Current Status of State Policies That Support School-Based Health Centers

Abstract

SYNOPSISObjectives. This study explored the current status of the role of state schoolbased health center (SBHC) initiatives, their evolution over the last two decades, and their expected impact on SBHCs' long-term sustainability.Methods. A national survey of states was conducted to determine (1) the amount and source of funding dedicated by the state directly for SBHCs, (2) criteria for funding distribution, (3) designation of staff/office to administer the program, (4) provision of technical assistance by the state program office, (5) types of performance data collected by the program office, (6) state perspective on future outlook for long-term sustainability, and (7) Medicaid and the State Children's Health Insurance Program (SCHIP) policies for reimbursement to SBHCs.Results. Nineteen states reported allocating a total of $55.7 million to 612 SBHCs in school year [2004][2005]. The two most common sources of statedirected funding for SBHCs were state general revenue ($27 million) and Title V of the Social Security Act ($7 million). All but one of the 19 states have a program office dedicated to administering and overseeing the grants, and all mandate data reporting by their SBHCs. Sixteen states have established operating standards for SBHCs. Eleven states define SBHCs as a unique provider type for Medicaid; only six do so for SCHIP.Conclusions. In 20 years, the number of state SBHC initiatives has increased from five to 19. Over time, these initiatives have played a significant role in the expansion of SBHCs by earmarking state and federal public health funding for SBHCS, setting program standards, collecting evaluation data to demonstrate impact, and advocating for long-term sustainable resources.

Economic Evaluation of School-Based Health Centers

“…Seventeen 1,2,10,12–18,20–22,24–26,28 of the 22 papers were peer-reviewed journal articles. The non-journal articles 9,11,19,23,27 were mainly reports on either the cost or benefit of the intervention.…”

“…The non-journal articles 9,11,19,23,27 were mainly reports on either the cost or benefit of the intervention. Geographically, all studies were from the U.S., with five 1,2,11,21,22 from the Northwest, six 16,19,23,25–27 from the Northeast, two 17,18 from the Midwest, two 9,10 from the Southeast, and seven 12–15,20,24,28 covering the whole U.S. Fifteen 1,11–16,18–22,24,26,28 of the 22 papers provided cost information, and ten 2,9–11,17–19,23,25,27 provided benefit information. Three studies 11,18,19 provided both the cost and benefit information.…”

“…1,11–16,18,20–22,24,26,28 Five studies used actual operation cost 12,18,21,22,26 , while nine studies 1,11,13–16,20,24,28 estimated costs from proxies such as operating budget, grant funding, or operating revenues. Operation costs ranged from $16,322 to $659,684 per SBHC per year.…”

“…Further, operation cost varied among the states. For instance, Schlitt and colleagues (2008) 24 provided grant funding information for 19 states, ranging from $16,322 to $306,476.…”

Predictors of lifestyle behaviors, trust of health care provider, and utilization of health services among adolescents living in a rural area.

“…SBHCs provide comprehensive medical and mental health treatment for adolescents at their schools. SBHCs are designed to overcome barriers that inhibit young people from getting needed health care, including lack of confidentiality or fear that confidentiality will not be maintained, transportation issues, fear that parents will be notified by insurer, inconvenient appointment times, costs, and anxiety about discussing personal health problems (Schlitt, Juszczak, & Eichner, 2008).…”