Under pressure to end a long running stalemate over the Connecticut state budget last year, lawmakers made a number of decisions that continued the destructive trend of unraveling the human services safety net. The continuation of recent years’ cuts to state subsidy funding for School Based Health Centers (SBHC) is among the most destructive of these reductions. With the new legislative session underway, we are hopeful lawmakers will find a way to halt this trend and reject the governor’s current proposal to reduce the budget further, by 5.84 percent, on top of the 2.14 percent cut to the SBHCs in last October’s approved budget.
If adopted, the combined cut of nearly 8 percent would guarantee the significant reduction in primary care and mental health services provided through Connecticut’s network of SBHCs, and some health center doors would likely close entirely. As just one of Connecticut’s SBHC providers, Child and Family Agency was forced by two prior consecutive years of cuts to close the doors of four of its then eighteen centers in June of 2016. The Department of Public Health’s commissioner at the time said:
“Decreased funding may result in a reduction of staff, hours, services or SBHC sites. Such reductions will directly impact the health and well-being of Connecticut’s students, particularly those from vulnerable populations. Reduction in funds will reduce access to services for school-aged children and adolescents (including those from uninsured and underinsured populations) including primary care, mental/behavioral health, dental and health promotion/education/risk reduction activities.”
The steady beat of damage has continued since then and the assumption in some corners that billing to insurance is adequate to sustain SBHC services is just plain wrong. Effective billing to Medicaid and commercial insurances comprises only 20 percent of what it takes Child and Family Agency to sustain its SBHCs, and that is with operating efficiently and underpaying its dedicated staff.
Ninety-six school-based health centers operate in 26 communities across Connecticut, serving over 44,000 youth and their families each year, many of whom are at risk for a host of physical health and social-emotional issues. SBHCs provide easy access to medical care, vaccinations, and in some cases basic physical exams that allow students to attend class in the first place. They are the usual source of care for thousands of children and teens who often cannot make it to their regular medical homes due to parents’ work demands, transportation challenges and other barriers.
Having been cited as critical in Connecticut’s Children’s Behavioral Health (2014), these programs are the best example of an up-front investment by local, state and federal government that pays huge dividends for taxpayers and the children and families who access them.
A recent study of an innovative service model by New Haven’s Clifford Beers Clinic shows a drop in the use of emergency room visits in communities that are able to take advantage of school based healthcare, along with improvements in dental care and mental health care. The data argue in favor of steadfast investment in school based health as the most cost effective approach to helping at-risk youth.
We recognize that the legislature faces a huge challenge in figuring out how to support private, non-profit human services while also strengthening the State’s overall fiscal health. At the same time, the year-after-year solution cannot be balancing the budget on the backs of Connecticut’s most needy citizens.
Rick Calvert is the CEO of the Child and Family Agency of Southeastern Connecticut which serves 79 communities through its medical, behavioral health, child care, after-school and community outreach services.