Presented by: Melva D. Visher, MA, RHIA, Vice President Community Health

1. Making Great Strides: Seizing Local Opportunities to Advocate for School-Based Health ServicesNASBHC Conference 2007Washington, DC Presented by: Melva D. Visher, MA, RHIA, Vice President Community Health Kaleida Health, Buffalo, NY Assunta Ventresca, Director Health Services, Buffalo Public School System, Buffalo, NY

2. Learning Objectives • At the end of this workshop, participants will be able to: • Apply successful strategies for local advocacy • Use suggested materials or design your own materials to educate local policymakers on student health needs and essential services for children • List shared challenges and effective methods of engaging parents in local advocacy efforts.

3. Buffalo, New York Community Profile • Total Population: 292,648 (U.S. Census) • Buffalo Public School Registration 37,483 Students (PK-12) • Non-Public School Registration 4,000 (PK-12) 64 Public schools and 20 non-public (Catholic, charter) school facilities • In 2005, 12 SBHCs located in Buffalo Public Schools (10 operated by Kaleida Health, 2 by Catholic Health System)

4. Regulatory Environment • Since 1913 NYS Education Department (Section 901, Article 19) Law requires “medical inspection” (aka: school health services) provided in school districts across the state • School districts in Buffalo, New York City and Rochester were exempted from the legislation, as these cities’ local public health departments were providing school health services when the NYS Education Law was enacted • In Buffalo, the Erie County Health Department provided and funded school health services for Buffalo Public Schools between 1913 and 2005

5. Regulatory Environment • In March 2005, the Erie County Health Department eliminated all funding for school health services • Buffalo school-age children were left without school health services for the first time in more than 90 years!

6. The “Call to Action” • Usually 3 reasons people engage in advocacy • Hope • Rising Expectations • Anger • The Buffalo experience/local advocacy agenda was prompted by anger

7. What is Advocacy? Successful Advocacy Identifying Problems + Finding Solutions = Changes in Policies and Programs An Introduction to Advocacy by: Ritu Sharma

8. Basic Elements of Advocacy • Select an Agenda • Use Data & Research, Identify Advocacy Audiences, Develop & Deliver Message • Build a Coalition • Make Persuasive Presentations • Evaluation of Efforts

9. Advocacy Agenda Ask yourself: • Will your issue bring a diverse group of individuals to the table? • Will that group be powerful enough to bring about change? • Will the group remain committed over time?

10. Data & Research/Audience & Message: The Buffalo Experience • Local Foundation convened a “workgroup” on Student Health Services – worked over a 2 month period. • Foundation funded the research and development of a White Paper on student health needs/services in Buffalo • White paper included recommendations that the Buffalo Board of Education provide funding for full-time nursing services in Buffalo schools, and New York State Health Department expand the number of SBHCs

11. Build A Coalition • Buffalo Coalition Members Represented a Diverse Group: • Health Insurers • Erie I BOCES • Health Systems (Catholic Health System and Kaleida Health • Parents • Local Foundation (convener) • Diocese of Buffalo • United Way • Colleges/University • Buffalo Public Schools • Erie County Department of Health

12. Persuasive Presentations • To Buffalo Board of Education and School Administration • To local lawmakers • To local advocacy groups • To parent networks • To school administration advocacy groups • To the media

13. Tools and Tips • Engagement Letters • Petitions • Local Action Network • Media/Traditional & Non-Traditional • State/Local School Health Coalitions • NASBHC Sign-On Materials • Partnerships • Parental Engagement

14. Results: Final Workgroup Recommendations • Full funding of school health services by Buffalo Board of Education (estimate 90 health professionals required) • Expansion of the number of SBHCs • Optimize Medicaid funding for nursing and health services for eligible students, based on their individualized (health) education plan (IEP)

15. Funding Resulting from the Buffalo School Health Advocacy Efforts • $1.2 million from Buffalo Board of Education in Fall 2005 to restore part-time health services for 2005-06 school year • $5.2 million annually from NYS Education Department to support full-time health services for 2006-07 AND 2007-08 school years • 3 new SBHCs opened in Fall 2006 operated by Kaleida Health, funded by NYS Department of Health • 2 additional new SBHCs are awaiting approval to operate (Catholic Health System)

16. Shared Challenges of Advocacy • Perceived apathy • Not a priority • Gaining attention for the cause • Sustaining the momentum • Communicating, communicating, communicating

17. Build and Sustain Momentum • Strike while the iron is hot • Build public awareness via media, community meetings and other means • Get key policy-makers involved in the cause (Legislator’s press conferences) • Partner with other/neighboring communities facing similar challenges (strength in numbers)

18. Engage Parents • Find parents of children with chronic health needs (shared passion) • Involve surrogates of parents (clergy, community groups, educators, etc.) • Educate, educate, educate… then communicate, communicate, communicate! • Make the cause a high priority for parents • Anger and inequities are powerful motivators

19. References • Buffalo City School District: Choice Committee Demographic and Other Information About the Buffalo Public Schools – March 2004 • Community Health Foundation of Western and Central New York. Health is Fundamental: A Community Report on Health Services in Buffalo Schools – June 2005 • Sharma, Ritu R., An Introduction to Advocacy. Website: www.aed.org/tools and publications • U.S. Census Bureau (www.census.gov) website Buffalo City Fact Sheet