An Overview of the School-Based Health Center Model Presented for: Date: Presented by:

What is a SBHC? SBHCs are health clinics located in schools that provide preventive and primary care to students Services provided are determined by the community, but most often include: health education, treatment of acute illnesses, management of chronic illnesses, and mental health services such as grief counseling, bullying, and suicide prevention SBHCs require a signed parental consent form before students can be provided services

What is a SBHC? In WV, SBHCs are sponsored by community health centers (18) and hospitals (1) and receive funding from state, federal, private sources, in-kind donations and patient revenue WV SBHCs follow a set of standards for care, including parental consent for enrollment and treatment

What is a SBHC?  Most SBHCS consist of a waiting/reception area, lab area, exam room(s) and offices  Are typically staffed by a receptionist/data entry clerk, nurse, and a nurse practitioner or physician assistant with supervision/consultation from a physician  Work with, but do not replace, the child’s physician or school nurse  Link to or serve as the child’s medical home if they do not have one

Snapshot of SBHCs  Nationally, the first SBHCs were created in the 1970’s…today, we have 1700 SBHCs in 45 states serving students in all grades  In WV, SBHCs were piloted in 14 schools in 1994…in there were 43 SBHCs providing services to 56 schools in 22 counties  Interest and commitment continues to grow in WV and across the states

Yellow = new SBHC sites

Benefits of SBHCs  Provide health care to children who may not otherwise seek care  Provide children with easier access to care  Promote prevention and early intervention  Help children stay healthy  Give all children an equal chance to succeed in school!

Benefits of SBHCs Studies by John Hopkins University, Emory University, Health Foundation of Greater Cincinnati, and others show that SBHCs: Decrease absenteeism & tardiness Reduce school discipline and behavior problems Save money by reducing the number of visits to the ER for the wrong reasons

Principles of SBHCs  Respond to the community  Support the school  Promote collaborative relationships  Focus on the student  Advance health promotion  Provide leadership for adolescent and child health

Why SBHCs? 23% of WV public school children require regular and ongoing health care services during the school day 55,000 students have IEPs WV students have high rates of asthma, diabetes, and obesity New focus on school-wellness at the national and state levels

WV SBHCs: Extensions of Current School Health Services Does not replace school personnel; augments school health programs Brings the community’s resources to the school Addresses unique developmental needs of youth Serving children requires the expertise of all health, education & social service providers

Part of Coordinated School Health Addresses most of the 8 components: School Meals and Nutrition Physical education Health Services Staff wellness Counseling, psychology and mental health Health education School environment Parent community partnerships

Core Services Comprehensive physical exams Risk screenings : GAPs, Bright Futures Diagnosis & treatment of minor injuries and illnesses Management of chronic conditions Lab tests Immunization campaigns Classroom/community health promotion Behavioral health counseling

WV’s SBHC standards include Provider coverage at least three half-days per week 24 hour back up Parental consent Services provided to all students, regardless of ability to pay Compliance with all state, local, national regulations,laws, professional standards regarding health care services

Planning Look at the entire school system and county Consider not only where the greatest need for services is but also where there is the feasibility of success and sustainability Consider a “hub” model

“Hub” Model A full time SBHC located in a school with student population of at least 700 students that is fairly centrally located within the county Would serve students from entire county Part time services to other schools based on needs including: Immunization campaigns Well Child exams Oral health sealants/treatment

Planning: A collaborative effort Identify key “stakeholders”: -Primary care center (FQHC/RHC) -Private medical community -School administration and staff -Behavioral health center -Local health department -Hospitals -Family Resource Network

Four–Step Planning Method 1.Needs Assessment – is the need sufficient to justify the intervention? If “yes” -- 2.Feasibility Study: Does the community have the interest? Resources? If “yes” -- 3.Work Plan: Working committee outlines key steps 4.Evaluation: Early and on-going

Funding Usually a combination of public and private sources:  Local School  County School System  Businesses/Corporations  Local Health Care  Foundations  Federal and State Be Creative !!!

Lessons Learned  Think big – start small  Consider a county-wide SYSTEMS approach  Multi-agency planning is a challenge – remember to include all of your partners!  Establish trust  Respect different organizational cultures  Avoid turf issues  Remember the goal: Healthy Students!

WV Resources

WV School Health Technical Assistance and Evaluation Center Robert C. Byrd Center For Rural Health Marshall University Richard Crespo, PhD Director Linda Anderson, MPH Coordinator Stephanie Montgomery Data and Evaluation Paula Fields, MSN, RN Clinical Issues

WV School-Based Health Assembly Statewide membership organization working to advance comprehensive health care in school settings Eileen BarkerBecky KingCo-coordinator

National Resources National Assembly on School-Based Health Care: Center for Health and Health Care in Schools: Center for School Based Health, Bureau for Primary Health Care, HRSA:

Questions & Discussion