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Developing Manageable Systems of Care in Education

Michael D. Wilhoit

Ed.D. Student
Program in Educational Leadership
UNC Chapel Hill

mwilhoit@email.unc.edu

"In the year of our Lord 1314, the Palnots of Scotland charged the fields of Baneckman. Starving and outnumbered, they fought like warrior poets. They fought like Scotsman and won their freedom."

Mel Gibson, Braveheart (1995)

"The spirit and dedication of the innovators may be more meaningful than bricks and mortar."

Joy Dryfoos, Full-Service Schools (1994)

Introduction

During the 1996 - 1997 academic year, I served under Dr. William Malloy as an assistant coordinator for the University of North Carolina's Professional Development School (PDS) At-Risk Initiative in Chatham County, North Carolina. I specifically worked with The Administrators Forum, a steering committee consisting of the county's fourteen principals. This Forum continues to provide direction for the ongoing PDS initiative in Chatham County.

The initiative focuses on meeting the needs of at-risk students on a county-wide basis. No particular school is singled out. I have worked closely with Chatham County School's fourteen principals. It has been quite an enjoyable process watching this team of principals collaborate in identifying a county wide need and adopt the Intercede to Succeed Program (ITS).

ITS is currently in four of Chatham's fourteen schools. Since its inception prior to the 1994-1995 school year, The Innovation and Developmental Services wing of the North Carolina Department of Public Instruction (DPI) has administered and evaluated the ITS program. In February 1997, Chatham County principals agreed that the ITS program could best meet the needs of their very diverse and growing at-risk student population in all their schools. ITS program goals are fourfold:

  1. Increase school success for targeted children with academic and/or behavioral difficulties.
  2. Increase parents involvement with their child's education.
  3. Improve collaboration between service providers to children and families, both within the school itself, and between the school and community.
  4. Teach students, school staff, and parents a common approach to problem solving and conflict management that will better enable them to resolve disagreements in a peaceful manner (Intercede to Succeed, 1996).

Chatham's experience is not isolated. Rather, it is representative of a national struggle to serve an ever diverse and troubled student population. School systems across America are trying to meet the growing social, health, and physical needs of students. Programs like ITS abound. How then can educators best serve their challenged clients?

An Emerging Issue

Developing manageable systems of care for students is a national issue of debate. Federal and state governments are increasing their call for integrative services to meet the burgeoning needs of young students and their families. Dr. Barbara H. Wasik, Director of the National Center for Home Visiting at the University of North Carolina at Chapel Hill, notes that systems of care are those programs that serve the whole student (Wasik, Roberts, and Lam, 1996). Services can range from after-school tutoring and social skills training for students to on-campus mental health counseling and medical care for entire families. "Manageable" denotes the balance between the level of service most appropriate to the students' needs and the systems ability to meet those needs.

As society looks more to schools for solutions, it behooves us as educators to consider our willingness to change and our preparedness to meet students burgeoning needs. In the following pages, I chronicle the emergence of the "systems of care" philosophy in the field of education, underscore the forces behind it, and consider its direction and prospects. I conclude with more practical implications for today's educator.

Background

Certain legislative landmarks mark the philosophic changes that lie behind our current struggle in education to create manageable systems of care for children (Wasik et al, 1996). The federal government first acknowledged the role of family and community in promoting health and welfare in the Social Security Act of 1935. It mandated funds for the physical and monetary needs of children and mothers in their homes. Then, in 1963, the Community Mental Health Centers Act expanded service provision with a special interest in offering developmentally services to children. With the federal government showing an increasing interest in the human service field, the 1960's fostered programs like Project Head Start in 1965 that called for family participation in meeting children's needs. In 1971, Secretary of Health, Education, and Welfare Elliot Richardson revealed the federal governments emphasis upon service integration:

Service integration refers primarily to ways of organizing the delivery of services to people at the local level. ÖIts objectives must include such things as: a) the coordinated delivery of services for the greatest benefit to people; b) a holistic approach to the individual and the family unit; c) the provision of a comprehensive range of services locally; and d) the rational allocation of resources at the local level so as to be responsive to local needs (Richardson, 1991).

Since the early seventies, key pieces of legislation mark the increasing philosophical shift at the federal level toward delivery of integrated and comprehensive services. Public Law 94-142, the Education of the Handicapped Act of 1972, asked states to "develop and implement a statewide, comprehensive, coordinated, multidisciplinary, interagency program of early intervention services for handicapped infants and toddlers and their families" (20 U.S.C., Secs. 1400-1485, 671b). In 1989, the passage of Public Law 101-239, the Omnibus Budget Reconciliation Act, created the Healthy Start program and called for the collaboration of seven federal agencies in serving the needs of pregnant women and their young children. In 1991, the U.S. Department of Education's National Education Goals echoed "the federal commitment to services that are comprehensive, family-centered, coordinated, and community-based" (Wasik, et al, 1996).

