How Does Access to Health Care Affect Teen Fertility and High School Dropout Rates? Evidence from School-based Health Centers

Telehealth is a growing model of delivering health care. School-based health centers (SBHCs) provide access to health care for youth in schools and increasingly use telehealth in care delivery. This article examines the recent growth of telehealth use in SBHCs, and characteristics of SBHCs using telehealth, including provider types, operational characteristics, and schools and students served. The percentage of SBHCs using telehealth grew from 7% in 2007-2008 to 19% in 2016-2017. Over 1 million students in over 1800 public schools have access to an SBHC using telehealth, which represents 2% of students and nearly 2% of public schools in the United States. These SBHCs are primarily in rural communities and sponsored by hospitals. This growing model presents an opportunity to expand health care access to youth, particularly in underserved areas in the United States and globally. Further research is needed to fully describe how telehealth programs are implemented in school settings and their potential impacts.

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Nurse Practitioner’s Ethical and Legal Dilemma: Caring for a Young Child Without a Parent in the School-Based Health Center Setting

Clinical Scholars Review ◽

10.1891/1939-2095.2.1.19 ◽

2009 ◽

Vol 2 (1) ◽

pp. 19-22

Author(s):

Mary Huang

Keyword(s):

Health Care ◽

Young Child ◽

Nurse Practitioners ◽

Access To Health Care ◽

School Setting ◽

Young Patients ◽

The United States ◽

Health Centers ◽

School Based ◽

School Based Health Centers

Since the 1980s, the number of school-based health centers has increased due to funding that lead to recognition by policy makers and health organizations. The mission was to provide comprehensive pediatric health care to children with limited access to health care and the uninsured. The goal was to decrease school absenteeism and missed work days by providing convenient primary and acute care while children are in school. For sponsoring organizations managing school-based clinics, allowing parents to be absent during clinic visits met its mission. However, the ease of young children receiving health care in the school setting without being accompanied by their parents has positioned nurse practitioners in an ethical and legal dilemma. Asking a young child significant health history during a physical examination or having them describe their chief complaints during an acute visit may not be the best way to provide good care to our young patients. Additionally, what are the legal responsibilities of a nurse practitioner when caring for a child without active participation of the parent? Little has been documented in the past about the dilemmas nurse practitioners face in school clinic settings. With increasing use and recognition of school-based health centers in the United States, the need for more discussion is required to explore solutions to provide quality comprehensive care for patients and their families.

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