1. 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

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…. A School 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 vs. SBHC 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

6. Statewide 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

7. Total number of Certified SBHCs = 45 Total number of Planning Phase I Sites = 17

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

9. Impact: Access to Care

10. Impact: Fewer Classes Missed

11. 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 Value of Care 2006-2007

12. Funding of Oregon SBHCs 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

13. Political climate 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

14. Student Confidentiality 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

15. Columbia County Public 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 County Public 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 County Public 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. Survey TopicOregon%Columbia County % % who have high blood pressure24.2%30.9% % who are obese (body mass index >30 kg/m2) 22.1%30.9% % of adults who currently smoke cigarettes 20.4%25.9%

18. Columbia County Public Health Need for SBHC Columbia County 8 th Grade Healthy Teens Survey Risk FactorPercentage of C.C. 8 th Graders No medical/physical care in previous year 48.6% Drunk alcohol in last month 34.5% Diagnosed with asthma 21.4% High risk of depression 19.3% Seriously considered suicide 16.4% Smoked cigarettes in last month 10.2%

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