Forces Driving Issue

The philosophical shift toward more comprehensive systems of care was created by the growing needs of students. The Children's Defense Fund provides a distinct outlook on the changing needs of children and their families. Consider their mission statement:

The Children's Defense Fund exists to provide a strong and effective voice for all the children of America, who cannot vote, lobby, or speak out for themselves. We pay particular attention to the needs of poor, minority, and disabled children. Our goal is to educate the nation about the needs of children and encourage preventive investment in children before they get sick, drop out of school, suffer family breakdown, or get into trouble. CDF is a private nonprofit organization supported by foundations, corporations, and individuals. CDF never has accepted government funds. Since 1973, CDF has been working to create a nation in which the web of family, community, private sector, and government supports for children is so tightly woven that no child can slip through. We believe that no child should be left behind, and that every child needs and deserves a Healthy Start, a Head Start, a Fair Start, a Safe Start, and a Moral Start in life. (Children's Defense Fund, 1997)

CDF offers revealing statistics on the lives of children and their families. Note that every day in America:

  • 1 mother dies in childbirth
  • 3 people under 25 die from HIV
  • 6 children and youths commit suicide
  • 14 children and youths are murdered
  • 16 children and youths are killed by firearms
  • 37 children and youths die from accidents
  • 92 babies die
  • 144 babies are born at very low birthweight
  • 326 children are arrested for alcohol offenses
  • 342 children are arrested for violent crimes
  • 359 children are arrested for drug offenses
  • 466 babies are born to mothers who received late or no prenatal care
  • 788 babies are born at low birthweight
  • 1,420 babies are born to mothers younger than 20
  • 2,444 babies are born to mothers who are not high school graduates
  • 2,556 babies are born into poverty
  • 3,086 public school students are corporally punished
  • 3,356 high school students drop out
  • 3,533 babies are born to unmarried mothers
  • 5,500 high school graduates do not go on to college
  • 6,042 children are arrested
  • 10,829 babies are born
  • 13,076 public school students are suspended (Children's Defense Fund, 1996)

The U.S. Census Bureau also supports the claim that children's lives are becoming more arduous. Their 1995 census provides statistics for persons and families in poverty selected by characteristic. Consider that more children live in poverty than any other age group. Nearly 21% of children under the age of 18 live in poverty. In addition, children growing up in single parent families are much more likely to experience poverty. Of families with no husband present in the home, 33% also live in poverty. Furthermore, the inner city is where we find the largest concentration of our poor. Twenty-one percent of poor people live in central cities (U.S. Census Bureau, 1995). One need only consider the effects of drug exposure (Hicks, 1993), female employment (Lubeck, 1995), and issues particular to rural settings (Magrab, 1992) to sense the increasing demands placed on today's student and the schools that service them.

Educational curriculum theorists Landon E. Beyer and Daniel P. Liston concur with this sentiment that today's students face new and difficult challenges. They note:

we are living in a period of daunting social problems. For instance, the crisis in health care and health care insurance, the fiscal problems of many states as well as the federal government, the lack of voter participation even in major elections, the racism especially evident in urban areas, and the actuality of wars and the threat of nuclear arms being used in them even with the end of the cold war document the domestic and international circumstances that make the future problematic (Beyer, L., Liston, D., 1996, p.166).

Other critical theorists, particularly those in the field of critical pedagogy echo this concern for the social and political turmoil surrounding America's schools and the children in them (Leistyna, P., Woodrum, A., Sherlbom, S., 1996). How then do we serve what Halpern labels a "growing number ofÖ vulnerable families" (1993, p.168)?

Where is Issue Going

Range of Services

Federal and state governments have shown an increasing willingness to meet the growing needs of children. This philosophical shift has had an effect not only on educational theory, but its practice as well. A range of systems of care services is currently being offered to students. In an effort to meet the needs children bring to school, programs are heading toward a collaborative and holistic approach and take several forms (Dryfoos, 1994).

There are three types of relationships that exist between schools and the social service organizations they are looking to for help: targeted services, cooperative partnerships, and collaboratives. Targeted services are offered by organizations outside an individual school or school system such as the D.A.R.E. drug awareness and prevention program. Cooperative partnerships occur when services are located on school grounds. School-based health clinics and nurseries are examples. Both organizations offering targeted services and cooperative partnerships administer the programs themselves. This saves the local education agency the time and money involved in running a program themselves. Collaboratives, on the other hand, are full service "one-stop" schools that can offer the complete array of social services needed by a particular community (Dryfoos, 1994, p.142). Collaboratives require joint administration by both the school and all social service agencies involved. The efforts made toward creating these new social service agencies with education as their centerpieces have yielded wonderful results (Dryfoos, 1994).

