A time to HEAL

For children in poverty, basic health screenings a gamechanger in classroom learning

By Maggie Heyn Richardson

Sometimes, it’s the simplest solution that yields the best results.

For Health and Education Alliance of Louisiana (HEAL), that means connecting the dots between the health care needs of children in poverty and how they succeed in the classroom. School-based hearing, vision and BMI screenings can reveal a multitude of data points that can get to the heart of what’s holding a student back academically, says CEO Connie Bellone of the New Orleans-based nonprofit.

“When we first started screening children, 48% of them failed their vision screenings,” Bellone says. “How can you pay atten-tion in class when you can’t see?”

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HEAL’s mission is to eliminate the health disparities of children in poverty through a holistic model that operates in public schools and brings teachers, school administrators and school nurses together, with them ultimately running the program.

The organization started as the Early Childhood and Family Learning Foundation in 2006 for the purpose of restoring early learning programs to young children in post-Katrina New Orleans. Health programming was a component of the work, and it revealed the strong connection between health and school success, says Bellone, a registered nurse.

At the time, the program was largely associated with one school where a multitude of community partners were work-ing together. Bellone says something became clear, that 20% of the served population required about 80% of staff time and resources—the so-called Pareto Principle in action.

“Over and over, we would hear that the special educa-tion students, or the ones who really struggled, were often the unhealthiest kids, including mental and behavioral health issues,” says Bellone. “Children often don’t have the vocabu-lary to describe what’s going on with them, so they act out and perform poorly.”

The model that would eventually became HEAL took root. It is based on the core principle of prioritizing children’s health within a school community through basic health screenings and through regular conferences and follow-up strategies between teachers and school nurses.

A decentralized model based on a “whole child” approach, HEAL has created a new culture of school-based health aware-ness and action. The program currently works in more than 50 schools in four school districts, and it has screened more than 47,000 children.

In February, HEAL received a $300,000 grant from the Blue Cross and Blue Shield of Louisiana Foundation to help the program expand across greater New Orleans and in other parts of the state over the next three years.

HEAL works through capacity building. Bellone dispatches her small staff to schools where, for a period of time, they demonstrate how to create a whole child-focused program, complete with annual health screenings and multi disciplinary action plans. HEAL nurses are part of the team and are some-times accompanied by junior and senior nursing students from the LSU School of Nursing.

“What we do is build the capacity of the school district to manage the health of the students,” she says. “We are teaching schools how to case manage kids, work with parents and access health benefits.”

The HEAL team stays as long as it takes to create a work-ing system within the school. For some schools, it happens in a matter of months, while other schools need three years. In the beginning, HEAL employees handle the bulk of the work, but then gradually train school staff on best practices.

Bellone says providing annual screenings has been a powerful tool and key to the program’s success. HEAL found that hear-ing and vision screening failures among children dropped from 48% to 17% after schools implemented annual screenings. The screenings not only reveal vision and hearing problems that need correction, but can also unearth other conditions, like glaucoma and diabetes.

Another factor in HEAL’s success is that its staff works closely with teachers and nurses to casework the needs of each student. As a team, these individuals discuss possible classroom modifications, parent follow-ups and what basic services a child may need to be able to thrive in and out of the classroom.

“This is where the magic happens,” says Bellone. “It gives everyone at the school buy-in. The nurses and teachers are given support and everyone understands the issues that might be going on with a particular student.”

Bellone says HEAL has also made a difference with teacher retention because teachers now have additional resources for children who were struggling academically. With their health issues being addressed, these students have a better chance of succeeding in the classroom. Grade point averages rose from between 25% and 60% in schools where HEAL operates.

Most importantly, the HEAL team shows schools and the Local Education Authority (LEA) or school district how to access Medicaid funds intended for school-based health care costs, including health screen-ings, speech therapy, occupational therapy, psychological counseling and other services. To date, Louisiana schools have not taken full advantage of accessing these federal funds, she says.

“We know how to access this funding stream and we can show LEAs how to do it,” says Bellone. “Louisiana is the fourth worst state in the country for accessing these funds, while having one of the highest numbers of children in poverty.”

Bellone adds that Louisiana has incorporated the importance of accessing these funds in its 2019 Medicaid State Plan. Using them for school-based health care means saving the state money now and as children get older, says Bellone.

Mukul Verma