School-Based Health Center Workgroup Looks at Creating Pilot Projects

Oregon currently has 65 certified school based health centers in 20 counties -- and more are expected to open within the next few years.    In the districts where they exist, they often serve as a critical access point for children with chronic health conditions, particularly mental health issues and asthma, who need continuous monitoring – some staying open over the summer so children can be seen for summertime illnesses and injuries.    Now, a workgroup created by a piece of legislation passed during the 2013 legislative session is looking at including school-based health centers in health transformation efforts. Workgroup members decided this week to set aside some of the $4 million appropriated by the Legislature for grant projects to help centers identify students’ primary care providers, and create pilot projects to further the work of school-based health centers.   Such health centers are also the place where many children receive routine immunizations and checkups, while keeping chronic conditions under control. Investing in prevention is one of the key concepts of House Bill 2445 -- sponsored by Rep. Nancy Nathanson (D-Eugene), Sen. Elizabeth Steiner Hayward (D-Portland) and Rep. Jeff Reardon (D-Portland). That bill called for the creation of a workgroup of medical sponsors of school-based health centers, local public health authorities, and school-based health coordinators as well as coordinated care organizations to develop recommendations for optimizing the effective and efficient use of school-based health centers. Of the $4 million appropriated to help the group carry out its work, $750,000 is immediately available to carry out the group’s recommendations.   Since about 55 percent of the services provided by school-based centers can’t be billed to insurance, one problem is figuring out how to expand this model, according to workgroup chair Rosalyn Liu, school-based health center program development specialist for the Oregon Health Authority. And before expanding this model, the state needs to figure out what school-based health centers are already doing well and how they can be helped.    Additionally, finding out what coordinated care organizations or healthcare organizations that partner with them are already doing -- in order to prevent duplicating efforts -- is going to be key, Liu said. “The idea is to be able to connect what's already being done, to piggyback off what's already being learned.”    And the initial $750,000 just isn’t enough to fund every project that might pique the group’s interest.    So the group has decided to focus on identifying a few small projects that school-based health centers need to complete and will need additional funding for, such as identifying students’ primary care providers, as well as opening up a competitive grant-application process that may be open to school-based health centers, coordinated care organizations, health partners or some combination thereof.   “If we were to split all the money across the board, that's really not a lot of money,” Liu said. She closed by suggesting that at its next meeting, the group should focus on creating a few grant funding opportunties for schools.   In addition -- and partly in response to concern from Kate Wells in Deschutes County that a competitive process would favor larger centers. The grant announcement will likely include several different requests for proposals, targeting school-based health centers of different sizes.    Christen can be reached at [email protected].