Large-scale school-linked health care program to increase teen access to sexual and reproductive health care

School-linked health care (SLHC) is one strategy used to increase teen access to sexual and reproductive health care. In one model program, a team from a local clinic divided its time between the clinic and nearby schools and provided education, counseling, referrals and medical services, which resulted in significant reduction in the teen pregnancy rate among students at program schools. The NYC Department of Health and Mental Hygiene (NYCDOHMH) adapted this model whereby NYCDOHMH staff working in public high school condom availability programs are also stationed at local health centers.

Implementation began in the South Bronx with an assessment of the local health care services and identification of potential SLHC clinical partners. Partner criteria included (1)-providing basic sexual and reproductive health care services and (2)-dispensing hormonal contraception–both regardless of teens' ability to pay and without parental consent as protected by NY law. For evaluation, established SLHC clinical partners were asked to provide service data and collect referral tickets given by NYCDOHMH staff in the schools.

In the 2006-07 school year, NYCDOHMH staff connected eight high schools with two SLHC clinical partners with a successful referral rate of almost 50% and with one clinical partner showing service rates that surpassed levels seen in the previous two years. In the 2007-08 school year, the program was expanded to include fifteen high schools and four clinical partners.

Preliminary data support that SLHC is a promising strategy while difficulties with consistent clinical service provision highlight the challenge of the NYCDOHMH partnership model.