In schools where comprehensive school health service programs have been implemented, the relationship between the school nurse and the school based health center (SBHC) is one that requires careful coordination of service delivery. While private health care systems may be inclined to provide health care free of charge in rural SBHC’s, it is not likely that health care services can continue without a reimbursement plan. The purpose of this study was to determine the impact of implementing a fee-for-service reimbursement plan through a rural K-8 SBHC on the service delivery of a comprehensive school health services program. Using an ex post facto descriptive research design, health care delivery data were collected from School Health Care Online software and school nursing records. Results of the statistical analysis revealed that prior to the implementation of a fee-for-service plan (where free services were provided), SBHC staff administered more acute care allowing school nurses to spend additional time providing classroom instruction. Following implementation of the fee-for-service plan, acute care through the SBHC significantly declined with acute care through school nursing increasing. Both the free-service model and the fee-for-service model had significant impacts on the kind of work performed by the SBHC staff and the school nurses. These results suggest that comprehensive school health service programs through rural K-8 schools should consider the service delivery consequences of the free-service model and the fee-for-service model prior to implementing a rural SBHC.
Learning Objectives: At the conclusion of this session, the participant in this session will be able to: 1. Describe the impact of implementing a free-service health care delivery model through a rural K-8 school based health center on the delivery of comprehensive school health services. 2. Describe the impact of implementing a fee-for-service health care delivery model through a rural K-8 school based health center on the delivery of comprehensive school health services. 3. Discuss the implications of free-service and fee-for-service health care delivery models when establishing rural school based health centers
Keywords: School-Based Health 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.