Student health and wellness was an emerging topic even before the COVID-19 pandemic hit. Now it’s a top concern for families and education leaders alike.  

House Bill 129, introduced by Rep. Kim Williams in state legislature last week, would build on the state’s existing network of school-based health centers by requiring them in all high-needs elementary schools. 

What are School-Based Health Centers (SBHCs)? 

School-based health centers are nothing like the “nurse’s office” most would imagine when thinking “school + health.” SBHCs, instead, are a health care delivery model that provides students with physical, behavioral, and preventive health services delivered by qualified medical and behavioral health providers located in a school setting. They are: 

• Sponsored by a health agency (hospital, medical practice, health center, etc.) 
• Different and separate from school nurses and counselors 
• Interactive with community providers (pediatricians, therapists, specialists)
• Available to all students regardless of insurance or ability to pay 

There are already dozens of SBHCs in Delaware, and for good reason. National studies reveal SBHCs have a positive impact on students’ physical and behavioral health, leading to reduced hospitalizations and even reduced instances of substance abuse.  

Critically, services provided by SBHCs help to reduce disparities in health care access and health outcomes. SBHCs have shown a positive impact on student seat time, absenteeism, and grade promotion—while demonstrating significant cost benefits for families and health providers.  

SBHCs in other states have been implemented based on student need. Historically, SBHCs in Delaware have been implemented based on student population size. 

According to HB129, Delaware will foot the bill on start-up costs for each school-based health center at two high–needs elementary schools per year until each high-needs elementary school has a center. “High–needs” in this case refers to any elementary school in the top quartile of three or more in percentage of low-income students, percentage of English learners, percentage of students with disabilities, percentage of minority students, or having 90 percent of its students classified as low-income, English learners, or minority.  

The legislation would also allow high-needs elementary schools that already operate school-based health centers to apply for reimbursement of previously expended funds necessary to establish said health center.  

The legislation comes at a time when state leaders are digging deeper into SBHCs. Delaware’s Division of Public Health and the volunteer School Based Health Alliance recently released a SBHC strategic plan to align on goals and assist with state leaders as they look go grow Delaware’s SBHC map—including updates to the systems, policies, and supports SBHCs need to start up, sustain, and improve. 

And the timing is right with the arrival of American Rescue Plan Act funds, which can go toward mental health purposes, as well as for capital and operational costs.  

Advocates have long called for more school-level support on the student health front. Comprehensive, family-centered medical care is linked to better performance in schools and less risky life behaviors.  

The Vision Coalition of Delaware recommended “a broad array of wrap-around services to students (e.g., physical and mental health services)” that “support the holistic development of schools in high-need communities” in its Student Success 2025 report in 2015.   

And in 2018, education and health partners collaborated on a landscape analysis of social and emotional supports in Delaware; and recommended expanding school-based health centers, as well as “[building] on existing successful partnerships with organizations that serve families and students by bringing outside resources into schools.” 

In Delaware, SBHCs are operated under statutory regulations 18 Del. C. §3365 and 3517G. Funding sources include: 

• State funding 
• Medicaid reimbursement 
• Commercial insurance reimbursement 
• In-kind support from schools and medical sponsors 

SBHC services vary by site and include: 

• Preventive care  
• Treatment of minor, acute conditions 
• Mental health and substance use screenings 
• Counseling  
• Testing and treatment for sexually-transmitted infections 
• Reproductive health  
• Nutrition counseling 
• Health promotion education 
• Referrals to community providers 
• Insurance and social service navigation 

When a high-stakes lawsuit over Delaware’s school funding system settled last fall, advocates said it didn’t go far enough. Now, at least 24 legislators agree Delaware must do more, including majorities of Senate and House Education Committees, the majority of the Legislative Black Caucus, and caucus leaders in both Chambers.

A new concurrent resolution, introduced by Rep. Nnamdi Chukwuocha and sponsored by Sens. Laura Sturgeon and Elizabeth Lockman, builds on the momentum of the settlement, Senate Bill 56. More importantly, it serves as a powerful symbol that legislators are actually committed to doing more to modernize Delaware’s inequitable funding system in a more holistic way.

This is big news. And it signals that legislators are ready to lead the work on systemic solutions—long urged by advocates—to improve the transparency, flexibility, responsiveness to student needs, and predictability of the entire education funding system.

The House Concurrent Resolution aims to build upon the October settlement—which recommended making “Opportunity Funding” a permanent fixture for Delaware schools—by actually addressing the state’s underlying funding process and formula. That formula, according to experts, countless reports, and advocates, is highly inequitable, and leaves vulnerable children and their schools at a disadvantage.

HCR24 “celebrates the passage of SB56,” the bill that would make Opportunity Funding permanent, but also “[d]escribes the need for additional action from the General Assembly to update and modernize remaining underlying systemic education funding inequities.”

