1. School Health Centers Putting Care Where the Kids Are
Samantha Blackburn, RN, MSN
Technical Assistance Director
California School Health Centers Association

2. 183 School Health Centers in CA
Alameda = 17
Contra Costa = 8
Del Norte = 1
Fresno = 5
Los Angeles = 61
Marin = 2
Orange = 5
Riverside = 3
Sacramento = 4
San Bernardino = 6
San Diego = 13
San Francisco = 17
San Joaquin = 8
San Mateo = 2
Santa Barbara = 1
Santa Clara = 8
Santa Cruz = 8
Shasta = 1
Solano = 2
Sonoma = 2
Stanislaus = 5
Tulare = 1
Tuolumne = 1
Ventura = 1
183 School Health Centers in CA

3. School Health Center Models
School-based health centers (on school campus)
Wellness centers (focus on mental health, health promotion)
Mobile vans
School-linked health centers
Student centers (may include after school, employment, college readiness, etc)

4. Grade Levels Served 183 SBHCs right now: 82 high schools
25 middle schools
60 elementary schools
remainder school-linked, or serving multiple schools

5. What services are provided?
% Centers
Medical Services
85%
Health Education
61%
Mental Health Services
59%
Reproductive Health - Screening and Education
Reproductive Health - Clinical Care
47%
Nutrition and Fitness Programs
36%
Dental Services - Prevention
30%
Dental Services - Treatment
14%
Youth Engagement Programs
National Assembly on School-Based Health Care, Census

6. Service Design Components Vary by SBHC
Location
Services
Staffing
Hours of operation
Community, partner engagement
Use to wrap-up your section, transition to Robert on district’s perspective

7. Who runs school health centers?
Federally Qualified Health Centers and other community health centers (1/2 ~ 90)
School districts (1/3 ~ 60)
County health departments (10)
Hospitals (8)
Mental health providers (7)
Community-based organizations (5)

8. How are school health centers financed?
Space and utilities are typically contributed by the school
Third-party reimbursement
Child Health and Disability Program
Family PACT
Medi-Cal
Healthy Families
Public and private grants
No financial support from the state

9. Why is sustainability an issue?
School health centers serve all students at a school even if they are:
Uninsured
Enrolled in a managed care plan that will not reimburse the school health center.
Reimbursement rates do not cover actual costs.
A significant portion of staff time is spent conducting education, outreach and case management which is not generally reimbursable.

10. School health centers extend health care beyond the walls of the exam room and provide a level of comprehensive service that pediatricians can rarely provide.
Manual Arts High School, Los Angeles, CA

11. Benefits of School-Based Immunization Delivery
Kids are there
Best turnout at school registration, family events
Follow-up Iz delivery easier for series
Schools are motivated: student Iz status tied to school, per-pupil funding (ADA)
SBHCs offer excellent facilities, follow-up, and case management
School districts know student Iz needs but don’t have time or resources to deliver Iz

12. School Immunization Recommendations
Partner with SBHCs
Unless they get vaccine and admin fee for all, SBHCs often deliver Iz to active patients only, so need support for community Iz campaigns
When there is no SBHC
Few school nurses have time/resources to administer, so allocate funding to staff Iz clinics at schools, or partner with another provider (CHC?)
Vaccine storage/handling
SBHC will have appropriate storage, regular school WILL NOT, so bring storage if no SBHC (coolers)

13. Considerations Information/education Immunization history
Youth-friendly materials best, multiple languages required, written and verbal (bilingual staff)
Immunization history
Safest if students/families to bring Iz record, SBHCs will have limited records (only for active patients)
Recordkeeping
School nurses/designee (e.g., secretary) in charge of school Iz records, reviewed at enrollment
Share student Iz record with school, even if Iz delivered by off-site provider
Bring additional Iz cards/forms

14. More Considerations Contraindications Adverse events
Don’t assume female students not pregnant, don’t ask in front of parent/guardian
Most youth don’t know allergy history
Adverse events
If no SBHC, provide clear guidance to students & families on who to call/where to go, otherwise school inundated with “advice calls” they can’t handle
What’s your experience? Partnerships and strategies that worked?

15. CSHC Resources Join CSHC for member benefits!
Trainings and technical assistance
Tools and Resources:
HIPAA or FERPA? A Primer on School Health Information Sharing in California
Guidelines for California’s School Health Centers
Third Party Billing: A Manual for California’s School Health Centers
Sam

16. Thank you! To contact us:
Samantha Blackburn
Technical Assistance Director
California School Health Centers Association