This document summarizes a webinar discussing considerations for reopening school-based health centers during the COVID-19 pandemic. Experts discussed various reopening models including in-person, hybrid, and distance learning and the mental health impacts on students. They also addressed health, educational, and operational concerns and the role school-based health centers can play in supporting students, staff, and collaborating with schools. This includes providing medical services, COVID-19 testing and education, mental health support, and helping establish safety protocols and track cases. Advocacy efforts to support these programs were also discussed.

1. School-Based Health Center Innovations
The Intersection of Public Health and Education; Sharing strategies and plans for the
re-entry of school-based health
July 30, 2020
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2. Important Take-Aways:
 Understand multiple aspects to consider when
planning each type of re-entry plan
 Consider how to further support school-based
medical, behavioral health providers and program
directors in these new models
 Hear how other school-based teams are supporting
students and addressing needs

3. Today’s Faculty Panel
Yvette Highsmith–Francis, MM; Vice President, Eastern Region, Community Health Center, Inc.
Seleena E. Moore, MPH; Senior Program Manager, School-Based Health Alliance
Dr. Rob Dudley, MD, MEd, FAAP; Pediatric Physician, Community Health Center, Inc.
Georgette Harrison, LPC, NCC; Director of Clinical and Community Partnerships, Child Guidance
Center of Southern Connecticut
Molly Ticknor, MA, ATR, LPC; Executive Director, Show-Me School-Based Health
Alliance of MO

4. Transitioning Out of Isolation
Living with SARS-COV-2 in an Educational
Environment
Rob Dudley, MD, MEd, FAAP

5. Considerations in Reopening Schools
Many factors to consider including
 Physical Safety
 Social distancing
 Cleaning and disinfecting
 Altered schedules/Phased reopening
 Local spread, testing capacity, school’s ability to limit
spread
 Conversation between BOE/DPH (state and local)/local
health organizations
How can a SBHC participate in planning
school reopening?

6. Considerations in Reopening Schools
Educational Concerns
 Students will have had a variety of experiences with
virtual learning
 Children with disabilities may have had greater impacts
from loss of therapies as well as instructional time
 IEPs may need updating
 Students may have troubles adjusting to new routines
and uncertainty in routines
How can SBHCs support educators and students as they
reenter school?

7. Considerations in Reopening Schools
Health Concerns
 Planning for exposures in school
 Clearance for children with special healthcare needs
 Health forms, immunizations, sports participation
clearance
How do SBHCs collaborate with school nurses, primary care
providers and educators to promote the health of students, staff,
and families?

8. Considerations in Reopening Schools
Mental Health Concerns
 Broader social and family stressors may affect student’s
ability to attend school or be ready to learn
 Students will have experienced different levels of
stressors
 Those with preexisting mental health conditions may
have fallen out of care or suffered exacerbations
 Risks of child abuse or neglect
 In-person classes may be interrupted by another wave
of the virus
What mental health resources can SBHC staff bring to
the table?

9. Resources
• Centers for Disease Control (CDC)
– https://www.cdc.gov/coronavirus/2019-ncov/community/schools-
childcare/index.html
• American Academy of Pediatrics (AAP)
– https://www.aappublications.org/news/2020/05/05/covid19schoolopening050
520
– https://www.healthychildren.org/English/health-issues/conditions/chest-
lungs/Pages/COVID-19-Information-for-Families-of-Children-and-Youth-with-
Special-Health-Care-Needs.aspx
– https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-
infections/covid-19-planning-considerations-return-to-in-person-education-in-
schools/
• American Academy of Child and Adolescent Psychiatry
– https://www.aacap.org/AACAP/Families_and_Youth/Resource_Libraries/covid-
19/resources_helping_kids_parents_cope.aspx

10. Reopening Format Matters
In-Person vs. Hybrid vs. Distance Learning
Daily mental health needs of children
will vary based on format
School Re-Entry Behavioral Health Considerations
Supporting Students, Caregivers and Staff

