School-Based Health Centers (SBHCs) 101: Service Delivery Models Service Delivery Models

2 SBHC Service Delivery Models

3 Primary Care Only Model NP/PA/MD 1-5 days/week NP/PA/MD 1-5 days/week Full or part-time (FT/PT) coverage Full or part-time (FT/PT) coverage No Mental Health/Substance Abuse Services No Mental Health/Substance Abuse Services

4 Primary Care-Mental Health Model PT or FT coverage PT or FT coverage Full Range of Prevention/Early Intervention Physical and Behavioral Health Services (age and developmentally appropriate, e.g. reproductive health) Full Range of Prevention/Early Intervention Physical and Behavioral Health Services (age and developmentally appropriate, e.g. reproductive health) Diagnosis, Treatment and Management of Minor Acute/Chronic Illnesses Diagnosis, Treatment and Management of Minor Acute/Chronic Illnesses Provision for after-hours care Provision for after-hours care

5 Staffing for Primary Care-Mental Health Model Medical provider (NP/PA/MD) Medical provider (NP/PA/MD) School nurse (if present) School nurse (if present) Mental Health provider (e.g.) Mental Health provider (e.g.) –Clinical Social Worker, –Psychologist/Psychiatrist, May include Substance Abuse Counselor if appropriate May include Substance Abuse Counselor if appropriate

6 Primary Care-Mental Health PLUS Model FT coverage if possible FT coverage if possible Primary care and mental health plus: Primary care and mental health plus: (one or more of the following) (one or more of the following) –Dental Services –Reproductive Health Services that include contraception dispensing/prescribing –Nutrition Counseling –On-site Substance Abuse Treatment

7 Staffing for Primary Care-Mental Health PLUS Model School Nurse School Nurse Medical provider (NP/PA/MD) Medical provider (NP/PA/MD) Mental Health provider Mental Health provider Dentist/Dental Hygienist Dentist/Dental Hygienist Addictions Counselor Addictions Counselor Nutritionist Nutritionist Health Educator Health Educator Social Worker Social Worker

8 SBHC Staffing Models (N=1235)

9 Alternative Models Services and Staffing School-Linked Health Centers School-Linked Health Centers Can mirror the service and staffing patterns of primary care only,Can mirror the service and staffing patterns of primary care only, primary care-mental health, and primary care-mental health PLUS models primary care-mental health, and primary care-mental health PLUS models Mobile Health Centers Mobile Health Centers Can mirror the service and staffing patterns of primary care only, primary care-mental health, and primary care- mental health PLUS modelsCan mirror the service and staffing patterns of primary care only, primary care-mental health, and primary care- mental health PLUS models

10 What Services Do SBHCs Offer?

11 Primary Care Services Provided by SBHCs (N= )

12 Reproductive Health Services Offered to Adolescents on Site (n= ) community type

13 Contraception Prohibition (N=853) Who Prohibits Dispensing Contraceptives in SBHCs Other Don’t know State Policy School Policy State Law Health Center School District

14 Mental Health Services in SBHCs With (n=805) and Without (n=388) Mental Health Providers * P<.01 * P<.01

Examples of Commonly Raised Concerns and Issues The following are issues that typically arise when discussing SBHCs and being prepared to answer adequately is the best strategy. –Reproductive Health –Parental Consent –Cost –Why in a school setting – resources concern

16 National Tools and Resources for Getting Started NASBHC website NASBHC website –Basics, –Training and Assistance, –Publications, and –Members Only Sections National Association of Community Health Centers’ (NACHC) CD-Rom, How to Start a Successful School-Based Health Center $25 National Association of Community Health Centers’ (NACHC) CD-Rom, How to Start a Successful School-Based Health Center $25

17 Questions and Answers