School Linked Services and Beyond

Initiatives to restructure community health and human services have fostered a school-linked services movement and contributed to the burgeoning of school-based and linked health clinics. This activity plays a major role in stimulating school-community collaboration and is a potential catalyst for system change related to school-owned programs and services designed to address barriers to learning.

This article highlights contributions of school-linked services and suggests it is time to think about more comprehensive models for promoting healthy development and to enhance barriers. Before proceeding, however, we need to clarify a bit of terminology. Prevailing use of the terms school-based and school-linked tends to encompass two separate dimensions:

(1) where programs/services are located and
(2) who owns them.

In either case, programs/services may be owned by schools or a community based organization or in some cases are co-owned. In addition, the term school-linked tends to be associated with the notion of coordinated services and school-community collaborations.

School-Community Collaborations

For several converging reasons (including a desire to enhance resources),various forms of school-community collaboration are being tested around the country. This represents a renewal of the 1960s human service integration movement. For instance, increasing numbers of projects are illustrating "one-stop shopping" -- a Family Service or Resource Center established at or near a school with an array of medical, mental health, and social services (Center for the Future of Children Staff, 1992; Dryfoos, 1994, 1995; Holtzman, 1992; Kagan, Rivera, & Parker, 1990; Kirst, 1991; Melaville & Blank, 1991). Such pioneering demonstrations show the possibility of developing strong relationships between schools and public and private community agencies.

By outstationing staff at schools, community agencies allow easier access for students and families -- especially in areas with underserved and hard to reach populations. Such efforts not only provide services, they seem to encourage schools to open their doors in ways that enhance family involvement. Families using school-based centers are described as becoming interested in contributing to school and community by providing social support networks for new students and families, teaching each other coping skills, participating in school governance, helping create a psychological sense of community, and so forth.

State of the Art

Michael Knapp (1995) notes that contemporary literature on school-linked services is heavy on advocacy and prescription and light on findings. As a descriptive aid, the accompanying table outlines some key dimensions of school-community collaborative arrangements.

Joy Dryfoos (1995) encompasses the trend to develop school-based primary health clinics, youth service programs, community schools, and other similar activity under the rubric of full service schools (adopting the term from Florida legislation). Her review stresses:

Much of the rhetoric in support of the full service schools concept has been presented in the language of systems change, calling for radical reform of the way educational, health, and welfare agencies provide services. Consensus has formed around the goals of one-stop, seamless service provision, whether in a school- or community-based agency, along with empowerment of the target population. ... most of the programs have moved services from one place to another; for example, a medical unit from a hospital or health department relocates into a school through a contractual agreement, or staff of a community mental health center is reassigned to a school ... But few of the school systems or the agencies have changed their governance. The outside agency is not involved in school restructuring or school policy, nor is the school system involved in the governance of the provider agency. The result is not yet a new organizational entity, but the school is an improved institution and on the path to becoming a different kind of institution that is significantly responsive to the needs of the community.

A primary interest of the school-linked services movement is to establish ways to enhance access to services, reduce redundancy, improve case management, coordinate resources, and increase efficacy. Obviously, these are desirable goals. In pursuing these ends, however, the tendency is to think in terms of integrating community services and putting some on school sites. This emphasis downplays the need to (1) restructure programs and services owned and operated by schools and (2) weave and redeploy school and community resources.

Nature and Scope of School-Community Collaborative Arrangements Focus 1. Improvement of program and service provision for enhancing case management for enhancing use of resources 2. Major systemic reform to enhance coordination for organizational restructuring for transforming system structure and function Scope of collaboration 1. Number of programs and services involved 2. Horizontal collaboration within a school/agency among schools/agencies 3. Vertical collaboration within a catchment area (e.g., school and community agency, complex of schools, two or more agencies) among different levels of jurisdiction (e.g., community, city, county, state, federal) Ownership of programs and services 1. Owned by school 2. Owned by community 3. Shared ownership Location of programs and services 1. School-linked 2. School-based Degree of cohesiveness among multiple interventions serving the same student/family 1. Unconnected 2. Communicating 3. Cooperating 4. Coordinated 5. Integrated

By focusing mainly on bringing community services to schools, the school-linked services movement tends to ignore the tremendous resources already in schools. Moreover, it produces tension between school-based staff and their counterparts in community-based organizations. (When "outside" professionals are brought in, school district pupil services personnel often view it as discounting their skills and threatening their jobs.) The trend also leads policy makers to the mistaken impression that linking community resources to schools can effectively meet the needs of schools in addressing barriers to learning. This colludes with the misguided tendency of some legislators to think school-linked services will free-up the dollars underwriting school-owned services.

