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?