Child Watch® Column:
Keeping Children Healthy, In School, and Learning

Release Date: January 15, 2016

Marian Wright Edelman

Brandon, a six-year-old in the Houston Independent School District, had two working parents until his father was laid off. Brandon lost his health insurance when his father lost his job. Brandon’s mother quickly scrambled to try to enroll her son who has asthma in new coverage, but met some obstacles and didn’t know where to turn. Then the school district, which had been working with the Children’s Defense Fund (CDF) and AASA (The School Superintendents Association), through a partnership supported by The Atlantic Philanthropies, stepped in and helped her find coverage for Brandon under the Children’s Health Insurance Program (CHIP). With his new health coverage, doctors discovered Brandon also had high blood pressure and prescribed medicine to control it. Now the school nurse monitors his blood pressure every day and Brandon is healthy and happy to be in school learning.

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Watch Brandon's Story

This morning, U.S. Department of Health and Human Services (HHS) Acting Deputy Secretary Mary Wakefield on behalf of HHS Secretary Sylvia Burwell and Acting U.S. Department of Education Secretary John King spoke from Brandon’s school district to encourage other districts across our country to take important steps to ensure children everywhere are in school each day healthy and ready to learn. They called on school districts to recognize the strong link between children’s health and academic performance and to forge deeper connections between health and education for students and families by increasing access to health insurance coverage and health care, creating school environments with physical and mental health supports to help students succeed, and strengthening coordination between health and education systems at the local and state levels. The Secretaries urged state and local health and education entities to collaborate around five action items:

  1. Helping eligible students and family members enroll in health insurance;

  2. Providing and expanding Medicaid reimbursable health services in schools, including immunizations, health screenings and others;

  3. Providing or expanding services that support at-risk students, including through Medicaid-funded case management;

  4. Promoting healthy school practices through nutrition, physical activity, and health education; and

  5. Building local partnerships and participating in hospital community needs assessments.

The Departments of Health and Human Services and Education have created a toolkit of existing resources to support real action in states and communities to strengthen the link between health and education. CDF and AASA’s school-based child health outreach and enrollment model that links health enrollment to school enrollment is one the Secretaries highlight as a best practice to increase enrollment in health coverage for students and their families. After five years of piloting school-based child health outreach and enrollment in Texas, in 2007 CDF began working in partnership with AASA to introduce and expand health enrollment as a routine and ongoing part of school district operations. The model provides a basic question for districts to add to their school registration materials: “What type of medical insurance do you have for this child?” Parents who answer “none” are noted and able to receive information from school district staff on Medicaid, CHIP or other health coverage options. But it doesn’t stop there. Parents can receive help applying for or renewing coverage for their children and for themselves and are introduced to community partners who can help them successfully navigate the process.

CDF and AASA over the years have partnered with school districts in Texas, California, Georgia, Louisiana, and Mississippi including urban, rural and suburban school systems serving elementary through high schools and hundreds of thousands of Black, Latino, Asian and White students. This work has gotten many children health coverage and led to an increased awareness among school superintendents, staff and parents about the important and positive connection between health and academic success. Many now see a link between chronic absences, poor health and lack of health coverage. When children with chronic conditions like asthma have health insurance allowing them regular access to doctors and needed treatment, they come back to school healthier just as Brandon has.

In one of these districts, the Edinburg Consolidated Independent School District (ECISD) in Texas’ Rio Grande Valley, health coverage screening has been built into the daily operations of Parental Involvement Assistants, or PIAs. Each of the district’s 41 school campuses has a PIA who, among other responsibilities, calls absent students’ homes every morning to ask why students are missing school. The PIAs make a home visit that same day if they don’t reach anyone, about 80 visits each day. If a child is home sick, the PIA asks about their insurance status and, if the student lacks coverage, offers the parent assistance filling out the application. During a recent phone call, a mother told the PIA all three of her children were previously enrolled in Medicaid but were no longer covered. The mother, whose native language was not English, had received three notices about renewing coverage but hadn’t understood them, and had not been able to renew. The PIA helped her navigate the process to reenroll the children in Medicaid.

Sandra Rodriguez, the district’s PIA Coordinator, is especially excited they have a new school-based health center attached to the district headquarters to refer families to through a partnership with the Doctors Hospital at Renaissance. The clinic serves all students regardless of ability to pay and served about 2,000 children, parents, and school district staff in its first four months of operation. For many Edinburg families this is the first time they can receive care near their home, school, and work, and regardless of their immigration status. Thanks to additional support from another local health system, the 945-square-mile district will soon have two mobile clinics making scheduled visits to school campuses farther from the clinic site.

More students and families need these kinds of supports. It is critically important that school districts and community partners across the country respond to Acting Secretary King’s and Secretary Burwell’s call to action to connect children to needed health coverage and ensure they’re in school and ready to learn. As Superintendent Lillian Maldonado French of the Mountain View School District in El Monte, California puts it, “Being in school matters and if we can do something to make sure our kids are in school every day, then that’s what we need to do.”


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Marian Wright Edelman is President of the Children's Defense Fund whose Leave No Child Behind® mission is to ensure every child a Healthy Start, a Head Start, a Fair Start, a Safe Start and a Moral Start in life and successful passage to adulthood with the help of caring families and communities. For more information go to www.childrensdefense.org.

Mrs. Edelman's Child Watch Column also appears each week on The Huffington Post.

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Submitted by ShalomMakers at: May 8, 2016
I am the bearer of yet another story of grandparents raising grandchildren. I am over 60 and my wife is over 55. We opted to step in to cater for a beautiful granddaughter who is now over 6. She's been living with us since age 1. Her mom, like millions of others, struggles with addictions that are criminalized rather than framed as a health and mental health issue. Our granddaughter is not in the foster care system and she is healthy, happy and enjoys regular contact with her mom. A friend and MD recently said, "drugs, and particularly heroin and Crack cocaine are the Scourge of the current generation - we must treat and prevent the disease and not by locking it up with the afflicted".

Submitted by Wmarsh at: February 6, 2016
This comes under the heading Liberty and Justice for All.

Submitted by Speech Pathologist at: January 20, 2016
The PIA's should also check to see if there is cigarette smoke in the home. It is the most common cause of childhood illness, and has been called "a form of child abuse" by a former Surgeon General, Jocelyn Elders.

Submitted by Sassy at: January 15, 2016
Thank you so much for your commentaries . I worked Family Service programs for 40 yrs but retired and you keep me in touch with the issues facing families/children. Keep up the great work!

Submitted by Melaine at: January 15, 2016
Keeping Children Healthy, In School, and Learning is a great column on the strides being made toward healthcare reform and the safety of our nation's children. I appreciate the information and will continue to advocate for the health of our citizens.