1 / 18

John Schlitt National Assembly on School-Based Health Care

John Schlitt National Assembly on School-Based Health Care. School Health in Era of Health Care Reform. School Health: A Force. 74,000 school nurses 14,000 SWers 99,000 counselors 30,000 psychologists 2,200 SBHCs Unknown #s physicians, mental health and substance abuse specialists.

brendan-austin
Download Presentation

John Schlitt National Assembly on School-Based Health Care

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. John SchlittNational Assembly on School-Based Health Care School Health in Era of Health Care Reform

  2. School Health: A Force • 74,000 school nurses • 14,000 SWers • 99,000 counselors • 30,000 psychologists • 2,200 SBHCs • Unknown #s physicians, mental health and substance abuse specialists Source: Lear JG. Health at school: a hidden health care system emerges from the shadows. Health Aff (Millwood) 2007;26:409–19.

  3. School Health: A Force • Surveillance data • Extensive child development knowledge • Cross-disciplinary competencies • System infrastructure

  4. Shifts in Health Care

  5. Redesign Experiments in State Medicaid Programs • Health Homes • Pay for Performance • Integrated Care Models

  6. Health Homes • Primary care redesign • Building block for most reforms • Patient-centeredness at the core • Care coordination/management • Enhanced access (24/7) • Electronic linkages to health neighborhood • Quality improvement

  7. Pay for Performance (P4P) • Provider incentives for tracking quality measures, adopting new roles/behaviors • Enhanced rates/fees • Augmented payments/bonus • Behavioral health????

  8. Integrated Care Models • Accountable Care Organizations • “vertical integration” • Provider-driven, not insurance-driven • Emphasis on accountability = performance • Shared savings as incentive to drive down costs, make smarter investments in front end

  9. Realigning Health with Care • Product: broaden concept to ameliorate effects of nonclinical determinants • Inadequate food, housing, safety • Place: beyond medical complex  neighborhoods • Provider: nontraditional team members • Community outreach workers, heath educators, coaches, resource coordination

  10. Integrated Health Neighborhood • Primary Care • Behavioral Health • Asthma • Depression • School failure • Substance use • Teen pregnancy • Obesity • Learning Supports • Public Health

  11. Schools in the Health Neighborhood • Point of entry to primary prevention, risk reduction and care management system • Inter-disciplinary team: whole child approach that unifies mind and body • Screen/address behavioral health needs often undetected and unmet by mainstream PC system • Meets young people where they are (literally) in terms of problems, pain, social and developmental challenges • Unprecedented opportunity for population health

  12. SBHC Lessons for Reformers • Co-location > collaboration > integration • Structural issues related to integration - space, data, scheduling – are not insurmountable • Breaks down hierarchy; maximizes skill sets • Minimizes stigma by normalizing within school setting

  13. New Competencies for School Health • Think “SYSTEMS.” • MEASURE quality. • Get WIRED. • Get COUNTED (and paid). • Know your VALUE. • Get to the TABLE. • Practice INTER-DISCIPLINARILY.

  14. New Competencies for School Health • Think “SYSTEMS.” • MEASURE quality. • Get WIRED. • Get COUNTED (and paid). • Know your VALUE. • Get to the TABLE. • Practice INTER-DISCIPLINARILY.

  15. General Reform Resources • National Academy of State Health Policy • Health Affairs • Kaiser Family Health Foundation

  16. NASBHC = School-Based Health Alliance

  17. My contact info: jschlitt@nasbhc.orgwww.nasbhc.org

More Related