Analyses of resources available in economically impoverished locales show how scant services are-- even when one adds together community and school assets (Koyanagi & Gaines, 1993). The picture is bleaker when one recognizes the many impediments to linking community services to schools (inflexible policies maintaining an overemphasis on narrow categorical funding, scarcity of designated local leaders, the dearth of interprofessional development programs).

Each day brings additional reports from projects such as New Jersey's School-Based Youth Services Program, the Healthy Start Initiative in California, the Beacons Schools in New York, Cities-in- Schools, and the New Futures Initiative. Not surprisingly, findings primarily reflect how hard it is to institutionalize such collaborations.

The New Futures Initiative represents one of the most ambitious efforts. Thus, reports from the on- site evaluators are particularly instructive. White and Wehlage (1995) detail the project's limited success and caution that its deficiencies arose from defining collaboration mainly in institutional terms and failing to involve community members in problem solving. This produced "a top-down strategy that was too disabled to see the day-by-day effects of policy. They conclude:

"Collaboration should not be seen primarily as a problem of getting professionals and human service agencies to work together more efficiently and effectively. This goal, though laudable, does not respond to the core problems .... Instead, the major issue is how to get whole communities, the haves and the have-nots, to engage in the difficult task of community development" (pp. 36-37).

Keeping the difficulties in mind, a reasonable inference from available data is that school- community collaborations can be successful and cost effective over the long-run. Analyses suggest better outcomes are associated with empowering children and families and having the capability to address diverse constituencies and contexts. However. addressing a full range of barriers requires going beyond a focus on services.

Beyond School-Linked Services and Full Service Schools

School-community collaboratives, school-linked services, school-based clinics, family service centers -- all hold great promise; they also are fraught with problems. They can enhance availability and access; they can also lead to policies jeopardizing the fragile resource base for essential services and programs. Unfortunately, too many policy makers are preoccupied simply with linking community health and social services to schools. In the process, they ignore the need to restructure the invaluable programs, services, and infrastructure school's already own and operate.

By themselves, use of health and human services are an insufficient strategy for dealing with the biggest problems confronting schools. They are not, for example, designed to address a full range of factors that cause poor academic performance, dropouts, gang violence, teenage pregnancy, substance abuse, racial conflict, and so forth. Moreover, the efficacy of any service may be undermined if it is not well-integrated with other services and with key programs at the school. As noted, in linking services to schools, the tendency is to link them to sites without attending to integrating them with a school's education support programs and the work of classroom teachers. These are not criticisms of the services per se. The point is that the services are only one facet of any effort to develop a comprehensive approach.

The need is for school-community collaborations that can complement and enhance each other and evolve into comprehensive, integrated approaches. Such approaches do more than improve access to health and human services. They address a wide array of the most prevalent barriers to learning -- the ones that parents and teachers know are the major culprits interfering with the progress of the majority of students.

It is ironic that, despite their skills as problem solvers, so many professionals work on the margins, rather than dealing with the biggest pieces of the problem.

Clearly, moving toward a comprehensive, integrated approach for addressing barriers to learning and enhancing healthy development involves fundamental systemic reform.. Central to such reform are policies and strategies that counter fragmentation of programs and services by integrating the efforts of school, home, and community. Required are

• policy shifts that establish a truly comprehensive, integrated approach as primary and essential to reform efforts,

• systemic changes designed to create an appropriate infrastructure upon which to build such an approach,

• designing and implementing change processes that can get us from here to there.

All this, of course, has immediate implications for altering priorities related to the daily work life of professionals who provide health and human services and other programs designed to address barriers to learning in schools and communities.

Policy Shifts

Despite the argument that schools should not be expected to operate nonacademic programs, it is commonplace to find educators citing the need for health and social services as ways to enable students to learn and perform. Also, increasing numbers of schools are reaching out to expand services that can support and enrich the educational process. Thus, there is little doubt that educators are aware of the value of health (mental and physical) and psychosocial interventions. In spite of this, efforts to create a comprehensive approach still are not assigned a high priority.

The problem is that the primary and essential nature of relevant programs and services has not been effectively thrust before policy makers and education reformers. Some demonstrations are attracting attention. However, they do not convey the message that interventions addressing barriers to teaching and learning are essential to successful school reform. The next step in moving toward a comprehensive approach is to bring the following point home to policy makers at all levels.

