Transcript Preventive Services Improvement Initiative

School-Based Health Centers
(SBHCs) 101:
Service Delivery Models
SBHC Service
Delivery Models
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Primary Care Only Model
NP/PA/MD 1-5 days/week
 Full or part-time (FT/PT) coverage
 No Mental Health/Substance Abuse
Services

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Primary Care-Mental Health Model
PT or FT coverage
 Full Range of Prevention/Early
Intervention Physical and Behavioral
Health Services (age and
developmentally appropriate, e.g.
reproductive health)
 Diagnosis, Treatment and
Management of Minor Acute/Chronic
Illnesses
 Provision for after-hours care

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Staffing for Primary Care-Mental
Health Model
Medical provider (NP/PA/MD)
 School nurse (if present)
 Mental Health provider (e.g.)
– Clinical Social Worker,
– Psychologist/Psychiatrist,
 May include Substance Abuse
Counselor if appropriate

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Primary Care-Mental Health PLUS
Model
FT coverage if possible
 Primary care and mental health plus:
(one or more of the following)

– Dental Services
– Reproductive Health Services that include
contraception dispensing/prescribing
– Nutrition Counseling
– On-site Substance Abuse Treatment
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Staffing for Primary Care-Mental
Health PLUS Model
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School Nurse
Medical provider (NP/PA/MD)
Mental Health provider
Dentist/Dental Hygienist
Addictions Counselor
Nutritionist
Health Educator
Social Worker
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SBHC Staffing Models
(N=1235)
Primary Care
Mental Health
Plus
31%
Unknown
4%
Primary Care
Only
31%
Primary CareMental Health
34%
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Alternative Models
Services and Staffing

School-Linked Health Centers
• Can mirror the service and staffing
patterns of primary care only,
primary care-mental health, and primary
care-mental health PLUS models

Mobile Health Centers
• Can mirror the service and staffing
patterns of primary care only, primary
care-mental health, and primary caremental health PLUS models
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What Services Do SBHCs
Offer?
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Primary Care Services Provided by SBHCs
(N= 1176-1259)
Dental Comprehensive Care
Dental Preventive Care
Dental Screenings/Diagnostics
Care for Infants of Students
Medications Dispensed to be Taken at Home
Assessment of Psycholigical Development
Standardized Behavioral Risk Assessment
Lab Tests
Immunizations
Treatment of Chronic Illness
Medications Administed in the Center
Nutrition Counselling
Sports Physicals
Asthma Treatment
Anticipatory Guidance
Prescriptions for Medicines
Screenings
Comprehensive Health Assessments
Treatment of Acute Illness
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0
10
20
30
40
50
60
70
80
90
100
Reproductive Health Services Offered
to Adolescents on Site (n= 897-931 )
Prenatal Care
Pap Smears
HIV testing
Follow- up of Contraceptive Users
Urine Based Chlamydia Screening
Sexual Orientation Counseling
Gyn Exams
Chlamydia Screening
STD Diagnosis and Treatment
Counseling for Birth Control
HIV AIDS Counseling
Abstinence Counseling
community type
Pregnancy testing
0
10
20
30
40
50
60
70
80
90
12
Contraception Prohibition
(N=853)
NO
30%
YES
70%
Other
Don’t know
Who Prohibits Dispensing
Contraceptives in SBHCs
State Policy
School Policy
State Law
Health Center
School District
0
10
20
30
40
50
60
70
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Mental Health Services in SBHCs With (n=805) and
Without (n=388) Mental Health Providers
*Medication Mngt/Admin
With MH Staff
*Long Term Therapy
Without MH Provider
*Psycho-education
*Case Management
*Substance Use Counseling
*Brief Therapy
*Tobacco Use Counseling
*Conflict Res/Mediation
*Skill-Building
*Screening
*Referrals
*Assessment
*Crisis Intervention
*Grief and Loss Therapy
*Mental Health Diagnosis
0
* P<.01
10
20
30
40
50
60
70
80
90
100
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Examples of Commonly Raised
Concerns and Issues
The following are issues that typically
arise when discussing SBHCs and
being prepared to answer adequately
is the best strategy.
– Reproductive Health
– Parental Consent
– Cost
– Why in a school setting – resources
concern
National Tools and Resources for
Getting Started

NASBHC website www.nasbhc.org
– Basics,
– Training and Assistance,
– Publications, and
– Members Only Sections

National Association of Community
Health Centers’ (NACHC) CD-Rom, How
to Start a Successful School-Based
Health Center $25 www.nachc.org
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Questions and Answers
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