School-Based Health Centers Essential to Building Community Schools

New York School-Based Health Foundation Intern, Sarah Bacio, speaks to Foundation’s newest board member, Christina Fuentes, a former educator with the NYC Department of Education and the driving force behind Sunset Park’s homegrown community school P.S. 24.

When the NYC Community Schools Initiative (NYC-CS) was first launched in 2014, Mayor Bill deBlasio committed to shifting the city’s educational landscape in a variety of ways, including the adoption of a more holistic approach to student learning. This included the establishment of 100 community schools, which aim to improve student achievement through strong partnerships among principals, parents, teachers, and community organizations.

“The jury is in– community schools work. Since day one, we have been on a mission to no longer let zip code determine academic success, and community schools are one way we are delivering on that promise.” -Mayor deBlasio.

According to the Coalition for Community Schools, a community school is defined as “both a place and a set of partnerships between the school and other community resources” and have a focus on “academics, health and social services, youth and community development and community engagement that leads to improved student learning, stronger families and healthier communities.” These schools are designed to become centers of the community and offer flexible hours for a range of support and opportunities to students, families and community members. In order to foster healthy learning environments, it is essential that community schools join forces with School-Based Health Centers (SBHCs) to improve health outcomes for their students.

Now with 267 community schools sites, New York City has the largest network of such schools in the country. In January 2020, the nonprofit Rand Corporation released the New York City Community Schools Impact Report. The evaluation tracked 113 community schools over three years, and found the initiative has significantly improved student outcomes in attendance, graduation rates, math scores, and the rate at which students advance to the next grade level compared to non-community Schools.

“The jury is in– community schools work. Since day one, we have been on a mission to no longer let zip code determine academic success, and community schools are one way we are delivering on that promise. From supporting students with in-school mental health services, to homework help and dental check-ups, these schools improve academic outcomes and cater to the unique needs of every student,” responded Mayor deBlasio.

For NYC community schools, every school uses a slightly different combination of resources, but they typically create an hour of extra learning time, conduct outreach to families to boost attendance, and receive extra staff to help coordinate the program. The schools also all partner with community-based organizations that offer a range of services, such as mental health counseling, vision screenings, or dental checkups. With their focus on building equitable educational systems and providing adequate health services to students, community schools are a key component in fostering connections between health and education.

Of the 49 million children who attend public school in the U.S., 47% live in families at or below the federal poverty level. Many of these children also experience inadequate health insurance, live in medically under-served communities, and have limited access to health care practitioners who can address their basic health needs. For these children, schools become a vital point of entry to receiving needed health care services and support. Therefore, in the effort to expand access to health care and improve student learning, SBHCs become a natural partner in the community schools movement.

Providing a well-rounded and holistic education for children in public schools means thinking, “what do privileged people provide for their kids?” -Christina Fuentes

With the important role of SBHCs in mind, I recently interviewed the New York School-Based Health Foundation’s newest board member,Christina Fuentes. Ms. Fuentes served as an educator with the NYC Department of Education for nearly 25 years. As principal of P.S. 24 in Sunset Park, Brooklyn, Ms. Fuentes helped build a robust array of school-based health services, renowned social-emotional learning programs, and a dual language program for the school’s low-income, immigrant community. In our conversation, we discussed what elements make up a successful community school, the positive impact on students and families, and the important intersection of health and education.

So what makes a successful community school?

As a framework to model her homegrown community school at P.S. 24, Christina Fuentes found that providing a well-rounded and holistic education for children in public schools means thinking, “what do privileged people provide for their kids?” This includes ensuring students receive a robust arts education, that they get a chance to travel outside of their neighborhood, that their healthcare is the best possible and they have extra academic help when needed. In order to cater to her own school community in Sunset Park, Ms. Fuentes and her team considered the needs of each individual student and by extension, the community as a whole.

“You know, everything was on a continuum of need in the school. So all kids got socio-emotional learning, and then some kids got mental health services that were more appropriate to their more extreme needs. And our community partners were pivotal in providing what we saw as essential for some of our kids.” In forming these strong partnerships with community organizations and adopting a need-based approach to schools, the educators at P.S. 24 were able to ensure that every student received the care and attention they needed.

According to the Harvard Family Research Project, in order to build strong community- school partnerships, it is first important to have a shared vision for learning and developmental outcomes for students which acknowledges the critical and complementary roles of schools, community partners, and families. Furthermore, building strong and sustainable partnerships means fostering relationships among all school staff at multiple levels (for example, at the district, school, and classroom levels). Lastly, clear data-sharing processes and agreements are important features of a strong collaboration. For building deep health‐education partnerships, such as an SBHC, a working leadership and management infrastructure must be in place that uses quality data, focuses on results, and facilitates professional development.

Ms. Fuentes echoed these key points with a particular emphasis on how community partners were to be treated in her school, “they had to be respected, because I wanted them to come back. I wanted them to understand the culture of our school. So that they would understand that we had very high standards for how we talked to our families and how we talked to our children.” With this common understanding, the educators at P.S. 24 were able to build strong and lasting partnerships in their community.