For school reform to produce desired student outcomes, school and community reformers must expand their vision beyond restructuring instructional and management functions and recognize that there is a third primary and essential set of functions involved in enabling teaching and learning.

The essential third facet of school and community restructuring has been designated the Enabling Component (Adelman, in press, 1995b; Adelman & Taylor, 1994). Such a component stresses integration of enabling programs and services with instructional and management components (see the figure on page 8). Emergence of a cohesive enabling component requires (1) weaving together what is available at a school, (2) expanding what exists by integrating school and community resources, and (3) enhancing access to community programs and services by linking as many as feasible to programs at the school.

Operationalizing an enabling component requires formulating a framework of basic program areas and creating a cohesive infrastructure for enabling activity. Based on analyses of what schools and communities already are doing, enabling activity can be clustered into six program areas. These encompass interventions to (1) enhance classroom- based efforts to enable learning, (2) provide prescribed student and family assistance, (3) respond to and prevent crises, (4) support transitions, (5) increase home involvement in schooling, and (6) outreach to develop greater community involvement and support (including recruitment of volunteers).

An essential infrastructure includes mechanisms for restructuring resources in ways that enhance each program area's efficacy. It also includes mechanisms for coordinating among enabling activity, for enhancing resources by developing direct linkages between school and community programs, for moving toward increased integration of school and community resources, and for integrating the instructional, enabling, and management components.

The concept of an Enabling Component provides a unifying focus around which to formulate new policy.

Adoption of an inclusive unifying concept is seen as pivotal in convincing policy makers to move to a position that recognizes enabling activity as essential if schools are to attain their goals. Evidence of the value of rallying around a broad unifying concept is seen in the fact that the state legislature in California was recently moved to consider the type of policy shift outlined here as part of a major urban education bill (AB 784).

After policy makers recognize the essential nature of a component for addressing barriers to learning, it should be easier to weave all such activity together (including special and compensatory education) and elevate the status of programs to enhance healthy development. It also should be less difficult to gain acceptance of the need for fundamental policy shifts to reshape programs of pre- and in-service education.

Building an Infrastructure

A policy shift is necessary but insufficient. For significant systemic change to occur, policy commitments must be demonstrated through allocation/redeployment of resources (e.g., finances, personnel, time, space, equipment) that can adequately operationalize the policy. In particular, there must be sufficient resources to develop an effective structural foundation for system change. Existing infrastructure mechanisms must be modified in ways that guarantee new policy directions are translated into appropriate daily practices. Well-designed infrastructure mechanisms ensure there is local ownership, a critical mass of committed stakeholders, processes that can overcome barriers to stakeholders working together effectively, and strategies that can mobilize and maintain proactive effort so that changes are implemented and renewed over time.

To institutionalize a comprehensive, integrated approach, mechanism redesign will be necessary with respect to at least five fundamental infrastructure concerns, namely, (1) governance, (2) planning and implementation associated with specific organizational and program objectives, (3) coordination/integration for cohesion, (4) daily leadership, and (5) communication and information management. In reforming mechanisms, new collaborative arrangements must be established, and authority (power) must be redistributed -- all of which is easy to say and extremely hard to accomplish. Reform obviously requires providing adequate support (time, space, materials, equipment) -- not just initially but over time -- to those who operate the mechanisms. And, there must be appropriate incentives and safeguards for those undertaking the tasks.

In terms of task focus, infrastructure changes must attend to (a) interweaving resources related to the enabling, instructional, and management facets of school and community, (b) reframing inservice programs -- including an emphasis on cross- training, and (c) establishing appropriate forms of quality improvement, accountability, and self- renewal. Clearly, all this requires greater involvement of professionals providing health and human service and other programs addressing barriers to learning . And this means involvement in every facet and especially the governance structure at the district level and at each school.

What's a Professional to Do?

In the last newsletter, we outlined three sets of functions health and human service personnel can perform for a school district: (1) direct service and instruction, (2) coordination, development, and leadership related to programs, services, resources, and systems, and (3) enhancing connections with community resources. Unfortunately, the need for direct services is so great and the number of available professionals so limited that most of the time goes to individual cases, and even then, only a small proportion of the many students, families, and school staff who could benefit from the services can be provided help. This lamentable state of affairs raises the topic of restructuring how such professionals spend their time.

