Partnering to Expand Adolescent Access to School Health Services

SUMMER JOHNSON: This is Public Health Review. I'm Summer Johnson. On this episode: Strong public health partnerships with schools enable successful adolescent health programs.

ALEXANDRA SONTAG: In Chicago, we are very lucky to have 33 school-based health centers. These are locations inside a school building that have tailored their services towards young people.

JOHNSON: Welcome to Public Health Review, a resource of the Association of State and Territorial Health Officials. On each episode, we explore what health departments are doing to tackle the most pressing public health issues facing our states and territories.

Today, we examine successful, coordinated efforts between the state and local level health departments and local school districts to address critical adolescent health needs in schools. Chicago’s Healthy CPS Initiative has used CDC's Whole School, Whole Child, Whole Community model and has in part been supported by CDC's What Works in Schools funding.

The school district's initiative, together with the Chicago Department of Public Health and the Illinois Department of Public Health, brings unique assets to provide comprehensive health services to Chicago's youth.

Nikki Goodman is the Healthy CPS Manager for Chicago Public Schools.

NIKKI GOODMAN: As adults, if we're hungry, we can't concentrate. If we are feeling any type of physical pain, we can't concentrate. If we are not feeling safe in our home environment, it's hard to concentrate. We want to make sure that we are putting in protections for students at school so they know they can focus on the joy of learning.

JOHNSON: I'd love for you to tell us about the importance of adolescent health from your perspective.

GOODMAN: I am a product of Chicago Public Schools—from kindergarten through senior year. The student health and wellness services we offer today weren't available when I was in school. Having these resources now is incredibly important to me. My own children are entering CPS, and I know there’s a behavioral health team at every school.

Students returning from traumatic experiences are supported. Students with diabetes or asthma not only carry their medication but are supported by trained staff who know what to do in emergencies. Ensuring these resources are available and accessible to students, staff, and schools is a humbling responsibility that I take seriously.

JOHNSON: What do you see as the biggest barriers to successful adolescent healthcare?

GOODMAN: Funding in the public sector is always a challenge. Collecting and presenting data accurately and transparently is key—not only to show where we are but also to highlight opportunities. Good data helps when applying for grants or requesting board funds. We also walk a fine line in education—we want to promote academics, but know that students can’t learn unless their other needs are met.

We rely on the Whole School, Whole Community, Whole Child model from the CDC as the foundation for Healthy CPS. It helps validate the work we do and reinforces that health is essential to academic success.

JOHNSON: There are a lot of players involved in improving adolescent health for Chicago youth. Describe those collaboration efforts.

GOODMAN: We all have some overlapping and some competing goals. At CPS, our priority is breaking down health-related barriers for students. A major step is connecting students and families to benefits that enable long-term care. We created the Children and Family Benefits Unit to identify students eligible for Medicaid and other programs. Out of our district, 77% of students are eligible for Medicaid, and 64% are currently enrolled.

After enrollment, we work with partners like Chicago Department of Public Health, Illinois Department of Public Health, and local hospitals such as Lurie, Rush, and University of Chicago. They provide mobile healthcare vans to schools — some at no cost.

During the pandemic, our relationship with CDPH was essential. They helped us build a contact tracing team, manage pushback on mandates like masking and isolation, and translate CDC guidance for a large school district. We even established a Disease Prevention and Response Team for issues like outbreaks and lice.

We also partner on sexual health services, including a condom availability program for grades 5 through 12, and menstrual hygiene products. Recently, we worked with CDPH on a vaping cessation campaign across CPS high schools that reached over a thousand students. CDPH is essential to our vision and efforts across many topics, from disease prevention to dental exams.

JOHNSON: How are the school-based health centers helping?

GOODMAN: They're all attached to schools. Some serve the broader community, others are for the school only. They’re run by different health partners and offer year-round wraparound services. If a student misses a mobile van visit, they can still access care at the school-based health center, including vaccines, physicals, dental and vision exams—ensuring they meet all health requirements.

JOHNSON: Tell us a little about the Healthy CPS initiative.

GOODMAN: Our Office of Student Health and Wellness developed it using the CDC's Whole School, Whole Community, Whole Child model. It’s a holistic approach to education that prioritizes health, wellness, and nutrition — factors that improve academic outcomes.

Healthy CPS gives schools tangible ways to meet over 50 health and wellness policies. For example, if a school struggles with integrating an extra 30 minutes of physical activity for K-8 students, we offer resources and strategies to help them comply.

JOHNSON: What would you like other states to know or take away from your story?

GOODMAN: Students are crucial members of our communities. We must invest in them. Aligning goals and initiatives to create safe environments for them makes sense. Local health departments should absolutely partner with schools to support student health and wellness. It benefits everyone.

