School-based health centers (SBHCs) are an increasingly important segment of the primary care network for children and adolescents; more than 1200 exist today. Survey data on services and policies from 806 SBHCs (response rate 67%) operating in 1998-99 documented that they provided care to over one million students and served over 500,000 unduplicated users. Student race/ethnicity included Hispanic (26%), black (29%), Asian (4%), Native American (2%), white (36%), and other (2%). Most SBHCs provided on-site primary care services, including preventive care (95%), vision and hearing screenings (94%), treatment for acute illness (94%), immunizations (91%), asthma treatment (91%), prescriptions (90%), lab tests (89%), administration of medications (86%), psychosocial assessments (73%), and dental screening (52%). Many health centers were active in the classroom too, with prevention programs such as tobacco (52%), alcohol (48%), HIV (49%), violence (44%), and pregnancy (41%). Medicaid was billed by 78%. Many followed clinical practice guidelines from EPSDT (73%), AAP (60%), GAPS (45%), Bright Futures (22%), and USPSTF (9%). A variety of clinical quality assurance tools were used: staff credentialing (88%), chart audits (87%), patient satisfaction surveys (72%), CLIA certification (69%), and environmental standards (67%). 75% of SBHC served as a training site for health care professionals. Most SBHCs (75%) provided care in conjunction with another provider; 22% reported they were the sole medical care home for most of their students. SBHCs provide a wide range of primary care services and have quality assurance mechanisms; SBHCs increasingly resemble other primary care providers and represent an important safety net provider.
Learning Objectives: The participant will be able to: 1. describe primary care and preventive services commonly provided in school-based health centers; 2. describe clinical staffing, program operations and quality assurance mechanisms commonly found in school-based health centers; 3. list commonalities and distinctions of school-based health centers as compared to mainstream primary care settings
Keywords: School-Based Health Care, Primary Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
The 128th Annual Meeting of APHA