Insert SHC/Sponsoring Agency Name and Logo
Mission Insert sponsoring agency mission statement SHC mission statement/goals/values ………………
Background History Insert a brief blurb about the history of your agency’s SHCs: How did they come about? Who were the key partners? What was the community response? Other notable early experiences?
Community Partners We partner with: Insert list of partners We receive funding from: Illinois Department of Public Health …
Program Overview Insert a brief blurb about your program goals and model. What are you focused on achieving? What are your core programs? How do you staff your sites?
Demographics Grades/Ages Served: Insert grades or ages served Census Information : Insert racial demographics % of Medicaid Eligibility : Insert Medicaid eligibility rate English Proficiency Rates : Insert English proficiency rates / languages spoken Free/Reduced School Lunch Program participants : Insert rate of participation in free/reduced school lunch program
Locations Insert site list with contact information for each and photos if available
Services Provided Insert list of all services provided (i.e. medical, behavioral health, nutrition, health education, etc.)
Patient Consent and Eligibility Briefly describe your processes for obtaining patient consent and verifying eligibility.
Staff Insert list of your staff and photos if available
Encounter Data Insert list of encounter data you currently track
Noted Accomplishments Insert list of accomplishments and awards (e.g. from your agency, from external partners, from school, from accrediting bodies, from government entities, or foundations).
Clinical Accomplishments Insert list of major accomplishments you’ve identified through clinical data monitoring (i.e. chronic disease management, immunizations, well-child visits, risk assessments, etc.)
Clinical Accomplishments Insert tables or graphs to illustrate the previous list
The Future Moving forward, what are you hoping to accomplish.
Insert logo and key contact information