Service and Targeting Guidelines
State Resources
- New York
Service, Operating, and Targeting Guidelines
New York
| Definitions
"School Based Health Centers SBHCsprovide age-appropriate
primary health, mental health, social and health education services.
These services must comply with New York State Child/Teen Health
Plan C/THP requirements*. In Comprehensive SBHCs,
primary health and mental health care services are performed
on-site. Some services, based on local need and expertise, may
be made available by referral and appropriate follow-up. In
Intermediate SBHCs, primary health care services are
provided on site but mental health services are assured through
referral and appropriate follow-up." (Guidelines for
School Based Health Centers in New York) |
Service Guidelines
| Services |
Comprehensive SBHCs |
Intermediate SBHCs |
Medical Care
|
|
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| Mental Health
On-site or by referral: individual, group, and family counseling;
and psychiatric evaluation or treatment. |
- Assessment, treatment, referral, and crisis intervention
for issues including: physical/ sexual abuse, alcohol/substance
abuse, social isolation, depression, and suicide.
|
- Mental health services are not required. Limited mental
health services may be provided on site or through a referral.
|
| Laboratory Testing |
Tests performed on-site include (but are not limited to): hematocrits/hemoglobins;
urinalysis-dipstix; wet-prep.
|
|
| Reproductive Health Care |
- Age-Appropriate reproductive health care is to be considered
an essential component of comprehensive primary care.
|
|
| Health Education: individual; group;
family; and support for classroom education. |
- Areas can include: substance prevention and cessation; intentional
and unintentional injury prevention; nutrition; social skills
development; death and dying issues; physical and emotional
development; conflict resolution; child abuse prevention;
violence prevention; STD/HIV/AIDS prevention; pregnancy prevention;
chronic conditions (i.e. asthma); general parenting skills;
chronic disease prevention (smoking cessation/prevention,
heart disease, osteoporosis); and dental health.
|
|
| Social Services |
Social service assessment, referral, and
follow-up for needs such as:
- Basic needs (food, shelter, clothing);
- Legal services;
- Public Assistance;
- Assistance with Medicaid and other health insurance enrollment;
- Employment services; and
- Day-care services.
|
|
| Other Services: |
Provided on-site or by referral:
- Dental care;
- Nutrition services;
- Specialty care; and
- Well-child care of students' children.
|
|
*The C/THP is New York State's EPSDT program. It is a
federally mandated initiative to provide comprehensive preventive health
care and diagnostic treatment and follow-up to children who are eligible
for Medicaid, up to the age of 21. It is designed to meet the Federal
and State requirements for the Early and Periodic Screening, Diagnosis
and Treatment (EPSDT) program which was created by the Title XIX of
the Social Security Act.
Operating Guidelines
| Operating Guidelines |
Comprehensive SBHCs |
Intermediate SBHCs |
Facility Requirements
|
- 1500 to 2000 square feet is recommended per 700 students;
- At least 1 exam room w/ a sink (1 room per full-time provider);
- 1 of each for the following: counseling room/private area;
laboratory area; patient bathroom; waiting room; clerical
area; infirmary area; and designated clean and soiled space
for clinic functions;
- Private telephone line for confidentiality and access to
community and back-up health providers.
|
|
| Staffing Requirements |
- A multi-disciplinary team must include: nurse practitioner/physician
assistant (1 FTE/700-1500 students enrolled in center);
physician (on site at least one 3-hr. session/week per NP
or PA); mental health counselor (1FTE/700-1500 enrolled
students); mental health supervisor (.1-.5 FTE per 700-1500
enrolled students); and Health Assistant (full time - all
school hours).
- Staff provided according to need: program manager; health
educator; community outreach worker; school nurse (RN); nutritionist;
dentist; dental hygienist.
|
- Same as Comprehensive SBHC with the exception of mental
health staff. Staffing hours and student/staff ratios are
equivalent to the Comprehensive SBHC requirements.
|
Health Care Access
|
- SBHCs must be open and staffed during all normal school
hours;
- Sponsoring institution ensures 24-hour access to services
for enrolled students during non-school hours and vacation;
- Parental consent is required unless individual is at least
18 years in age or qualifies to give consent under Section
2504 of the NY State Public Health Law.
|
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| Managed Care |
- Agreements must be negotiated between the sponsoring institution
and managed care plans whose Medicaid and Child Health Plus
enrollees are served by the SBHC.
|
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Sponsoring Institutions
|
- "...Article 28 and Article 44 facilities and other health
care providers experienced in delivering ambulatory care services
to school age children."*
|
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| Quality Management and Improvement |
- QM and QI activities should address: management of clinical
conditions, documentation of care, use of services, staff
qualifications, system organization, patient satisfaction,
patient knowledge and changes in patient behaviors.
- Designate a quality management and improvement coordinator.
- Clearly define goals, objectives and standards of care that
identify what program wants to accomplish.
- Measure the achievement of desired performance and take
actions to address problems identified.
- Written policy and procedures on the following: provider
credentials and maintenance; professional continuing education;
pre-employment procedures; staff and program evaluation; measures
of patient satisfaction; medical record review; complaint
and incident review; and corrective actions and time frame.
|
|
*Public Health Laws - Article 28 licenses
diagnostic and treatment centers (hospitals and free standing community
health centers); and Article 44 licenses health maintenance organizations.
Targeting Guidelines
General Purpose: "School-based health centers
(SBHCS) can improve access to primary care for underserved children
and youth. SBHCs bring comprehensive primary care services to the place
where children and youth are during the day and address critical health
problems that make it difficult for students to learn."
| Targeting Criteria |
Comprehensive SBHCs |
Intermediate SBHCs |
SBHC Location
|
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Student Need
|
- Number of children in underserved communities;
- Demographics: socio-economic status (students eligible for
free or reduced lunch program and Medicaid); ethnic/racial
breakdown;
- Health status indicators (i.e. infant mortality rates, adolescent
pregnancy rates, and immunization levels);
- Size of total school population.
|
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| Sustainable Programs |
- SBHC must be able to demonstrate financial viability.
|
|
Sources
New York State Department of Health. Principles and Guidelines
for School-Based Health Centers in New York. New York: New York State
Department of Health, Revised May, 1996.
New York State Department of Health. Request For Application
For School Based Health Centers. New York: New York State Department
of Health, 1995.
New York State Department of Health. School-Based Health
Centers in New York: One Page Summary, No date.
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