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SESSION: G4 |
| ROOM |
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| DATE |
Friday, June 19, 2015 |
| TIME |
9:45am-11:00am |
| ABSTRACT CATEGORY |
Systems |
ABSTRACT TITLE |
A Call for Action on Policy and Practice Recommendations from a National 5-year SBHC Demonstration Project.
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ABSTRACT SUMMARY |
This 5-year CMS-funded project demonstrated that SBHCs are crucial in engaging adolescents in their health care and in delivering quality services to youth. The purpose of this panel is to present 13 broad and far-reaching recommendations based on project findings, lessons learned, and barriers encountered. We will discuss the ways in which these policy considerations can enable SBHCs to improve adolescent health care, calling for national and state action to make these recommendations a reality.
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ABSTRACT DESCRIPTION |
The Centers for Medicare and Medicaid Services demonstration project focusing on School-Based Health Centers (SBHCs) is ending after five years. This project, awarded to Colorado and New Mexico was one of only 10 CHIPRA Quality Demonstration grants given out to demonstrate and showcase ways to improve quality of care. This project demonstrated that SBHCs are crucial in engaging adolescents in their health care and in delivering important services. Specifically, the project showed significant gains in: selected clinical quality measures (EPSDT examinations, immunizations, and screening and treatment for sexually transmitted infections and depression/anxiety), integrating the Patient-Centered Medical Home (PCMH) model into SBHCs, improving data collection for policy and practice, and engaging youth in their care. These gains are documented in a final report, entitled “Right Place. Right Time. School-based Health Centers Improve Care for Adolescents,” which documents key messages and findings, including:
• All Colorado SBHCs received PCMH recognition and New Mexico coaches developed a simplified NCQA-based assessment tool to systematically integrate PCMH practices into SBHCs
• SBHCs that received QI coaching in particular clinical areas improved the quality of care delivered to adolescents
• Coaches supported SBHC staff in engaging students in their care, with a specific focus on health literacy and health efficacy
• Improvements were made in encounter data entry, collection, and reporting in order to better describe the vital role SBHC play in the health care system
However, despite the successes documented in this report, a number of barriers were also encountered which prevented delivery of optimal care. These included:
• Lack of resources at SBHCs – limited provider hours, lack of equipment needed to draw labs and store vaccines, provider turn-over
• Need for policies and support to ensure that adolescents maintain insurance coverage – lost revenue for services provided to eligible but uninsured youth
• Need for new policies around provision of explanation of benefits for confidential services for adolescents, and others – lost revenue from private insurance companies that SBHC do not have contracts with to protect adolescent confidentiality
• Need for adolescent mental health quality measures to assure early identification and treatment of common conditions – lack of standard screening and assessment requirements, limited mental health providers in SBHCs and for community referrals
• Exclusion or lack of recognition of SBHCs in programs and policies that provide enhanced reimbursement or additional funding – inability of SBHCs to qualify for national PCMH recognition that guides MCO payment programs, lack of enhanced reimbursements as FQHC look-alikes
Our project presents 13 broad and far-reaching recommendations that fall into three groupings: funding enhancements, regulation and requirement changes, and practice improvements. Together, these recommendations address the barriers to providing high-quality care and set forth a new overall direction to enable SBHC best practices and sustainability.
The purpose of this workshop is to present our policy recommendations based on the findings and lessons learned from the project and discuss the ways in which these policy considerations can enable SBHCs to improve adolescent health care, using New Mexico as an example and calling for national and state action to make these recommendations a reality.
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PRESENTER(S) |
NAME: Gerry Fairbrother PhD ORGANIZATION: Academy Health
NAME: Jane McGrath MD, FAAP ORGANIZATION: Envision New Mexico
NAME: Yolanda Cordova MSW ORGANIZATION: NM Department of Health
NAME: McKane Sharff MS ORGANIZATION: Envision New Mexico
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AUDIENCE |
ADMINISTRATORS: N |
PRIMARY HEALTH: Y |
MENTALHEALTH: N |
ORGANIZATIONAL: Y |
PUBLIC HEALTH: N |
EDUCATION: N |
YOUTH: N |
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