Health check

New Medicaid rules could threaten funding for New York City’s school-based health centers

PHOTO: Joe Mahoney/The iNews Network

A change in New York state’s Medicaid reimbursement rules could reduce low-income students’ access to healthcare at hundreds of school-based clinics in New York City — and advocacy organizations are looking at ways to mitigate potential funding shortfalls.

The new rules will create a more complicated reimbursement process, which may cause some providers to shut down or reduce the services they offer, said Lorraine Gonzalez, director of health policy for the Children’s Defense Fund New York.

School health providers, for instance, will have to negotiate individual contracts with multiple “managed care organizations” which distribute Medicaid funds, instead of using a “fee-for-service” model. The new rules also create a new credentialing process for school-based health workers.

There are 145 school-based health centers in New York City covering 345 schools, and they offer everything from physicals and vision checks to help managing chronic conditions. In some cases, they are part of the city’s community schools, which offer students extra social services and other supports.

“There’s been a lot of negotiating at the table — the state has done a great job hearing from all parties,” Gonzalez said. But she warned, “If we don’t mitigate the risks of closures, then you’ll have kids living in poverty with fewer resources for pediatric care.”

This week, CDF released policy recommendations to prevent potential closures or reductions in services that could be created by a more complicated reimbursement process. Medicaid is the largest third-party funding stream for school-based health providers, which tend to be stationed in schools with higher proportions of poor students and students of color, Gonzalez said.

The changes in Medicaid rules won’t take effect until July 2017, but the Children’s Defense Fund issued a series of recommendations this week. You can read them here, or read this CDF report for more details.

tailoring transformation

How a Memphis school that missed the turnaround tide plans to catch up under Hopson’s budget

PHOTO: Laura Faith Kebede
Principal Antonio Harvey shows kindergarteners how to blow bubbles during a graduation celebration at Hawkins Mill Elementary School in the Frayser community of Memphis.

Located in one of the most concentrated neighborhoods of school turnaround work in America, Hawkins Mill Elementary School is in many ways a throwback to Memphis public education before the city became a battleground for school improvement efforts.

It’s one of the few schools in the city’s Frayser community that hasn’t undergone a major intervention plan in the last decade — unlike the state-run, charter and Innovation Zone schools that surround it.

But that’s about to change.

As part of his initiative to invest in struggling schools instead of just closing them, Superintendent Dorsey Hopson picked Hawkins Mill to join more than a dozen other Memphis schools that will receive new resources under next year’s budget for Shelby County Schools. (You can see the full list here.)

Dubbed “critical focus schools,” the schools were chosen for reasons that range from poor test scores to low enrollment to aging buildings — all criteria that district leaders have used in recent years to close more than 20 schools.

But about $5.9 million in new investments soon will be spread across the schools based on transformation plans developed this spring with school administrators, teachers and parents in partnership with district leaders.

Principal Antonio Harvey says the process has inspired a climate of hope at Hawkins Mill, which has been among the state’s 5 percent of lowest-performing schools since 2012.

“We’re getting the message out there that we’re invested in this community, we’re not giving up on this community, we support you,” said Harvey, who just completed his fourth year at the elementary school.

For years, the school’s leaders have tried to turn around academics in a zip code where about half the households live on less than $25,000 per year. But there’s never been a significant influx of resources, making progress negligible.

As part of Hopson’s budget, Hawkins Mill will receive an extra $300,000, mostly for staff hires that include a science teacher, teacher assistants, an instructional facilitator and an interventionist. The school also will require more team projects in classrooms; add a STEM specialty for science, technology, engineering and math; and host a dance academy under Watoto Memphis, an Afro-centric performing arts program.

“We were able to sit down and put a lot of energy into the plan because the thinking process was already there,” Harvey said of the new strategy.

Most of the needs had been identified in previous years but were a pipe dream without additional investments, according to Janet Rutherford, the school’s professional learning coach.

“Now we can make this happen,” she said.

 

Teams for other critical focus schools also have been developing transformation plans, each tailored to meet their individual needs and challenges.

Some are borrowing components from Shelby County Schools’ flagship turnaround program called the iZone. Those include an hour tacked onto the school day, retention bonuses for top teachers, and more teacher coaches.

Like other schools in the newest initiative, Hawkins Mill will have to meet benchmarks within three years if it wants to avoid closure. Those benchmarks are still being identified, but school leaders at Hawkins Mill are already figuring out how to address other challenges with enrollment, attendance and behavior. The plan includes home visits for chronically absent students and launching Hawks Buck Store, a weekly incentive program in which students can win prizes for good behavior.

Note: 2013-14 science and 2014-15 social studies test scores were not listed in the state report card. Elementary students did not take TNReady in 2015-16.

Community leaders are welcoming the investments in a school that was eyed for takeover in 2015 by Tennessee’s Achievement School District. At the time, Hawkins Mill was being considered for operation by the ASD’s direct-run Achievement Schools, which includes five Frayser schools already in turnaround mode.

