An Overview of the SchoolBased Health Center Model

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An Overview of the School-Based Health Center
Model

• Presented for
• Date
• Presented by

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What is a SBHC?

• SBHCs are health clinics located in schools that
  provide preventive and primary care to students
• Services provided are determined by the
  community, but most often include health
  education, treatment of acute illnesses,
  management of chronic illnesses, and mental
  health services such as grief counseling,
  bullying, and suicide prevention
• SBHCs require a signed parental consent form
  before students can be provided services

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What is a SBHC?

• In WV, SBHCs are sponsored by community health
  centers (18) and hospitals (1) and receive
  funding from state, federal, private sources,
  in-kind donations and patient revenue
• WV SBHCs follow a set of standards for care,
  including parental consent for enrollment and
  treatment

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What is a SBHC?

• Most SBHCS consist of a waiting/reception area,
  lab area, exam room(s) and offices
• Are typically staffed by a receptionist/data
  entry clerk, nurse, and a nurse practitioner or
  physician assistant with supervision/consultation
  from a physician
• Work with, but do not replace, the childs
  physician or school nurse
• Link to or serve as the childs medical home if
  they do not have one

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Snapshot of SBHCs

• Nationally, the first SBHCs were created in the
  1970stoday, we have 1700 SBHCs in 45 states
  serving students in all grades
• In WV, SBHCs were piloted in 14 schools in
  1994in 2005-06 there were 43 SBHCs providing
  services to 56 schools in 22 counties
• Interest and commitment continues to grow in WV
  and across the states

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Yellow new SBHC sites
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Benefits of SBHCs

• Provide health care to children who may not
  otherwise seek care
• Provide children with easier access to care
• Promote prevention and early intervention
• Help children stay healthy
• Give all children an equal chance to succeed in
  school!

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Benefits of SBHCs

• Studies by John Hopkins University, Emory
  University, Health Foundation of Greater
  Cincinnati, and others show that SBHCs
• Decrease absenteeism tardiness
• Reduce school discipline and behavior
• problems
• Save money by reducing the number of visits
• to the ER for the wrong reasons

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Principles of SBHCs

• Respond to the community
• Support the school
• Promote collaborative relationships
• Focus on the student
• Advance health promotion
• Provide leadership for adolescent and child health

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Why SBHCs?

• 23 of WV public school children require regular
  and ongoing health care services during the
  school day
• 55,000 students have IEPs
• WV students have high rates of asthma, diabetes,
  and obesity
• New focus on school-wellness at the national and
  state levels

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WV SBHCs Extensions of Current School Health
Services

• Does not replace school personnel augments
  school health programs
• Brings the communitys resources to the school
• Addresses unique developmental needs of youth
• Serving children requires the expertise of all
  health, education social service providers

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Part of Coordinated School Health

• Addresses most of the 8 components
• School Meals and Nutrition
• Physical education
• Health Services
• Staff wellness
• Counseling, psychology and mental health
• Health education
• School environment
• Parent community partnerships

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Core Services

• Comprehensive physical exams
• Risk screenings GAPs, Bright Futures
• Diagnosis treatment of minor injuries and
  illnesses
• Management of chronic conditions
• Lab tests
• Immunization campaigns
• Classroom/community health promotion
• Behavioral health counseling

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WVs SBHC standards include

• Provider coverage at least three half-days per
  week
• 24 hour back up
• Parental consent
• Services provided to all students, regardless of
  ability to pay
• Compliance with all state, local, national
  regulations,laws, professional standards
  regarding health care services

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Planning

• Look at the entire school system and county
• Consider not only where the greatest need for
  services is but also where there is the
  feasibility of success and sustainability
• Consider a hub model

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Hub Model

• A full time SBHC located in a school with student
  population of at least 700 students that is
  fairly centrally located within the county
• Would serve students from entire county
• Part time services to other schools based on
  needs including
• Immunization campaigns
• Well Child exams
• Oral health sealants/treatment

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Planning A collaborative effort

• Identify key stakeholders
• Primary care center (FQHC/RHC)
• Private medical community
• School administration and staff
• Behavioral health center
• Local health department
• Hospitals
• Family Resource Network

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FourStep Planning Method

• Needs Assessment is the need sufficient to
  justify the intervention? If yes --
• Feasibility Study Does the community have the
  interest? Resources? If yes --
• Work Plan Working committee outlines key steps
• Evaluation Early and on-going

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Funding

• Usually a combination of public and private
  sources
• Local School
• County School System
• Businesses/Corporations
• Local Health Care
• Foundations
• Federal and State
• Be Creative !!!

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Lessons Learned

• Think big start small
• Consider a county-wide SYSTEMS approach
• Multi-agency planning is a challenge remember
  to include all of your partners!
• Establish trust
• Respect different organizational cultures
• Avoid turf issues
• Remember the goal

• Healthy Students!

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WV Resources
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WV School Health Technical Assistance and
Evaluation CenterRobert C. Byrd Center For Rural
HealthMarshall University

• Richard Crespo, PhD
• Director
• 304-691-1193
• crespo_at_marshall.edu
• Linda Anderson, MPH
• Coordinator
• 304-523-0043
• landerson_at_marshall.edu

• Stephanie Montgomery
• Data and Evaluation
• 540-776-7953
• smontgom_at_marshall.edu
• Paula Fields, MSN, RN
• Clinical Issues
• 304-846-9739
• pfields4_at_yahoo.com

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WV School-Based Health Assembly

• www.wvsbha.org
• Statewide membership organization working to
• advance comprehensive health care
  in school settings
• Eileen Barker Becky King
• Co-coordinator Co-coordinator
• 304-342-1330 304-757-5280
• ewbarker_at_charter.net bk517_at_attglobal.net

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National Resources

• National Assembly on School-Based Health Care
  www.nasbhc.org
• Center for Health and Health Care in Schools
  www.healthinschools.org
• Center for School Based Health, Bureau for
  Primary Health Care, HRSA www.bphc.hrsa.gov

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Questions Discussion