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An Overview of the
School-Based Health Center Model
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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
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
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 child’s physician
or school nurse
Link to or serve as the child’s medical home if they
do not have one
Snapshot of SBHCs
Nationally, the first SBHCs were created in the
1970’s…today, we have 1700 SBHCs in 45 states
serving students in all grades
In WV, SBHCs were piloted in 14 schools in
1994…in 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
Yellow = new SBHC sites
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!
Benefits of SBHCs
Studies by John Hopkins University, Emory
University, Health Foundation of Greater
Cincinnati, and others show that SBHCs:
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Decrease absenteeism & tardiness
Reduce school discipline and behavior
problems
Save money by reducing the number of visits
to the ER for the wrong reasons
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
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
WV SBHCs: Extensions of Current
School Health Services
• Does not replace school personnel; augments
school health programs
• Brings the community’s resources to the school
• Addresses unique developmental needs of youth
• Serving children requires the expertise of all
health, education & social service providers
Part of Coordinated School Health
Addresses most of the 8 components:
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School Meals and Nutrition
Physical education
Health Services
Staff wellness
Counseling, psychology and mental health
Health education
School environment
Parent community partnerships
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
WV’s 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
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
“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
Planning: A collaborative effort
Identify key “stakeholders”:
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Primary care center (FQHC/RHC)
Private medical community
School administration and staff
Behavioral health center
Local health department
Hospitals
Family Resource Network
Four–Step Planning Method
1. Needs Assessment – is the need sufficient
to justify the intervention? If “yes” -2. Feasibility Study: Does the community
have the interest? Resources? If “yes” -3. Work Plan: Working committee outlines
key steps
4. Evaluation: Early and on-going
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 !!!
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!
WV Resources
WV School Health Technical Assistance and
Evaluation Center
Robert C. Byrd Center For Rural Health
Marshall University
Richard Crespo, PhD
Director
304-691-1193
[email protected]
Stephanie Montgomery
Data and Evaluation
540-776-7953
[email protected]
Linda Anderson, MPH
Coordinator
304-523-0043
[email protected]
Paula Fields, MSN, RN
Clinical Issues
304-846-9739
[email protected]
WV School-Based Health Assembly
www.wvsbha.org
Statewide membership organization working to
advance comprehensive health care in school settings
Eileen Barker
Co-coordinator
304-342-1330
[email protected]
Becky King
Co-coordinator
304-757-5280
[email protected]
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
Questions & Discussion