Charlie Caswell, a longtime community leader and pastor at Union Grove Baptist Church, said he hopes Shelby County Schools will use the Achievement Schools’ community engagement model as it implements the transformation plans.

“Our hope is that it will be a game-changer for schools to have the autonomy based on what they know their needs are in the community,” he said.

Changes

As Denver gentrifies, which neighborhoods are losing public school students?

PHOTO: Marissa Page
Members of Denver's Strengthening Neighborhoods Initiative committee examine demographic data at a meeting Monday.

As more young adults move to Denver and the cost of housing skyrockets, some city neighborhoods are seeing drops in the percentages of people of color and children.

Those changes affect Denver Public Schools, which has been the fastest-growing urban school district in the country. But that growth is slowing. Birth rates are down and many of the new transplants responsible for Denver’s population boom don’t have kids.

In addition, rising housing prices are pushing families out of some neighborhoods. A recent report by the Colorado Children’s Campaign found that the 92,000-student district is more racially segregated now than it was ten years ago. (DPS Superintendent Tom Boasberg has said he doesn’t necessarily agree with that claim.)

A new committee created by the Denver school board got a closer look this week at population changes and demographic shifts in Denver’s 78 neighborhoods.

The Strengthening Neighborhoods Initiative committee is set to spend the next six months studying how gentrification is impacting schools. The 42 members are tasked with suggesting ways to increase racial and economic integration in DPS schools and address the declining number of school-aged children in certain parts of the city.

The data provided to the committee at its second-ever meeting Monday night includes a lot of numbers, and you can see them in full at the bottom of this story. But we’ve pulled out some highlights.

Five neighborhoods where the number of students who attend a DPS school declined from 2010 to 2015.

1. Highland in northwest Denver, down 21 percent.
2. Marston in southwest Denver, down 14 percent.
3. Lincoln Park in west Denver, down 13 percent.
4. Jefferson Park in northwest Denver, down 12 percent.
5. Sunnyside in northwest Denver, down 6 percent. Bear Valley in southwest Denver and Clayton in central Denver also saw 6 percent decreases.

Five neighborhoods that saw big demographic shifts from 2010 to 2015.

1. Northeast Park Hill in near northeast Denver, where the percentage of black residents shrunk from 55 to 42 percent and the percentage of white residents grew from 11 to 20 percent.

2. Baker in northwest Denver, where half the residents in 2010 were Hispanic. By 2015, white residents were the majority: 56 percent compared 34 percent who were Hispanic.

3. Whittier in central Denver, where 40 percent of residents in 2010 were black and 38 percent were white. In 2015, 24 percent of residents were black and 50 percent were white.

3. Globeville in central Denver, which saw its Hispanic population decrease from 80 percent to 61 percent and its white population increase from 15 to 33 percent.

5. A few neighborhoods saw increases in the percentage of residents of color and decreases in the percentage of white residents, though white residents remained the majority. They include Hampden in southeast Denver and Washington Virginia Vale in near northeast Denver.

Five neighborhoods that saw big changes in the percentage of families living in poverty from 2010 to 2015.

1. Baker in northwest Denver, where the percentage of families living in poverty fell from 47 percent in 2010 to 17 percent in 2015, which is the citywide poverty rate.

2. Jefferson Park in northwest Denver, where the percentage fell from 48 to 24 percent.

3. Lincoln Park in northwest Denver, where the percentage fell from 47 to 26 percent.

4. West Colfax in northwest Denver, which saw the sharpest increase from 20 to 35 percent.

5. College View in southwest Denver, which saw an increase from 29 to 38 percent.

The data shows that many of Denver’s neighborhoods are racially segregated. Here are the neighborhoods where 80 percent or more of residents in 2015 were of one ethnicity.

Westwood in southwest Denver, 80 percent Hispanic
Elyria Swansea in central Denver, 83 percent Hispanic
West Highland in northwest Denver, 80 percent white
Civic Center in northwest Denver, 82 percent white
City Park in central Denver, 81 percent white
Congress Park in central Denver, 82 percent white
Cherry Creek in central Denver, 87 percent white
Speer in southeast Denver, 86 percent white
Washington Park West in southeast Denver, 85 percent white
Washington Park in southeast Denver, 90 percent white
Belcaro in southeast Denver, 93 percent white
Cory-Merrill in southeast Denver, 86 percent white
Platt Park in southeast Denver, 89 percent white
University Park in southeast Denver, 84 percent white
Wellshire in southeast Denver, 92 percent white
Southmoor Park in southeast Denver, 87 percent white
Hilltop in near northeast Denver, 90 percent white
There were no neighborhoods where 80 percent or more of residents were black.

The committee is set to meet next in August to discuss DPS’s existing integration policies.

Chalkbeat intern Marissa Page contributed information to this report.