Children with unmet health needs have a difficult time engaging in the educational process. Many health delivery models have been attempted over the last century, but none were successful. Our school-based health centers are designed to address the limitations of the school nurse, who could not make a medical diagnosis, prescribe medications, advise on reproductive health concerns, conduct mental health counseling, or provide dental care, etc.
In 1902 the first school nurse was hired in New York City to work with students and their family’s health care needs, in particular, tuberculosis. But, obviously, there were limitations to what the school nurse could do.
Dr. David Appel was a young and eager resident in social pediatrics at Montefiore. Seeing the great need in the community, he designed a comprehensive school health center as his social medicine project. It was a great plan, but budget constraints made it almost impossible to implement, at that time.
However, ten years later, a door opened when new reimbursement regulations made school health clinics a possibility. The Chairman of the Department of Family Medicine offered Dr. Appel the challenge of his lifetime - to create a sustainable school health program at Montefiore. Challenge accepted!
Through great vision and leadership, along with creative partnerships, institutional support, statewide advocacy and the hard work of everyone involved in the program, the comprehensive model of school-based health care was born. In the beginning, the program had three part-time sites. By 1996, Montefiore had grown to seven health centers with full-time medical services and partnerships for dental and mental health services. Over the next few years, mental health, dental and community health services were fully integrated into the program.
By 2005, in just under ten years, the Montefiore School Health Program had more than doubled its sites to fifteen elementary, middle and high schools.
Today, the Montefiore School Health Program has 21 comprehensive SBHCs serving the health care needs of 65 schools and over 30,000 children.
As you can see, Dr. Appel’s idea has more than come to fruition. But that’s not stopping him or us.
As we face the future of school-based health, big plans are in place to open 10 more clinics serving 23 more schools by 2020! Help Dr. Appel reach EVERY KID, EVERY DAY!