SCHOOL BASED HEALTH CENTERS
IMPROVE HEALTHCARE ACCESS, SCHOOL ATTENDANCE,
AND ACADEMIC ACHIEVEMENT ROBERTA BAVIN, DNP, CPNP PEDIATRIC NURSE PRACTITIONER CLOVIS USD CHILDREN’S HEALTH CENTERS Vision and Voice for Healthy Students MARCH, 2013
Overview of presentation Clovis USD Located in Central California Sponsored by school district Two SBHC
Unique funding to improve healthcare access HRSA Grant for new building
Utilize technology to improve quality of care
Focus on getting kids healthy, ready to learn Back to school sooner after mild illness/injury
Improved school attendance Increases academic scores Leads to improved long term achievement.
CLOVIS USD SBHC Clovis USD currently has two SBHC sites
They are unique as school district sponsored SBHCs
Each is staffed with one pediatric nurse practitioner and one clerical support person
Physician collaboration is available by phone/email
Average encounters from 8000-9000 per school year
On staff Certified Application Assister
SERVICES PROVIDED Children from birth through 18 are seen
Well/sick care WIC screenings Sports screenings Immunizations/TB skin tests
Most children are on Medi-Cal or are uninsured
All vaccines are obtained through VFC program
All private insurance patients pay $30 cash fee Well/sick care, WIC screenings Sports screenings
All uninsured patients pay $30 cash fee for well, sick sports, WIC $15 each, cash administration fee per vaccine $10 cash for PPD
INNOVATION AND COLLABORATION
CUSD is innovative Application and receipt of HRSA building grant Operating out of the new SBHC, effective 9/4/12 Received multiple other grants (First Five, Kaiser)
CUSD SBHC collaborates with all CUSD schools/school nurses Facilitate referral and follow-up of identified health conditions Encourages students to return to school sooner Improving attendance and academic achievement
CUSD SBHCs also partner with local coalitions Immunization Coalition-improve school readiness via immunizations Asthma Coalition-increases appropriate use of inhalers at school and
increases asthma awareness and education for students and families
INNOVATIVE TECHNOLOGY CUSD SBHCs are in the process of
implementing EHR system Practice Fusion (Free EHR)
Has been using CAIR for 12 years Allows for immunizations sharing
Recently qualified to receive Stage 1 Meaningful Use money Done independently of any support
agencies
Grant from Kaiser in process Support use of computer in each exam
room Modernization of one health center facilities Wal-Mart grant to purchase supplies
TRACKING USAGE Since 2002, CUSD SBHC utilized spread sheets to track usage
SBHC usage varies Time of year
Sports screenings (during summer and prior to sports seasons) Sick visits (during flu season) Well visits (prior to first grade physical due date)
Patient insurance status Other economic variables Federal funding (vaccine 317 funding loss) Job markets Parental income changes
TRACKING ATTENDANCE Track average daily attendance (ADA) based upon SBHC
visits
Each visit counts as “1” ADA
Realize this is a very low estimate
Can’t truly estimate how long child would have stayed out of school without SBHC access
Average amount daily received per student is in the $45 range (+/-$5) (Varies by school district)
Approximate ADA savings per year is calculated
CLOVIS USD ENCOUNTERS AND ATTENDANCE DATA
School Year
Total # Encounters
Av. Daily Encounters
ADA Saved #
ADA Saved $
2008-2009
9480 34.3 2553 $114,885.00
2009-2010
9500 34.2 2647 $119,115.00
2010-2011
8745 30.8 2635 $118,575.00
2011-2012
8007 27.4 2433 $109,485.00
July 1- Feb 28, 2013
5674 (projected 8511 thru 6/13)
30.2 1545 (projected 2317 thru 6/13)
$ 69,525 (projected $104,265 thru 6/13)
USAGE VARIES BY YEAR RELATED TO OUTSIDE FACTORS
The 2010-11 and 2011-12 data showed usage declines Federal elimination of 317 vaccine funding for SBHC Local insurance funding/reimbursement changes
Unfortunately, many patients had to be turned away.
First quarter of 2012-13 Average daily encounters are increased
Anticipating further increased usage Healthy Families insured children Rolling into Medi-Cal during 2013
Blue Cross- (6,000 kids) March 1st Cal Viva/Health Net- (14,000 kids) April 1st Kaiser HF- (600 kids) August 1st
SBHC IMPROVE HEALTHCARE ACCESS, SCHOOL ATTENDANCE AND
ACADEMIC ACHIEVEMENT It is an amazing feat
So many patients can be cared for
One PNP and one clerical staff per site
Providing cost effective quality pediatric healthcare
Positively influencing school attendance
Positively impacting academic achievement.
Thanks so much for your attention- Are there any questions?