveness, and comprehensive primary care services. Staff received training in cultural humility to better serve diverse student populations. Utilizing resources such as interpretation services, free vaccines for children, sliding scale and no bill visits, liaising with community resources, and best practices in caring for immigrant and refugee youth, we facilitated a “one-stop shop” for school enrollment support. Flexible staffing allowed SBHC team members to be available during and outside of traditional clinic hours, enhancing service to students and families.

Results: The establishment of an onsite SBHC addressed barriers to pre-enrollment testing for families. Through standardized communication processes and evidence-based algorithms, non-clinical staff efficiently connected families with appropriate next steps. Ongoing education for SBHC team members improved patient comfort and streamlined processes using electronic medical records. The model expanded to multiple locations, increasing access and awareness of culturally humble healthcare. The average time from enrollment to school start date has decreased from eight to ten weeks to less than a week to process medical documentation and services. Future steps include connecting students to medical homes and linking families to financial resources.

Conclusion: As a result of the services provided and the relationship established with district and families, students and families recognize the SBHC as a site not only for healthcare access, but an information hub that helps families eliminate non-academic and non-clinical barriers to learning, connecting health and education. Next steps include further developing processes to connect students to a medical home, installing dedicated staff to link families to financial resources, and continued partnership with the district to improve educational outcomes for vulnerable children.