JOHNSON: Next we turn to Dr. Alexandra Sontag, Director of School Nursing at the Chicago Department of Public Health.

SONTAG: My role is to provide clinical expertise and support at the intersection of public health and schools. I bring experience as a school nurse, a nurse practitioner, and from working in public health.

JOHNSON: Why do you think adolescent health is so important?

SONTAG: I love teenagers — they’re my favorite population. They’re not set in their ways and are hungry to learn. They want autonomy and are eager to make informed decisions. From a medical perspective, they’re enthusiastic and curious, which makes them a joy to work with.

JOHNSON: What do you think are the biggest challenges to providing great healthcare for youth?

SONTAG: I’m lucky to live in Illinois, which has progressive policies, especially for youth healthcare access. But the biggest challenge is awareness — many adolescents don’t know their rights. In Illinois, youth aged 12 and up can access limited services without parental consent, such as STI testing, mental health, and birth control. But they often don’t know this.

At CDPH, we train school nurses on this, teaching the history of school nursing and how it is deeply rooted in public health.

JOHNSON: What’s the goal of all this collaboration?

SONTAG: Local health departments educate the community about rights that come from state legislation. We work closely with the Illinois Department of Public Health on a range of topics, including immunizations. IDPH provides school-specific dashboards for immunization rates — very helpful tools.

They also certify our 33 school-based health centers, which tailor services to young people. Our partnership with IDPH helps amplify resources and connect youth to care.

JOHNSON: Tell us more about the Healthy CPS initiative goals.

SONTAG: Healthy CPS helps schools understand health-related policies at local, state, and federal levels. This includes things like food rules, sexual health education, and more. One example is the CPS policy requiring all schools serving grade 5 and up to make condoms available. CDPH supplies all the condoms to CPS and other schools that want to participate. These policies are backed by national best practices.

JOHNSON: What are your biggest takeaways about adolescent health?

SONTAG: Schools need people to show up consistently. If we place demands on schools without offering support, they’ll feel overwhelmed. Their primary job is education. Healthy students learn better, but we must decrease the burden on schools to make collaboration effective.

Public health professionals should acknowledge schools’ challenges and offer help. When you show up with resources and understanding, schools are more willing to engage.

JOHNSON: Sally Lemke, a School Health Nurse Consultant with the Illinois Department of Public Health, agrees.

SALLY LEMKE: Adolescence is critical. It’s when young people explore autonomy and make decisions that shape their future. Health systems can support them through targeted programming and adolescent-focused services.

JOHNSON: What are the biggest barriers to successful adolescent healthcare?

LEMKE: Barriers are complex. Cultural values and community norms differ. That’s where state-local partnerships are key. Structurally, adolescents may lack access to youth-centered care or may not know their rights. That’s a big hurdle.

JOHNSON: What strengths do the partners bring?

LEMKE: Local health departments bring data, delivery systems, and promotion tools. Schools have infrastructure — nurses, social workers, and trusted staff. School health centers complement those existing services and help fill care gaps.

JOHNSON: Illinois has school-based health centers. How do they help?

LEMKE: Illinois has 65 centers. Most are located in schools; a few are linked centers near schools. They provide comprehensive care: preventive, primary, sexual and reproductive, and often mental health. They work alongside school nurses and social workers, especially in areas with health disparities. Adolescents are more likely to seek care in school settings.

JOHNSON: How do you tailor services for diverse populations?

LEMKE: The School Health Center Code sets service requirements. Locally, schools may adapt how services are delivered. For instance, if a school doesn’t allow contraception onsite, the center must provide a referral process. All certified centers meet a core set of evidence-based standards.

JOHNSON: When do these collaborations work best?

LEMKE: Leadership buy-in and dedicated time are crucial. Shared priorities must be identified. Having champions helps, but sustainable systems matter more. Collaboration isn’t linear—you need to be adaptable to succeed.

JOHNSON: What is Illinois doing right that others could learn from?

LEMKE: We align with evidence-based adolescent care. We increase access to reproductive health and mental health services. These efforts reduce unintended pregnancies and support healthier futures.

JOHNSON: Here's Nikki Goodman again with final thoughts.

GOODMAN: When talking with public health departments, schools should highlight the policies they need to meet and ask for support. Public health departments have the resources and expertise. Schools have the space and the students. We should pool those resources and work together.

JOHNSON: Thank you for listening to Public Health Review. If you liked this episode, share it with colleagues or on social media. If you have comments or ideas, email us at pr@astho.org.

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For Public Health Review, I’m Summer Johnson. Be well.