1. Rockingham County Student Health Centers Cathy DeMason, RN BSN Director, Rockingham County Student Health Centers Improving the health and school performance of our students

2. About Rockingham County A Tier One rural county-economically- distressed Shortage of primary care providers Almost forty percent of residents live with incomes below 200% of the Federal Poverty Level The child poverty rate has increased from 23% in 2007 to 28% in 2012

3. Student Health Centers’ History Morehead Memorial Hospital identified a need to increase access to care for adolescents Community partners came together Conducted a needs assessment Defined services based on needs assessment Opened in the fall of 1994 in each of the 4 high schools in Rockingham County

4. Community Partners Develop goals and objectives Understand each others roles in the process Foster cooperation and collaboration Important to share information and resources Conduct the needs assessment

5. RCSHC’s Community Partners Annie Penn Hospital Morehead Memorial Hospital Rockingham County Schools Rockingham County Department of Public Health Rockingham Pregnancy Care Center

6. Purpose of the Needs Assessment Important step in order to determine the current status of health for your population Gather data from a wide array of sources- surveys, focus groups, public forums Determine your community's strengths, weaknesses, gaps and needs Use the needs assessment to garner both local support and funder support Analyze data to determine next steps

7. Mission Statement Improving the health and school performance of Rockingham County students by providing comprehensive health care through education, prevention, treatment, and referral

8. Why is a SBHC Needed? Close gaps in adolescent health care Provide care for uninsured & underinsured Teens feel ignored by traditional health care systems Eliminate the transportation barrier to obtaining health care 1 in 5 youth has at least one serious health problem

9. Goals Increase access to care Gather data on health status of teens Reduce behaviors that pose health risks Improve mental health status

10. Increased Access to Care Parental consent required 85% of students have parental consent 72% of students that used the health centers in 2013-2014 reported missing less school

11. Services Provided Diagnosis & treatment of minor injuries & illnesses Immunizations Simple lab tests Social work assistance Abuse/violence interventions & referrals Dental screens & referrals Physical exams

12. Services Provided Vision & hearing screens OTC & prescription medications Mental health assessments, counseling & referrals Nutrition counseling Health education programs & support groups Sports physicals STI testing, pregnancy testing and prenatal care referral

13. Services Provided Multidisciplinary team Embedded in school system-work closely with School Nurses, school staff and SHAC Provide an integrated system of care Use Evidence-based tools and methods

14. Staffing Nurse Practitioner, Physician Assistant or RN on site daily LCSW-20 hours each week Registered Dietitian- one-two days/month Social Worker- one day a week Health Educator- one day every other week Pregnancy/Parenting Educator- one-two days/month Medical Clerk/Secretary on site daily

15. Evidence-based Screening Tool Rapid Assessment for Adolescent Preventive Services (RAAPS) is a web-based risk assessment Initiated this program in January 2013 Replaced our paper and pencil risk assessment The majority of students prefer the on-line format Improved data collection-data from individual risk assessments automatically entered into data base allowing for easy retrieval Students receive educational material targeted to their specific risks

16. Programs to Target Risky Behaviors Parent/Teen Education on Cyber Safety Texting & Driving Video Bullying and Sexting Video Buckle up campaign Health bulletin boards Videos & Brochures Promote Abstinence- Baby Think it Over Dolls, Empathy Belly

18. Yearly Data Gathered to assess current health status of adolescents Data gathered from: parent & student surveys, Parent Strength and Difficulties Questionnaire, utilization of services, & RAAPS Used to track health risk behaviors Used to provide educational programs Measures the impact of what we are doing

19. Improved Mental Health- Daily Crisis Intervention on Site Surveys have documented decreases in: attempted suicides the number of students considering suicide dating abuse depression and/or stress

20. Sustainability Important to diversify funding Critical to continue to maintain and build new partnerships Prevent duplicating services and programs-share resources with other agencies Evaluation component Update strategic plan on a regular basis Communicate, collaborate and cooperate

21. Foundations Federal Public Grants Local Funding Community Partners State Public Grants NC Health Choice Medicaid Private insurance Patient fees NC offers competitive grants each year that SBHC’s can apply for, currently receiving Past recipient of HRSA grant Funding Sources Patient revenue Reidsville Area Foundation Kate B. Reynolds Charitable Trust, Duke Endowment March of Dimes Morehead Memorial Hospital, Annie Penn Hospital, Rockingham County Schools all provide $ and in kind support United Way of Rockingham County Agency Donations and fundraisers Other sources of in kind support Rockingham County Health Department, Rockingham County Pregnancy Care Center

22. Advisory Board Parents Students Clergy Principals School board member, teachers & other school personnel Annie Penn Hospital Morehead Memorial Hospital Physicians Representatives from the health department & social services Community and business representatives

23. Community Bene fits Attend to unmet health needs Easy access to health care Screen to prevent & treat diseases Provide safe place for teens to talk about troubling issues Compliment existing health care system

24. Community Benefits Represent wise investments: Help to keep teens out of the hospital and ER Increase attendance-keep teens in school Reduce parental work absences Detect illness early Manage chronic diseases Linking health care with schools boosts academic success

25. Investing in our students now will benefit our community far into the future

26. Questions ?