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Nuts and Bolts of Oregon School-Based Health Centers

Janet Matthews, MS, FNP, WHCNP School-Based Health Center Program Manager Adolescent Health Section Office of Family Health Oregon State Public Health Division, DHS. Nuts and Bolts of Oregon School-Based Health Centers. Aisha Krebs School-Based Health Center Program Coordinator

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Nuts and Bolts of Oregon School-Based Health Centers

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  1. Janet Matthews, MS, FNP, WHCNP School-Based Health Center Program Manager Adolescent Health Section Office of Family Health Oregon State Public Health Division, DHS Nuts and Bolts ofOregon School-Based Health Centers Aisha Krebs School-Based Health Center Program Coordinator Columbia Health District- Public Health Authority

  2. SBHCs provide accessible health care to youth • Health care access for youth • Supports youth being in class • Prevention messages delivered

  3. ASchool Based Health Center…. • Delivers a core set of primary health care services (physical, mental, preventive) • To children and youth in an identifiable school space • During regular scheduled times • By qualified health professionals • In a collaborative relationship with the local educational and healthcare community

  4. SBHC Addresses . . . • Barriers to access • Health care provider shortage • Underserved populations • High proportions of high risk youth

  5. SCHOOL NURSE Employed by School Manages student immunizations program Coordinates screenings Chronic SH case mgmnt Manage chronic medication delivery during school Oversees SH programs FERPA regulated SBHC Employed by Medical Sponsor Administers immunizations Conducts screenings, PEs Acute care of both acute and chronic needs Administer and prescribe medications Counseling, prevention and wellness promotion HIPPA regulated School Nurse vs. SBHC

  6. 2007: 45 Centers in 19 Counties 28 High Schools 5 Middle Schools 9 Elementary Schools 3 Combined Grade Schools 2006-2007 Oregon SBHCs served: 20,831 clients 69,034 visits Statewide

  7. OREGON SCHOOL-BASED HEALTH CENTERS 2008 • MULTNOMAH COUNTY • Binnsmead MS Jefferson HS Marshall HS • Cleveland HS Lane MS Parkrose HS • George MS Lincoln Park ES Portsmouth MS • Grant HS Madison HS Roosevelt HS COLUMBIA COUNTY Lewis & Clark ES *Rainier *St. Helens HS *Vernonia WASHINGTON COUNTY Merlo Station HS *Forest Grove *Tigard HS UMATILLA COUNTY Pendleton HS Sunridge MS CLACKAMAS COUNTY Oregon City HS *Canby HS *New Urban HS WASCO COUNTY *The Dalles Wahtonka HS YAMHILL COUNTY Willamina HS Clatsop Hood River UNION COUNTY La Grande HS MARION COUNTY Hoover ES Wallowa Tillamook Morrow Sherman BAKER COUNTY Baker HS LINCOLN COUNTY Newport HS Taft HS Toledo HS Waldport HS Gilliam POLK COUNTY *Falls City GRANT COUNTY *TBD Linn BENTON COUNTY Lincoln ES Monroe ES/MS Crook WHEELER COUNTY Mitchell K-12 LANE COUNTY North Eugene HS Sheldon HS South Eugene HS Springfield HS Winston Churchill HS Harney Malheur COOS COUNTY Marshfield HS Counties with Certified SBHCs Counties with Certified SBHCs and Planning Phase I Sites New Counties with Planning Phase I Sites Lake DOUGLAS COUNTY Roseburg HS *Douglas HS CURRY COUNTY *Brookings-Harbor *Indicates location of Planning Site **Indicates location of Advanced Planning Site KLAMATH COUNTY *Gilchrist School JOSEPHINE COUNTY Illinois Valley HS Lorna Byrne MS *Evergreen ES JACKSON COUNTY Ashland HS **Jewett ES *Butte Falls/Prospect Oak Grove ES Crater HS Phoenix ES Jackson ES Washington ES JEFFERSON COUNTY Madras HS DESCHUTES COUNTY La Pine K-12 Campus *Bend *Redmond Oregon State Public Health Division, DHS, Office of Family Health, Adolescent Health Section, School-Based Health Center Program, 971-673-0252 As of January 2008 Total number of Certified SBHCs = 45 Total number of Planning Phase I Sites = 17

  8. Increased access to health care • Number of SBHCs has doubled each decade • Number of clients has increased by almost 500% since their inception in 1986 • Today, 38,606 students have access to SBHCs at their school

  9. Impact: Access to Care

  10. Impact: Fewer Classes Missed

  11. Value of Care 2006-2007 • The State of Oregon contributed $1,370,000 to SBHCs • This supported the delivery of over $2,614,000 in health care services including… • Over $1,142,000 in services to uninsured clients

  12. Public health infrastructure support from State DHS Based on a formula: per range of total number of certified SBHCs in a county Additional sources found on local level: County funds School districts Hospitals Community health providers Grants Local fundraising Funding of Oregon SBHCs

  13. OR Legislature has supported the # of SBHCs doubling each decade 1985-86 Initial Legislative dollars 2004 Expansion dollars for SBHCs into 5 new counties 2007 Expansion dollars for SBHCs into 5 new counties and 7 existing counties Political climate

  14. School Districts request SBHC parental consent along with general registration Clarify Oregon minor consent laws Reproductive health - no age restriction Mental Health - 14 yrs and older Physical Health - 15 yrs and older Student Confidentiality

  15. Columbia CountyPublic Health Need for SBHC • A. Demographics- Economic Indicators • 13% of children live in poverty • 33% of public school children eligible for free and reduced lunch • B. Health Disparities (2006 Col.Co. Data) • 15% of children were uninsured • 21% of children were on Oregon Health Plan

  16. Columbia CountyPublic Health Need for SBHC • Sacagawea Health Center Data 2006-07 • 20% of patients were on Oregon Health Plan • 36% of patients had NO insurance Of SHC patients who visited the center 3 or more times……. • 47% had NO insurance • 27% on Oregon Health Plan • 13% had Kaiser insurance (no providers in Columbia Co.)

  17. Columbia CountyPublic Health Need for SBHC Health Risk Indicators - BRFSS Data 2002-05 The percentages of individuals living with these risks are statistically significant when compared to the data from the entire State of Oregon.

  18. Columbia CountyPublic Health Need for SBHC Columbia County 8th Grade Healthy Teens Survey

  19. Columbia CountyPublic Health Need for SBHC • C. Access to Health Care • Columbia County is the most medically underserved County in Oregon - Oregon Area of Unmet Healthcare Needs Evaluation • Columbia County currently has a Health Professional Shortage Alert -Federal Government Designation

  20. Aisha Krebs SBHC Program Coordinator PH: 503.397.4651 x 206 Fax: 503.397.1424 apoole@chdpublichealth.com For more information:

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