The funding situation for student-based wellness centers is dire, said Marihelen Barrett, executive director of the alliance.

“The high schools have been level-funded for years,” she said. “And so that’s actually eaten into the buying power with inflation. They’re really tight on funding.”

There are more than 50 school-based health centers operated by many of the state’s health systems, according to the alliance. High schools automatically get state-funded wellness centers under current law. Some of those also support the middle schools in their districts.

While two elementary schools, Baltz and Frederick Douglass elementary schools, got $340,000 in the fiscal year 2020 state budget, advocates said more recent elementary school centers have received no legislative financial support or operational dollars.

Along with stagnant state funding of high school clinics, dozens of state lawmakers representing New Castle County say they have heard from school nurses over the past several months that the ChristianaCare Health System cut services at several New Castle County schools without first notifying the Division of Public Health and the school districts.

ChristianaCare operates school-based health clinics in 19 high schools and seven elementary schools in New Castle County and the city of Wilmington. There’s seven school districts in the county. The state Department of Education website shows there’s 31 high-needs schools in Delaware, 28 of them in New Castle County.

A spokesperson for ChristianaCare said some of the high school wellness centers only have medical providers on-site three days a week for the 2023-2024 school year. The nonprofit health system said it made the staffing changes based on previous enrollment and utilization numbers.

In a statement, the spokesperson said medical providers are onsite at the elementary schools every day of the week. While behavioral health therapists are also onsite everyday at each wellness clinic it operates, community health workers and nutritionists have to rotate among schools. It noted medical assistants and school district coordinators are also on its teams.

A June 2023 letter to ChristianaCare’s Erin Booker and signed by more than two dozen lawmakers said that school nurses had expressed concern that the lack of these critical services will have a drastic impact on families and students. The letter obtained by WHYY News was signed by several lawmakers of both political parties and copied to the secretary of the Delaware Department of Education and New Castle County’s seven school districts, including Christina, Red Clay, Colonial and Brandywine.

However a spokesperson for the Division of Public Health disputes that ChristianaCare’s staffing changes have affected services.

“We [the Department of Health and Social Services/Division of Public Health] do not mandate the staffing,” Media Relations Coordinator Laura Matusheski said. “They are required to deliver the services and have been doing so with zero impact on the students.”

Barrett said she continues to hear about the service cuts in high school school-based health centers operated by ChristianaCare. She said these kinds of cuts mean the centers don’t function effectively for students. Her group is asking lawmakers to add $1.5 million, a 20% increase for high school centers.

“One of the most important services that the school-based health centers provide is mental health support and help with trauma and on focus on trauma-informed care,” she said. “The other major focus is on health equity, trying to make sure that underserved kids that are experiencing social determinants of health concerns, such as food insecurity and homelessness, make sure that those needs are met. So it’s more than medical care, it’s more than just coming to get your earache taken care of. And that’s why it’s so important that it be a multidisciplinary service.”