The resolution requires the Department of Education to report information to the General Assembly to help illuminate systemic inequities in the current education funding system to inform future legislative proposals.

Opportunity Funding, an investment that Governor John Carney first proposed and the legislature approved in 2018, provides schools with additional money for English learners and students who are from low-income families. The settlement proposes that Opportunity Funding become permanent and almost double in size to $60 million annually by the 2024-25 school year ($35 million per year for the 2021-22 and 2022-23 school years).

While research shows that more money for students with high needs is a good thing, advocates like the Education Equity Delaware coalition believe that we must address how funding is allocated, not just how much.

Now, legislators agree that Opportunity Funding is a “floor,” and not a “ceiling.” This additional funding only impacts less than five percent of the overall education budget; the structure of the remaining 95 percent remains the same.

Our current system was built to address the needs of children in the 1940s. The world has changed since then. Our student population has evolved to comprise diverse populations and unique needs. Our access to technology, the connections among our schools and their communities, higher education partners and local employers have changed dramatically. To ensure we’re not only providing the resources that all of our children need to succeed, but delivering it in ways that enable school leaders the flexibility they need to use those dollars to meet the unique needs of their students, we need to step back and modernize our funding system holistically.

We’re approaching a century; it’s past time. Nearly every other state has modernized its system, (some multiple times), since the 1940s. We can do this. HCR24 could help advocates finally reach that ceiling. Here’s how:

1. Sign this petition to encourage legislators to support this resolution
2. Share the petition with your networks
3. Follow Education Equity Delaware on Facebook for updates and information

The 2021 Local Child Care Market Rate Survey has officially arrived, courtesy of Delaware’s Division of Social Services. And while it shows a small uptick in child care tuition costs across the state (five to nine percent since 2018)—the true headline is that the survey will still help determine how (and how much) Delaware funds child care. And that’s a bad thing.  

“Market rates” are the prices providers charge private-paying families for care. The point of the survey is to collect confidence intervals (remember “percentiles” from statistics?) on what providers are charging. That information is then thrown into the equation for how much Delaware funds “Purchase of Care” (or POC)—a state subsidy that helps cover child care tuition for low-income parents. POC families make up a huge portion of many providers’ enrollees.  

And as any Delaware child care provider can tell you, Purchase of Care rates don’t come close to covering what it costs to care for a young child. Delaware only covers 65 percent of the 75^th percentile of rates. 

The survey’s release marks another flashpoint in the odd and longstanding disconnect between state support of child care and the true needs of families and providers—who also happen to be struggling through a historic pandemic.  

As we’ve said before, using market rate studies to determine POC rates is not a great idea, for a lot of reasons.  

Even the 2021 report itself helped paint the dire predicament in which many providers find themselves…albeit in a sterile, academic presentation:  

In other words, child care centers are in a major financial crisis. Since COVID, providers’ costs are up 50 percent. Staffing demands with COVID restrictions are significant—reducing opportunities to combine classrooms or leverage “floater” teachers that go from room to room, and PPE costs are significant. 

Today, to reach the 75th percentile of 2021 rates (not 65 percent but the full 75th percentile), advocates are pushing for a $60 million state investment in FY2022: $40 million more in the state budget for POC rates and $20 million more to stabilize the industry. Learn more about how advocates are fighting to #FundOurFuture.  

Back in January, we wrote about Delaware’s frustrating school registration process. It’s an all-over-the-place approach that involves a ton of paperwork and offers little help to non-English-speaking families.

But help could soon be on the way. SB 82 was introduced this week by Sen. Elizabeth Lockman, and aims to rewrite Delaware code on public school registration.

With 2021 technology, there’s no reason Delaware can’t adopt a modern, one-stop digital shop that allows families to choose the option more convenient for them—paper or online, and in multiple languages. Ultimately, a common, uniform system would simplify the process for families and districts, enable schools to engage with families and plan in advance of the school year, and integrate data systems.

There are currently 29 school districts and charter schools in Delaware that provide kindergarten and 41  that accept students in other grades; each with its own registration and enrollment process. Parents are often asked to fill out paper forms in-person at schools during the workday. In kindergarten alone, there are 29 different registration systems.

The Delaware Readiness Teams was instrumental in the issue gaining traction. Responses to a 2018 Delaware Readiness Teams survey about families’ experiences with the current Kindergarten registration system showed us that parents, caregivers, and families have asked for a more streamlined, simplified process for registration. The survey showed that three out of four caregivers call the registration process hard or extremely hard. Further, almost 100 percent of Spanish-speaking families who took the survey believe the process is hard or extremely hard.

Not surprisingly, the DRTs have also come out in support of the bill. Want to join them in advocating for this common-sense bill? Tell your legislator to support SB 82 as a first step toward a system that works for families.