Committee advances Child Health Equity Act to expand school-based services and data tracking

Councilwoman Felicia Porter, chair of the Baltimore City Council Public Health and Environment Committee, opened a committee hearing and said the panel would take testimony and consider Council Bill 25-0013, the Child Health Equity Act, a measure intended to expand access to comprehensive health services for Baltimore City students.

The Baltimore City Health Department’s Bureau of School Health described existing services and gaps. Francine Childs, acting deputy commissioner and assistant commissioner for the Bureau of School Health, said the department provides services to nearly 76,000 students through school health suites (in every school) and 13 school-based health centers (SBHCs). She said 4 SBHCs are operated by the Health Department, 8 by Baltimore Medical System and 1 by Johns Hopkins. Childs outlined services from emergency response and screenings to case management and EPSDT-level primary care in SBHCs.

Melina Turtle, director of the immunization program, told committee members that as of March 31 the City Schools compliance rate was 98.9 percent based on an enrollment of 76,292, with 843 students out of compliance. Turtle said those out of compliance are often on catch-up schedules, including students new to the city or country. The Health Department said it operates immunization clinics (two FTE nurses, clinics five days a week) and receives Vaccines for Children (VFC) supplies for SBHCs.

The department described school dental, vision and hearing activity: two health department dental clinics for residents age 6 and up and partnerships (Smile Maryland and Oral Health Impact Project) for in-school dental services with parental written consent; state-mandated hearing and vision screens (about 15,764 hearing and 17,729 vision screens annually); and the Vision for Baltimore program (about 16,000 screenings a year on a three-year rotation and roughly 2,200 students receiving glasses annually through partner programs).

Committee members pressed staff for additional data and operational detail. Chair Porter and Council members asked for a school-by-school breakdown of SBHC and school health suite utilization and a roster showing how many of the 843 students out of compliance used school-based services versus visiting external providers. Melina Turtle said she could provide the March 31 compliance numbers and that more detailed breakdowns could be requested from City Schools; Francine Childs and other Health Department staff agreed to supply additional reports at the committee’s request.

Members pressed about consent and confidentiality. Heather Lane, clinical director for Health Department SBHCs, explained that SBHC services require parental registration and consent for most services but that Maryland’s minor consent law allows students to receive family planning and certain sexual health services and mental health referrals without parental consent; staff contact parents for other visits and send visit reports home unless doing so would conflict with legal exceptions or pose risk to the child.

On staffing and record integration, the Health Department said it currently operates four SBHCs directly and is hiring nurse practitioners; the department reported two nurse practitioners on board, a third scheduled to start later in the month, and ongoing recruitment. The department confirmed it will integrate SBHC records into the Health Department’s OCHIN/EPIC electronic health record beginning with the new school year (target: August) and pledged to provide a status update after integration. Committee members requested details on staffing hires (FTE counts, vacancy rates) for fiscal year 2025.

Council members discussed the city’s MOU with Baltimore City Public Schools and the limits of local authority given state law. Councilman Torrance noted the long-standing MOU relationship and that state law already defines many school health obligations; county counsel and the Health Department confirmed the MOU’s service definitions are driven by state statute. Kathy Smith (Health Department legal counsel) said a renewed agreement would be signed imminently to spell out funding breakdowns and responsibilities. Torrance requested a committee meeting involving the administration, Health Department and City Schools to consider state-level options in 2026 that could change funding and structure.

Community partners and health system representatives testified in support of improving school-based services. David Castro, community school director at Lakeland Middle, described how in-school preventive services reach students who otherwise have limited access to care. Representatives from the University of Maryland Medical System, University of Maryland Medical Center and the University of Maryland School of Medicine described partnerships offering screenings, mental-health supports, career pipelines, and neighborhood-focused pediatric programs; the School of Medicine highlighted chronic disease burdens (high asthma and childhood obesity rates) and urged expanded, integrated services.

The committee voted to move Council Bill 25-0013 as amended to second reader; the motion passed and the bill will appear on the next full Council calendar. The Health Department and City Schools submitted agency reports and indicated they stand by them with amendments and follow-up information to be provided to the committee.

The committee recorded several official data and follow‑up requests: (1) school-by-school counts of students using SBHCs and school health suites; (2) a breakdown of the 843 students out of immunization compliance by site of care (school health suite, SBHC, or external provider); (3) a status update on SBHC integration into OCHIN/EPIC following planned onboarding; (4) written protocols and referral guidelines used after abnormal hearing and vision screenings; and (5) staffing and vacancy counts for school nurses and nurse practitioners for FY25.

Committee members indicated a follow-up hearing will focus on program design, partner integration and targets for expanding screening and chronic disease identification in schools.