Dr. John T. Macdonald Foundation

SCHOOL HEALTH INITIATIVE

The Dr. John T. Macdonald Foundation School Health Initiative, the second of the foundation's signature programs, creates a comprehensive and coordinated system of health clinics in several feeder patterns in our public schools.

Ensuring Healthier Children

School health clinics were once a staple of public school education experiences. Virtually all public schools enjoyed the presence and security of a school clinic and nurse, which ensured an environment for healthy and productive students. Over time, however, these programs have been significantly scaled back. Tight budgets, overcrowding, and substandard space have culminated in a situation that nears a public school health crisis. Students simply cannot perform well academically if they are in poor physical health or if they are not practicing healthy behaviors outside of school.

Providing health care and health education in schools is a cost-effective way to reduce barriers to health services and, ultimately to learning. Despite growing interest among educators and health professionals, it has been difficult to develop and maintain a comprehensive and coordinated school health program in Miami-Dade County, the fourth-largest public school system in the nation.

In July 2000 the Dr. John T. Macdonald Foundation partnered with the University of Miami School of Medicine to develop and implement a comprehensive school-based health program within a single feeder pattern of the Miami-Dade County Public School system. This initiative is designed to provide access to comprehensive primary health care including wellness education and support services, all within a school setting. The model utilizes the five schools that comprise the North Miami Beach feeder patter for the provision of these services: Fulford Elementary, Greynolds Park Elementary, G.K. Edelman/Sabal Palm Elementary, John F. Kennedy Middle School, and North Miami Beach Senior High. The primary goal of the School Health Initiative is to provide the most basic health care, health promotion and disease prevention education, and psychosocial services for medically underserved children from elementary to high school-in our public school system.

Working in cooperation with Miami-Dade County Public Schools and other community-based partners, the Department of Family Medicine Community Health Affairs at the University of Miami Miller School of Medicine, and the Initiative’s Medical Director, Joycelyn Lawrence, M.D., direct the project. Key components of the project include the provision of basic school nursing and social worker services at the three elementary schools and operation of four school-based health centers offering comprehensive primary care and mental health services at the middle and high schools. Age-appropriate care is provided within a holistic framework that takes into account cultural and linguistic differences as well as the developmental needs of students and their families. Services are available to all of the 15,000 children who attend the participating schools regardless of their ability to pay. Preventative dental services are provided to the elementary school children, and vision screening and vision care are secured, despite county-wide funding cut-backs. Furthermore, by using a successful methodology called service learning, the program links academics to community service tasks and, in the case of health professions students, gives learners a chance to acquire knowledge and skills that will help them address patients' real-world problems. The project also currently includes telehealth. Utilization of teleheath increases primary care services, facilitates staff trainings, and expedites subspecialty referrals with UM physicians, such as cardiology, psychiatry, and dermatology. The Adult Evening Clinic opened at North Miami Beach Sr. High this year. Parents whose children are enrolled in the clinic program and who also suffer from chronic disease were able to receive primary care services from our staff. Multidisciplinary teams and innovative health professions education and training are used to create a signature program that can serve as a model for more feeder patterns and other communities. The program seeks to elevate awareness of the need and generate support for a strong school health program among elected and appointed officials, state and federal agencies, school administrators, teachers and counselors, and community members. Collaborative efforts with these groups are essential to the long-term success of the School Health Initiative. By focusing on risk assessment, prevention, early diagnosis and treatment, the Dr. John T. Macdonald Foundation School Health Initiative has developed innovative approaches to long-term problems such as childhood obesity and asthma. We proudly boast of our partnership with the Batchelor Foundation and the Children’s Trust School Health Connect, critical to making this most important initiative a national model and a success.

In 2010, the Dr. John T. Macdonald Foundation once again renewed its commitment to this project. To date, we have awarded $8,538,546 to the Initiative. With its future in North Miami Beach and North Miami more secured, the project is now actively working with elected and appointed officials, state and county agencies, school administrators, teachers and community activists to take the Foundation’s original vision to the next level, working and continuing to expand it, and continuing to promote improved school-based health services and better academic students throughout the district.