Nuts and Bolts of Oregon SchoolBased Health Centers

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 Aisha Krebs School-Based Health Center Program Coordinator Columbia Health District- Public Health Authority

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

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

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

School Nurse vs. SBHC n SCHOOL NURSE n n n n Employed by School Manages student immunizations program Coordinates screenings Chronic SH case mgmnt Manage chronic medication delivery during school Oversees SH programs FERPA regulated n SBHC n n n n 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

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

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

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

Impact: Access to Care

Impact: Fewer Classes Missed

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

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

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

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

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

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

Columbia County Public Health Need for SBHC Health Risk Indicators - BRFSS Data 2002 -05 Survey Topic Oregon% Columbia County % % who have high blood pressure 24. 2% 30. 9% % who are obese (body mass index >30 kg/m 2) 22. 1% 30. 9% % of adults who currently smoke cigarettes 20. 4% 25. 9% The percentages of individuals living with these risks are statistically significant when compared to the data from the entire State of Oregon.

Columbia County Public Health Need for SBHC Columbia County 8 th Grade Healthy Teens Survey Risk Factor Percentage of C. C. 8 th Graders No medical/physical care in previous year 48. 6% Drunk alcohol in last month 34. 5% 21. 4% 19. 3% 16. 4% Diagnosed with asthma High risk of depression Seriously considered suicide Smoked cigarettes in last month 10. 2%

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

For more information: Aisha Krebs SBHC Program Coordinator PH: 503. 397. 4651 x 206 Fax: 503. 397. 1424 apoole@chdpublichealth. com