Prototypes

Dryfoos' prototype school is a social service collaborative with education at its core. Consider the examples of Hanshaw Middle School in Modesto, California and IS 218 in Washington Heights, New York. Hanshaw Middle School began with the vision of superintendent James Enochs and door to door approach of principal Chuck Vidal in 1986. Hanshaw began with practically no standing relationship between the school system and community agencies. Through Enochs' collaborative emphasis, the Interagency Children's Services Coordinating Council was established to serve a growing school district with increasing economic and ethnic diversity, particularly Modesto's Hispanic community. One-third of the school's population is limited English proficient. Hanshaw blossomed with funds from California's 1991 Healthy Start Support Services for Children Act. The school is divided into seven communities, each connected to a branch of California State University and a local business. Teachers use an interdisciplinary curriculum with team teaching. On campus services include family support, education, health, dental screening and assessment, child welfare services, academic support, tutoring, mental health and substance abuse counseling, and off campus referral services.

It took parents, educators, and community agencies four years to turn IS 218 in Washington Heights, New York into Salome Urena Middle Academies (SUMA). The Children's Aid Society of New York conducted a need survey in 1988. After discovering the lack of services provided in the Hispanic community surrounding IS 218, CAS developed a partnership with the New York City school system. After obtaining a grant for construction start-up cost, in 1989, CAS and educators began building bridges of trust into this forgotten community with summer camp programs and medical assistance. Three years later, SUMA, named after a Latino poet, opened its doors to 1,200 students. The school is open from 7:00 a.m. to 10:00 p.m. on school days, summers, weekends, and holidays. Like Hanshaw, the school uses a team teaching approach and is divided into learning units called Academies. Each academy offers a different academic track. On- campus services include a family resource center, medical and mental health suite. SUMA is staffed heavily by community volunteers. Students run a school store and teach Spanish to community police officers.

Dryfoos notes that while schools like Hanshaw and Salome Urena are dramatically successful in meeting student needs, their creation requires participation in a sometimes painful process.

Implications for Education

We are in a changing profession with heightened expectations. If we are to effectively meet the fluctuating needs of our students and expectations of their parents, we must be willing, like Hanshaw and Salome Urena, to invest in a long range process that includes the following.

  1. Start with a vision.
  2. Involve the community.
  3. Focus on family.
  4. Take a holistic approach: consider social, health, and academic needs
  5. Make research-based decisions.
  6. Restructure school bureaucracy.
  7. Find realistic and innovative funding resources.
  8. Remember change is a process, not an event.
  9. Involve those closest to the point of implementation.
  10. Seek full central administrative office support.
  11. Demand ownership from all key players.
  12. Demand long term commitment from school systems and community agencies (Dryfoos, ch. 7).

Building trust, vision, and perseverance while rethinking current educational structures are at the heart of these changes. How then can local educators become involved?

Preparation for Educators

Take a Leading Role

With the need for sound evaluation and research, educators can take a leading role in the change process by developing discerning frameworks for systems of care programs. In doing so, they must be familiar with particular principles and examples as they address student needs. The Bureau of Maternal and Child Health (1993) provides ten such guiding principles for this process of change. Principles of care need to be collaborative, family-centered, community-based, culturally competent, coordinated, comprehensive, universal, accessible, developmentally-appropriate, and accountable. Comprehensive services denote a holistic approach to family needs while universal service includes those without school children.

Chatham County, North Carolina as Realistic Exemplar

Prior to the 1994-1995 school year, the North Carolina Legislature responded to the needs of its children by creating the Intercede to Succeed (ITS) Intervention and Prevention Grant Program. Chatham County applied for and won a grant. Currently, ITS is in four Chatham elementary schools serving children in kindergarten through second grade. Each full-time case manager works with 30 students while the half-time case manager works with 15 students. Time is split between teaching basic reading and writing skills, and coordinating social services for the student's family.

The University of North Carolina School of Education also maintains a Professional Development School in Chatham County. Faculty members and graduate assistants are working to help Chatham County extend ITS services to all of the county's 14 schools. This cooperative partnership between the North Carolina Legislature, UNC-CH, and ITS in the Chatham County schools is changing children's lives for the better. Recent program evaluations reveal an increase in student achievement for student participants.

ITS is unique. The state provides an additional administrator to the county's central office to oversee the program. In addition, ITS uses the case manager model from the health industry. Chatham County currently employs three full-time case managers and one half-time case manager. School administrators favor the program because of the increases in student achievement and the doing full-time employee with no regular classroom teaching responsibilities.

Chatham's story is still unfolding, but we can learn from their example as we strive to develop manageable systems of care for the students in our classrooms. Like Chatham County, it might behoove us to build on what we are already doing well.

Reference List

Beyer, L., Liston, Daniel P. (1996) Curriculum in conflict: social visions, educational agendas, and progressive school reform, New York, NY: Teachers College Press, Columbia University.

Bureau of Maternal and Child Health (1993). Community integrated service system guidance. Washington D.C.: Department of Health and Human Services, pp. 2-4.

Children's Defense Fund (1996). Facts and Figures: Everyday in America. [WWW document]. URL http://www.childrensdefens.org/facts.html

Childrens Defense Fund (1997). Welcome to the children's defense fund. [WWW document]. URL http://www.tmn.com/cdf/index.html

Dryfoos, Joy G. Full-service schools: A revolution in health and social services for children, youth, and families, San Francisco: Jossey-Bass, 1994.

Halpern, Robert (1993). The social context


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