SCHOOL CLINICS: Growing Despite Contraception Concerns
The number of schools with health clinics has nearly doubled over the last four years, but only one quarter provide birth control, according to a survey released today. The survey, funded by the Robert Wood Johnson Foundation, was released by Making the Grade, a resource center on school-based health care based at the George Washington University. The researchers solicited telephone and written surveys from health departments and school clinics in all 50 states (Making the Grade release, 10/26). The clinics now total 1,154, up from 900 in 1996. Julia Graham Lear, the project's director, cited the "rise in concern over HIV and AIDS" and declining "opposition to dispensing birth control" as factors fueling the increase. "In the 90s, there's a much greater ... understanding of sexual activity and a desire to have resources in the schools that are honest and educational," she said. But a separate survey conducted by Advocates for Youth "found that three out of four school-based health centers do not provide contraceptives to students," a number that has "remained steady from 1994 to 1997, at about 26%." Lear said, "In some states and some communities, school boards have said, 'You can do this, but we want you not to deal with contraception.'" But Advocates for Youth contends that "[w]ithout these services, (clinics) are not meeting the full range of needs of children and youth" (AP/Washington Post, 10/26). The Making the Grade survey found that federal funding for the clinics has declined $2.5 million in the last two years, but the clinics are billing more "third-party payers, such as Medicaid and commercial insurers," and funding from the Children's Health Insurance Program may also offset funding losses. Denise Chuckovich, president of the National Assembly of School-Based Health Care, said, "School-based health centers are incredibly well-tailored to fulfill the goals of the new children's health insurance program -- their location makes it easy for newly insured children to access services, and their attention to behavioral health issues means they are addressing the most troubling problems of school-aged children today." Lear noted that "15 states reported $8.2 million in payments from Medicaid," while five states received $700,000 and seven received $140,000.
Making The Grade Findings
- The clinics are concentrated in urban areas, with 63% located in cities, while only 26% are in rural areas and 11% in suburban locations.
- Clinics in 38 states are eligible for Medicaid reimbursements.
- In 28 states, clinics are eligible for Kiddiecare reimbursements.
- Twenty-five states are encouraging clinics to participate in Medicaid managed care.
- About half of the states have adopted standards of operation for the clinics, and seven states license them (MTG release, 10/26).