1. MENTAL HEALTH SERVICES IN SCHOOL HEALTH CENTERS IN NORTH CAROLINA

2. Brief Overview of State-Funded School Health Centers in North Carolina  Managed by School Health Unit of NC Division of Public Health  Centers are partially supported by state funds  28 School Health Centers in 15 counties are included in NC Division of Public Health’s school health center program  25 centers are school-based (most in middle and high schools) and 3 are school-linked  All have community-based advisory councils and strong collaborative support from community partners  Consultation/TA provided by state multi-disciplinary team

3. Types of School Health Centers Comprehensive model –Preventive –Medical –Nutrition –Mental/behavioral health –Health education

4. Types of School Health Centers Alternate Model –Offers Basic Health Services* and at least one of the following services: Preventive Medical Nutrition Mental Health *Includes health risk screening and referral for medical and mental/behavioral risks

5. School Health Center Sponsors Local Health Departments Hospitals Federally funded Community Health Centers 501 c 3 organizations

6. Benefits of Integrating Health and Mental Health Care in School Setting Holistic approach to adolescent health— screening, assessment, treatment and /or referral for health and mental health issues Non-threatening setting for addressing mental health concerns On-site multi-disciplinary consultation available

7. Framework for Mental/Behavioral Health in School Health Centers NC Quality Assurance Standards –Scope of Services –Provider Qualifications –Documentation Requirements –Content areas for policies/procedures

8. Framework for Mental/Behavioral Health Services Mental/Behavioral Health Performance Measures –ADD/ADHD –Inappropriate, violent or aggressive behavior –Social skills/relationships –Depression and/or anxiety –Tobacco –Alcohol/drugs

9. Mental/Behavioral Health Scope of Services  Prevention  Psychosocial Screening  Anticipatory Guidance  Intervention/Treatment (Basic)  Case Management  Problem Solving/Supportive Counseling  Situational Crisis Intervention  Consultation to school and school based personnel  Referral/follow-up

10. Behavioral / Mental Health Scope of Services  Intervention / Treatment (Advanced)  Crisis Intervention Involving Serious Mental/Emotional Issues  Short-Term Individual Psychotherapy  Short-Term Group Psychotherapy  Optional Services  Psycho-educational Groups  Psychological Testing  Substance Abuse Treatment

11. Mental Health Providers in School Health Centers Provider qualifications for each level of service are specified in Standards Must meet Medicaid and Health Choice requirements in order to bill Amount of mental health provider time varies across centers from 4 hours per week to 72 hours per week

12. Mental Health Providers in School Health Centers May Be Employed by center’s sponsor Contractual (individual provider or private mental health agency) In-kind contribution

13. Continuous Quality Improvement in School Health Centers NC Quality Assurance Standards Mental Health Performance Measures Chart Review Center Multi-disciplinary Team Meetings Bi-Annual Reports to State Consultation/Technical Assistance from State Credentialing/Re-credentialing

14. Technical Assistance for School Health Center Behavioral/Mental Health Providers  Clinical Issues  CQI Process  Credentialing  Coding / Billing  Policies/Procedures  Orientation of New Staff  Information about Resources  Facilitation of Mental Health Work Group

15. Questions/Information Contact: Beverly Hester Beverly.hester@ncmail.netBeverly.hester@ncmail.net or 919-707-5604 Or Dan Garson-Angert Daniel.garson.angert@ncmail.netDaniel.garson.angert@ncmail.net or 919-707-5666