1. Rush School Health Centers

2. Mission Statements  Rush University strives to provide the best health care for the individuals and diverse communities we serve through the integration of outstanding patient care, education, research and community partnerships. Rush School Health Center The Rush School Health Centers, in partnership with schools, families, and the community will:  Increase access to the very best care by providing school-based physical and mental health services to youth.  Provide culturally sensitive and age appropriate health education that promotes healthy lifestyle choices.  Engage youth in self-care and advocacy that empowers them to take responsibility for their own health and promote that of their families and communities.  Provide services that enable youth to attain the physical and emotional well-being and academic achievement necessary for them to maximize their potential as adults.

3. Background History Rush is a large academic medical system with a history spanning 175 years. The University was the fist medical school in the city and still has the reputation of being one of the premier hospital and health systems in Chicago. The Rush School Based Health Centers (SBHC) are comprised of 3 sites:  The Rush SBHC at Orr Academy, a traditional 4 year high school on Chicago’s west side, was the 2 nd SBHC to open in the state of Illinois in 1986.  The Rush SBHC at RTC Medical Preparatory High School, a selective high school for students who intend to pursue health careers.  The Rush SBHC at Simpson Academy, a school (grades 6-12) exclusively for pregnant and parenting girls. The former Chicago Public School Board of Education asked Rush to sponsor and staff the SBHC that was built in 2010 with CPS funds.

4. Community Partners Rush SBHCs Partner with:  Youth Service Project for the provision of mental health services at our Orr site.  The Ounce of Prevention for Doula services for pregnant girls (Simpson and Crane)  Options for Youth for subsequent pregnancy prevention (Orr) We receive funding from:  Illinois Department of Public Health  VNA Foundation for prenatal services  Polk Bros Foundation for mental health services  The Rush Women’s Board for supplies and medicines  Epic for support of our EMR  The Tisdahl Foundation for operating dollars

5. Program Overview The Rush SBHCs are Nurse Managed Health Centers (NMHC) that offer a comprehensive model of wellness that focuses not only on the physical care of students, but on education, resource linkage, asset building and emotional wellbeing. We provide a full-range of health services from prenatal care and well-baby visits to urgent care and mental health services.  Each SBHC is staffed with one NP, one CMA, and one front desk person. Two RNs float to provide additional clinical support, school outreach, and student clinical experience coordination.  We have a Social Worker who spends one day a week in 2 different SBHCs.  We also partner with an outside agency for the provision of mental health services 4 days a week in our third SBHC. About 100 Rush students spend time in the SBHCs annually in some capacity for clinical experience. This allows us to do a tremendous amount of outreach and teaching to our student patients.

6. Demographics Census Information : 75% African American 20% Hispanic 5% or less White % of Medicaid Eligibility : 90-95% eligible English Proficiency Rates : Nearly 100% Free/Reduced School Lunch Program participants : 90-95% participating Serving Grades 6-12

7. Schools Locations Rush Health Center at Crane Rush Health Center at Simpson Rush Health Center at Orr  2245 W. Jackson Blvd Room 110 Chicago IL 60612 773-534-7582  730 N. Pulaski Room 109 Chicago IL 60624 773-534-8924  1321 S. Paulina Chicago IL 60608 773-534-7202 Clinic Hours Monday – Thursday 9am – 3pm Friday 9am – 1pm

8. Services Provided  Primary Care wellness visits  Prenatal Care  Well Baby Visits  Immunizations  Acute Care  School Physicals  Sports Physicals  Laboratory  Care Coordination  Mental Health Counseling  Linkage to dental through CPS  Linkage to vision through CPS  Care of chronic conditions such as asthma and diabetes  Education programs: - Asthma - Reproductive Health - Immunization Completion - Mental health - Obesity Prevention

9. Patient Consent and Eligibility  Rush SBHCs are focused on serving students (0 – 20) and their children.  We are able to directly verify Medicaid coverage through the Medi and/or Ecare system that links directly to IL Dept. of HFS.  Our Patient Access Department verifies coverage during the pre- registration process as well.  Rush SBHCs obtains parental/guardian consent for all primary care, non-reproductive health care. We obtain minor consents for minor protected reproductive health services and up to 5 mental health visits. Patient Consent Forms

10. Staff  Physician and Medical Director: - Maria Brown, DO  Program Director: - Sally Lemke WHNP  Nurse Practioners: - Tanisha Winston, FNP - Gret Wood, FNP - Lauren Ellis, FNP  Social Worker: - Steve Gillenwater  Medical Assistants: - Charnelle Blair - Chrishon Parker - Latasha McClendon-Muhammed

11. Encounter Data Rush SBHCs are currently tracking the following patient encounter data:  Vaccine completion rates  School compliance information (Physical and Immunization completion)  BMIs and nutritional counseling  Asthma identification and treatment  Parenting teens and contraception use  Pregnancy related outcomes (birthweight, adequate prenatal care, GA at delivery…)  Mental health issue identification, treatment and follow up  Risk assessment rate completion  STI screening, identification, and treatment  Vision and dental referral  Anticipatory guidance for adolescent issues (reproductive health, STI prevention, pregnancy prevention, safety and violence, nutrition, depression/suicidality, oral health…)

12. Noted Accomplishments  2012: Clinical care programming for reproductive health featured as an AHRQ Innovation due to positive outcomes.  2012: International Care Challenge “Helping Hands” award winner  2013: Director Sally Lemke DNP, WHNP-BC awarded Rush Faculty Community Service award  2015: Poster presentation highlighting the clinical outcomes and increased access through SBHC efforts awarded the Rush Way award by the Rush Patient Safety and Quality Dept.  2015: our SBHC at Simpson was the first SBHC in Illinois to receive Title X funding for the provision of family planning services  All 3 of our SBHCs have achieved 100% benchmarking on IDPH auditing for the past 3 years.

13. Clinical Accomplishments  Significant reduction in subsequent pregnancy rates among parenting girls. Positive pregnancy tests rates for parenting girls at Simpson have fallen from 30% in 2011 to a current rate of 8%.  Lower than average preterm births among pregnancies with primary care management in SBHC. Less than 5% of pregnant teens whose pregnancies were cared for in the SBHCs delivered prematurely.  Reduced rates of Sexually Transmitted Infections. Rates of STIs at Simpson have been reduced by half since the health center opened. Rates at Crane and Orr have improved as well. All-school STI screens are conducted each year at Simpson and Orr in collaboration with the CDPH and CPS.  Improved identification and management of students with asthma: Identification of students with asthma has more than quadrupled in the past year alone.  100% graduation rate at Simpson Academy. Simpson Academy boasts a 100% graduation rate for the past 4 years with nearly 90% of 2014 graduates enrolled in an institution of higher education.

14. Clinical Accomplishments Significant increase in number of patient visits Significant increase in immunization rates

15. Clinical Accomplishments Significant increase in diagnosis of patients with mental health issues

16. Program Goals  This past year, a Lean Six Sigma project focused on improving the financial sustainability of the Rush SBHCs through improved productivity and increased billed charges.  Long term goal is to increase provider productivity by 30% within the next year.  Increase enrollment at all 3 SBHCs: Recent approval for Title X funding at our Simpson site will help us increase productivity at that site.  We are also working on the extension of our program and services to the community within these school districts.

17. Rush School Based Health Center is looking to contract with managed care providers as participating/contracted primary care facilities.