School-Based Health Centers (SBHCs) 101: Service Delivery Models

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School-Based Health Centers School-Based Health Centers (SBHCs) 101: (SBHCs) 101: Service Delivery Models Service Delivery Models

description

School-Based Health Centers (SBHCs) 101: Service Delivery Models. SBHC Service Delivery Models. Primary Care Only Model. NP/PA/MD 1-5 days/week Full or part-time (FT/PT) coverage No Mental Health/Substance Abuse Services. Primary Care-Mental Health Model. PT or FT coverage - PowerPoint PPT Presentation

Transcript of School-Based Health Centers (SBHCs) 101: Service Delivery Models

Page 1: School-Based Health Centers (SBHCs) 101: Service Delivery Models

School-Based Health CentersSchool-Based Health Centers(SBHCs) 101:(SBHCs) 101:

Service Delivery ModelsService Delivery Models

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SBHC Service SBHC Service Delivery Models Delivery Models

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Primary Care Only ModelPrimary Care Only Model

NP/PA/MD 1-5 days/weekNP/PA/MD 1-5 days/weekFull or part-time (FT/PT) coverageFull or part-time (FT/PT) coverageNo Mental Health/Substance Abuse No Mental Health/Substance Abuse

ServicesServices

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Primary Care-Mental Health ModelPrimary Care-Mental Health Model PT or FT coveragePT or FT coverage Full Range of Prevention/Early Full Range of Prevention/Early

Intervention Physical and Behavioral Intervention Physical and Behavioral Health Services (age and Health Services (age and developmentally appropriate, e.g. developmentally appropriate, e.g. reproductive health)reproductive health)

Diagnosis, Treatment and Management Diagnosis, Treatment and Management of Minor Acute/Chronic Illnesses of Minor Acute/Chronic Illnesses

Provision for after-hours careProvision for after-hours care

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Staffing for Primary Care-Mental Staffing for Primary Care-Mental Health ModelHealth Model

Medical provider (NP/PA/MD)Medical provider (NP/PA/MD)School nurse (if present)School nurse (if present)Mental Health provider (e.g.)Mental Health provider (e.g.)

– Clinical Social Worker,Clinical Social Worker,

– Psychologist/Psychiatrist,Psychologist/Psychiatrist,May include Substance Abuse May include Substance Abuse

Counselor if appropriateCounselor if appropriate

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Primary Care-Mental Health PLUS Primary Care-Mental Health PLUS ModelModel

FT coverage if possible FT coverage if possible Primary care and mental health plusPrimary care and mental health plus:: (one or more of the following)(one or more of the following)

– Dental ServicesDental Services– Reproductive Health Services that include Reproductive Health Services that include

contraception dispensing/prescribingcontraception dispensing/prescribing– Nutrition CounselingNutrition Counseling– On-site Substance Abuse TreatmentOn-site Substance Abuse Treatment

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Staffing for Primary Care-Mental Staffing for Primary Care-Mental Health PLUS ModelHealth PLUS Model

School NurseSchool Nurse Medical provider (NP/PA/MD)Medical provider (NP/PA/MD) Mental Health providerMental Health provider Dentist/Dental HygienistDentist/Dental Hygienist Addictions CounselorAddictions Counselor NutritionistNutritionist Health EducatorHealth Educator Social WorkerSocial Worker

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SBHC Staffing ModelsSBHC Staffing Models(N=1235)(N=1235)

Unknown4%

Primary Care-Mental Health

34%

Primary Care Only31%

Primary Care Mental Health

Plus31%

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Alternative ModelsAlternative ModelsServices and StaffingServices and Staffing

School-Linked Health CentersSchool-Linked Health Centers• Can mirror the service and staffing Can mirror the service and staffing

patterns of primary care only, patterns of primary care only, primary care-mental health, and primary primary care-mental health, and primary

care-mental health PLUS modelscare-mental health PLUS modelsMobile Health CentersMobile Health Centers

• Can mirror the service and staffing Can mirror the service and staffing patterns of primary care only, primary patterns of primary care only, primary care-mental health, and primary care-care-mental health, and primary care-mental health PLUS modelsmental health PLUS models

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What Services Do SBHCs What Services Do SBHCs Offer?Offer?

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Primary Care Services Provided by SBHCsPrimary Care Services Provided by SBHCs(N= 1176-1259)(N= 1176-1259)

0 10 20 30 40 50 60 70 80 90 100

Treatment of Acute Illness

Comprehensive Health Assessments

Screenings

Prescriptions for Medicines

Anticipatory Guidance

Asthma Treatment

Sports Physicals

Nutrition Counselling

Medications Administed in the Center

Treatment of Chronic Illness

Immunizations

Lab Tests

Standardized Behavioral Risk Assessment

Assessment of Psycholigical Development

Medications Dispensed to be Taken at Home

Care for Infants of Students

Dental Screenings/Diagnostics

Dental Preventive Care

Dental Comprehensive Care

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Reproductive Health Services Offered Reproductive Health Services Offered to Adolescents on Siteto Adolescents on Site (n= 897-931 )(n= 897-931 )

community typecommunity type0 10 20 30 40 50 60 70 80 90

Pregnancy testing

Abstinence Counseling

HIV AIDS Counseling

Counseling for Birth Control

STD Diagnosis and Treatment

Chlamydia Screening

Gyn Exams

Sexual Orientation Counseling

Urine Based Chlamydia Screening

Follow- up of Contraceptive Users

HIV testing

Pap Smears

Prenatal Care

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Contraception ProhibitionContraception Prohibition(N=853)(N=853)

0 10 20 30 40 50 60 70

YES70%

NO30%

Who Prohibits Dispensing Who Prohibits Dispensing Contraceptives in SBHCsContraceptives in SBHCs

OtherOther

Don’t knowDon’t know

State PolicyState Policy

School PolicySchool Policy

State LawState Law

Health CenterHealth Center

School DistrictSchool District

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Mental Health Services in SBHCs With (n=805) and Mental Health Services in SBHCs With (n=805) and Without (n=388) Mental Health Providers Without (n=388) Mental Health Providers

0 10 20 30 40 50 60 70 80 90 100

*Mental Health Diagnosis

*Grief and Loss Therapy

*Crisis Intervention

*Assessment

*Referrals

*Screening

*Skill-Building

*Conflict Res/Mediation

*Tobacco Use Counseling

*Brief Therapy

*Substance Use Counseling

*Case Management

*Psycho-education

*Long Term Therapy

*Medication Mngt/Admin With MH Staff

Without MH Provider

* P<.01* P<.01

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Examples of Commonly Raised Examples of Commonly Raised Concerns and IssuesConcerns 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

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National Tools and Resources for National Tools and Resources for Getting StartedGetting Started

NASBHC websiteNASBHC website www.nasbhc.org – Basics, Basics, – Training and Assistance, Training and Assistance, – Publications, and Publications, and – Members Only Sections Members Only Sections

National Association of Community National Association of Community Health Centers’ (NACHC) CD-Rom, Health Centers’ (NACHC) CD-Rom, How How to Start a Successful School-Based to Start a Successful School-Based Health CenterHealth Center $25 $25 www.nachc.org

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Questions and AnswersQuestions and Answers