Three Components to be Addressed in Reforming Education

    Direct Facilitation                        Addressing Barriers 
        of Learning        ---------    --------    to Learning        
 (The Instructional Component)                 (The Enabling Component)

                                     |     
                                     |
                          Managing Schooling and Schools    
                            (The Management Component)    

There is adequate evidence to make the case that increased dividends might accrue if personnel devoted a greater proportion of their talents and time to creating a comprehensive, integrated approach for addressing barriers to learning and enhancing healthy development. (Such an approach should not be confused with participating on a multi-disciplinary team that discusses cases or coordinates resources.)

Developing such an approach, however, requires shifting priorities and redeploying time for program coordination, development, and leadership.

Clearly, staff providing health and human services can contribute a great deal to the creation of a comprehensive, integrated approach. Equally evident is the fact that they cannot do so as long as they are completely consumed by their daily caseloads. Their's must be a multifaceted role -- providing services as well as vision and leadership that transforms how schools address barriers to learning and enhance healthy development.

Concluding Comments

As indicated by the Carnegie Council Task Force on Education of Young Adolescents (1989):

School systems are not responsible for meeting every need of their students. But when the need directly affects learning, the school must meet the challenge.

To meet this challenge, the search for better practices continues as a high priority. Allowing this fact, it also can be stressed that existing work provides more than a sufficient basis for generating a range of essential interventions. In doing so, however, steps must be taken to counter the piecemeal and fragmented approach that characterizes most school and community efforts.

As emphasized throughout this discussion, effectively meeting the challenges of addressing persistent barriers to learning and enhancing healthy development requires melding resources of home, school, and community to create a comprehensive, integrated approach. Getting there from here involves a policy shift that places the development of such an approach on a par with current reforms related to instruction and school management.

Some Relevant References

Adelman, H.S. (in press). Restructuring support services: Toward a comprehensive approach. Kent, OH: American School Health Association.

Adelman, H.S. & Taylor, L. (1994). On understanding intervention in psychology and education. Westport, CT: Praeger.

Adler, L., & Gardner, S. (Eds.), (1994). The politics of linking schools and social services. Washington,DC: Falmer Press.

Cahill, M. (1994). Schools and communities: A continuum of relationships. New York: The Youth Development Institute, The Fund for the City of New York.

Carnegie Council on Adolescent Development's Task Force on Education of Young Adolescents (1989). Turning Points: Preparing American Youth for the 21st Century. Washington, DC: Author

Center for the Future of Children Staff (1992). Analysis. The Future of Children, 2, 6-188.

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

Dryfoos, J. (1995). Full service schools: Revolution or fad? Journal of Research on Adolescence, 5, 147-172.

Holtzman, W.H. (1992). (Ed.), Community renewal,family preservation, and child development through the School of the Future. In W.H. Holtzman, (Ed.),School of the Future. Austin,TX: American Psychological Association and Hogg Foundation.

Hooper-Briar, K., & Lawson, H. (1994). Serving children, youth and family through interprofessional collaboration and service integration: A framework for action. Oxford, OH: The Danforth Foundation and the Institute for Educational Renewal at Miami University.

Kagan, S.L., Rivera, A.M., & Parker, F.L. (1990). Collaborations in action: Reshaping services for young children and their families. New Haven, CT: Yale University Bush Center on Child Development and Social Policy.

Kirst, M.W. (1991). Improving children's services: Overcoming barriers, creating new opportunities. Phi Delta Kappan, 72, 615-618.

Knapp, M.S. (1995). How shall we study comprehensive collaborative services for children and families? Educational Researcher, 24, 5-16.

Koyanagi, C., & Gaines, S. (1993). All systems fail. National Mental Health Assoc.

Melaville, A., & Blank, M. (1991). What it takes: Structuring interagency partnerships to connect children and families with comprehensive services. Washington, D.C.: Education and Human Services Consortium.

Sheridan, S.M. (1995). Fostering school/community relationships. In A. Thomas & J. Grimes (Eds.), Best practices in school psychology -- III. Washington, DC: National Association for School Psychologists.

U.S. Department of Education, et al. (1995). School- linked comprehensive services for children and families: What we know and what we need to know. Washington, D.C.: Author.

U.S. General Accounting Office (1993). School-linked services: A comprehensive strategy for aiding students at risk for school failure. (GAO/HRD-94- 21). Washington, DC: Author.

White, J.A., & Wehlage, G. (1995). Community collaboration: If it is such a good idea, why is it so hard to do? Educational Evaluation and Policy Analysis, 17, 23-38.