Comprehensive Services

E.1   Comprehensive Services Requirements:

a.  The following includes services that must be available either:

  • On-site at the school-based health center (On)
  • By direct referral (Ref) from the center (see definition H.1.a)
  • Some services are considered recommended (Rec), either on-site or by referral but are not mandatory
b.   Primary Care Elem (K-5) Middle(6-8) High 9-12
Core EXP Core EXP Core EXP
Comprehensive medical& psychosocial histories On On On On On On

Comprehensive physical
exams per EPSDT
On On On On On On

Immunizations1 On On On On On On

Developmental
assessments
Ref Ref Ref Ref Ref Ref

Pre-assessment of educational, achievement & attendance problems On On On On On On

Evaluation and treatment of:
  • non-urgent problems
On On On On On On
  • acute problems
On On On On On On
  • chronic problems
On On On On On On

Triage of medical emergencies On On On On On On

Medical case management Ref On Ref On Ref On

Medical specialty services Ref Ref Ref Ref Ref Ref

 

c. Screening Elem (K-5) Middle(6-8) High 9-12
Core EXP Core EXP Core EXP
Height/weight/body mass index (BMI) On On On On On On

Blood pressure On On On On On On

Vision screening On On On On On On

Hearing screening Ref Ref2 Ref2 Ref2 Ref2 Ref2

Scoliosis screening On On On On On On

1includes all required vaccines for school attendance excluding Varicella which may be provided by referral given its unique storage requirements
2recommended on site

d. Dental Elem (K-5) Middle(6-8) High 9-12
Core EXP Core EXP Core EXP
Visual inspection of
teeth & gums
On On On On On On

Preventative dental treatment
(Fluoride available by prescription)
On On On On On On

Comprehensive dental evaluation & treatment Rec Rec Rec Rec Rec Rec

 

e Pharmacy Elem (K-5) Middle(6-8) High 9-12
Core EXP Core EXP Core EXP
Capacity to write prescriptions for
non-urgent, acute & chronic problems
On On On On On On

Administration of OTC &
prescription medication
On On On On On On

 

f. Reproductive Health    Services Elem (K-5) Middle(6-8) High 9-12
Core EXP Core EXP Core EXP
Reproductive health exam
(inclusive of pap, pelvic, testicular exam)
Ref Ref On On On On

Prescriptions for contraceptives
(hormonal, diaphragm, IUD)
Ref Ref Ref Ref

Condom availability;
for treatment of documented or presumptive STD Ref3 Ref3 Ref3 Ref3
for STD/ pregnancy prevention use Ref3 Ref3 Ref3 Ref3

Pregnancy testing and counseling Ref Ref On On On On

Prenatal care Ref Ref Ref Ref Ref Ref

STD/STI treatment Ref Ref On On On On

HIV pre- & post-test counseling Ref Ref Ref On Ref On

HIV/AIDS treatment Ref Ref Ref Ref Ref Ref

3recommended on site

g. Preventive Health     Services Elem (K-5) Middle(6-8) High 9-12
Core EXP Core EXP Core EXP
Provision of age-appropriate anticipatory guidance On On On On On On

Risk factor assessment On On On On On On

Targeted patient education;
Individual (one-on-one) On On On On On On
Group On On On On On On

 

h. Mental Health     Services Elem (K-5) Middle(6-8) High 9-12
Core EXP Core EXP Core EXP
Individual mental health assessment, counseling and treatment Ref On Ref On Ref On

Alcohol and other drug pre-assessment On On On On On On

Alcohol and other drug counseling & treatment Ref Ref Ref Ref Ref Ref

Group counseling Ref On Ref On Ref On

Family counseling Ref Ref Ref Ref Ref Ref

Crisis intervention (coordinated with school plan) On On On On On On

 

i. Social Services Elem (K-5) Middle(6-8) High 9-12
Core EXP Core EXP Core EXP
Assessment & management Ref Ref Ref Ref Ref Ref

 

j.Other Elem (K-5) Middle(6-8) High 9-12
Core EXP Core EXP Core EXP
Outreach activities(e.g. classroom, school, community health promotion/ health education activities) Rec Rec Rec Rec Rec Rec

E.2   Equipment Requirements:

  1. Center must have equipment necessary to provide all required services.
  2. Equipment must be checked regularly and maintained in good working order.
  3. Center must have appropriate emergency medical equipment (e.g. first aid kit) which is inspected regularly for items that need to be replaced or replenished.

E.3   Medications Guidance:

  1. Recommend on-site availability of OTC and other medications that can be administered with standing orders or by the primary care provider as allowable by law, including ORS/OAR, OHD protocols, nurse practice act and board of pharmacy regulations.
  2. When medications are to be administered on site, a written policy must be in place with clear designation of staff roles and responsibilities as well as documentation procedures.
  3. A system must be in place to assure follow-up of medication compliance.

E.4   Preventive Health Services Guidance:

  1. See OMAP guidelines for counseling interventions for general and high-risk populations ages birth-10 and ages 11-24.

E.5   Social Services Guidance:

  1. SBHC staff should have knowledge of local social service referral sources and documentation of standard referral protocols. A memo of understanding between the SBHC and community social service agencies is recommended to facilitate referrals and social service case management.