11. In-Person Learning
 Increase in school avoidance behavior
 Increase in pre-existing OCD symptoms, emergence of
contamination fears
 Academic performance anxiety
 Difficulties wearing masks for extended periods
 Fantasy about “returning to normal”
 Presence and intensity of anxiety will impact child’s ability
to learn
 Anxiety about returning to the home (interpersonal
violence, abuse, neglect)

12. In-Person Re-entry Considerations
 Collaboration with school staff to address school
avoidance
 Anxiety-reduction strategies
 Normalization of the desire to “return to normal”
 Possibility for mask breaks
 Supporting students and staff in identifying individual
zone for optimal learning
 Collaboration and plan with school staff and
colleagues upon suspicion of IPV or abuse

13. All Distance Learning
 May be a continuation or fine-tuning of procedures in place
in Spring 2020
 Student and caregiver frustration about being unable to
“return to normal”
 Academic performance anxiety
 Students who are not logging on for sessions or classes
 Caregivers who struggle helping children complete
academic work
 Lack of contact with children who are at-risk for abuse,
neglect
 Exacerbation of social skill challenges

14. Distance Learning Re-Entry Considerations
 Critical assessments of procedures implemented in Spring
2020
 Validation of caregiver and student frustration
 Close collaboration with school staff for early identification
of children who are starting to struggle/caregivers who say
they don’t know how to support child/student no longer
logging on
 Structured opportunities for real-time virtual contact with
children who are at risk for abuse, neglect
 Facilitation of social skills virtual groups

15. Considerations For All Formats
 Identifying relationships that need bolstering
 Re-entry support groups
 (Re) Establishing a therapeutic alliance with caregivers
 Identification of case management needs
 The way we listen to children, caregivers, staff hasn’t
changed

16. School Re-Entry / Role of SBH with COVID-19
Molly Ticknor, MA, ATR, LPC
Executive Director

17. Considerations for School Re-Entry
Operations & Physical Space Community Partnerships
Support & Collaboration with
School District Partners
Health Education
Addressing Student Needs
Socio-Emotional Health of Staff
Infection Control HIPAA/FERPA Guidelines

18. Role of SBH Programs
to Support School
Re-Entry
Closing the immunization gap critical to re-opening schools
Providing COVID testing if approved (or any other diagnostic
testing)
Supporting tracking cases & quarantine efforts to reduce
exposure & spread
Providing preventative & urgent care &
behavioral/mental health services to address gaps &
reduce ED visits
Providing medical supplies (i.e. PPEs, thermometers, etc.)
that schools/school nurses may not be able to access
Supporting the establishment of school cleaning & sanitizing
procedures
Educating staff on the symptoms of COVID-19, helping to establish
protocols for screening, assessing symptoms, and providing basic
health education

19. Considerations for Schools & SBH
Programs:
Partnership / Collaboration
• Collaborate early and often with school administrators and
school nurses
• Schedule periodic meetings throughout the summer
• Identify roles and responsibilities
• Make decisions jointly based on school re-entry planning
decisions
• Determine health priorities to address student needs
• Partner to prepare education on trauma informed practices
and resiliency for teachers and SBH program staff
• Collaborate with school social workers / case managers to
address social determinants and outreach efforts

20. Advocacy Efforts
• Support the growth and sustainability of
School-Based Health Programs as funding is
made available
• Advocate for children’s health coverage and
care -
• Advocate for additional and continued
reimbursement for virtual visits
• Advocate for reimbursement of case
management / wraparound supports for
families related in addressing social
determinants of health 20

21. Resources
• https://moschoolhealth.org/
• https://moschoolhealth.org/wp-content/uploads/2020/07/Draft-
Guidance-for-Reopening-SBH-
Programs_7.20.2020_CURRENTDRAFT.pdf
• https://www.mosba.org/2020/04/05/msba-resources-for-the-
covid-19-pandemic-2/
• https://www.cchpca.org/
• https://www.cdc.gov/coronavirus/2019-
ncov/community/schools-childcare/Schools-Decision-Tree.pdf

22. Thank You!
Please contact us with your questions.
WeitzmanLearning@chc1.com
For more information, visit our websites:
www.sbh4all.org
www.weitzmaninstitute.org/coronavirus