What is the positive impact of community schools?

According to Rand’s assessment, NYC’s Community Schools Initiative (NYC-CS) had positive effects for students across various outcome measures with some exceptions. First, NYC-CS had a positive impact on attendance for students in all grades and across all three years of the study. Furthermore, NYC-CS had a positive impact on on-time grade progression in all three years of the study and on high school students’ graduation rates in two of the three years. The initiative also led to a reduction in disciplinary incidents for elementary and middle school students, but not for high school students. Last, teachers’ reports of shared responsibility for student success increased at elementary and middle schools in the second and third years of the study.

“We tried to look at kids’ and families’ needs in a seamless way. We had this beautiful new building and we thought, let’s use it to its fullest extent by serving families. If families are doing better, then they can support their kids to receive a better education.” -Christina Fuentes

Community-school partnerships have the power to improve student outcomes outside of academics as well. Strong partnerships can provide continuity of services for students and families, facilitate access to learning opportunities and developmental supports, encourage information sharing about students to best support individual learning, and provide family members with entry points into the school day to support their student’s learning.

For Christina Fuentes, building strong relationships with families was especially important in her school community, “we tried to look at kids’ and families’ needs in a seamless way. We had this beautiful new building and we thought, let’s use it to its fullest extent by serving families. If families are doing better, then they can support their kids to receive a better education.” For P.S. 24, located in the large immigrant community of Sunset Park, this took the form of programs that provided parents with opportunities to receive their high school diplomas and ID cards that would help legitimize them in the U.S. In this sense, the positive impact of community schools extends beyond the individual child and fosters a sense of support and trust between schools and families.

What is the role of healthcare in community schools?

It should be no secret that healthier students mean better learning outcomes. The literature review published in the Journal of School Health, identified health problems affecting school‐aged youth that are highly prevalent, disproportionately affect urban minority youth, causally affect academic achievement, and can be effectively addressed through school-based health programs. Based on these criteria, seven health disparities were selected as priorities to help close the achievement gap: (1) vision, (2) asthma, (3) teen pregnancy, (4) aggression and violence, (5) physical activity, (6) breakfast, and (7) inattention and hyperactivity. Research clearly shows that these health problems influence students’ motivation and ability to learn. The paper concludes that a coordinated approach characterized by programs and services involving different groups of people, playing different roles, but forming a team and working toward a common set of priority goals, is integral in improving students’ learning motives and abilities.

Community schools that involve deep relationships with partners are able address student learning disparities by providing opportunities and services that promote healthy development of young people. According to another study published in the Journal of School Health, Building Sustainable Health and Education Partnerships, the schools and districts with strong health partnerships have shown improvements in attendance, academic performance, and increased access to mental, dental, vision, and health supports for their students.

In P.S. 24, aside from having their own SBHC in partnership with Lutheran Hospital (now NYU Langone Hospital Brooklyn), providing students with healthcare also meant teaching students to value and prioritize their health, a lesson that would hopefully carry on into their adulthood, “As a part of the dental clinic, nurses would do education in the classroom for kids. They would come in and show how to properly brush teeth and have little presentations, so it really made it clear that health is important, and educating ourselves about our health is important.”

Ms. Fuentes continued to explain the importance of providing students with school-based health services, not only for their own academic achievement, but also for their families wellbeing, “if kids can get their best basic health care taken care of in school, then they aren’t going to miss out on valuable classroom time, their parents aren’t going to have to take off from work and lose income because a lot of our parents, if they didn’t work they didn’t get paid.” By providing health services in their school, similar to how a SBHC would, the educators at P.S. 24 were able to care both for their students and their families.

“You know it was extra work for the staff, but it was part of our mission and the way we thought schools should be for everybody. And there’s something really beautiful about having a school where everyone could get their needs met.” -Christina Fuentes

Thus clearly SBHCs play a potentially pivotal role in the success of community schools. By expanding access to school-based health care, we expect better health and academic outcomes for students, as well as more meaningful relationships with families and communities. Although NYC is ahead of the curve in providing such services, there is still much room for growth and expansion beyond the current 267 community schools.

For Christina Fuentes and her team, P.S. 24 was never designated an official community school, meaning they never received funding from the Department of Education for their services, “ And it shouldn’t be that way, I think all schools should be community schools and get the support from the system in order to do that.” Even lacking special funding, P.S. 24 was able to build a model community school, “we had to do it because we thought it was important. And we took it to heart and did the extra work needed.” The commitment of the educators at P.S. 24 exemplifies what it means to be a community school. By relying on grant funding and support from community partners, P.S. 24 was able to greatly improve the quality of education their students received and build trusting relationships with families. In Ms. Fuentes’ words, “You know it was extra work for the staff, but it was part of our mission and the way we thought schools should be for everybody. And there’s something really beautiful about having a school where everyone could get their needs met.”

To read more about Christina Fuentes, check out our Trustee Bio Page.

Sources: