School based health center

Farawyn · Mar 3, 2016

I don't even know what that is, I'm sorry. :blink:

peacockblue · Mar 3, 2016

I don't know what that is either.

OldDude · Mar 3, 2016

I've heard of them and understand the concept but I have no idea of the real workings of one.

Farawyn · Mar 3, 2016

Here.

School-Based Health Center - School-Based Health Centers - New York City Department of Education

SchoolNursey · Mar 3, 2016

It's an independent clinic that serves students. They usually have a NP, social worker, sometimes a dentist. They are usually owned by a parent company. The ones I have researched are for profit organizations and they bill the insurance company of the students they aee. Many school districts are using them and giving school nurses the boot.

Farawyn · Mar 3, 2016

We have 3 on LI in the lower economic school districts.

Are these Medicaid based?

OldDude · Mar 3, 2016

We have 3 on LI in the lower economic school districts.
Are these Medicaid based?

I can answer that for you without even researching it...yes. Without medicaid billing these types of businesses couldn't exist.

SchoolNursey · Mar 3, 2016

I can answer that for you without even researching it...yes. Without medicaid billing these types of businesses couldn't exist.

Exactly, they are money makers for the cooperation. I may be wrong, but from what I understand, there was also something in Obama care that funded these clinics.

DEgalRN · Mar 3, 2016

We have them in the school districts around me, but not in my school. I think they're a great idea here. Though they collect insurance, they don't charge the students anything (I'm not sure if they waive co-pays/deductibles, etc, or don't charge insurance at all or have some other way of handling it though.)

From my understanding, in my state, they're a completely separate entity from the school nurse. They're not going to administer medications prescribed by outside providers and they don't respond to emergencies at the "first responder." They require an appointment, whereas I don't (although I wish I could! :)) They can also do things like pregnancy tests and rapid strep tests (which would be amazing!)

I'm curious how it increases nurse's visits? Since I don't actually have first hand knowledge, I'm interested in your thoughts about that.

SchoolNursey · Mar 3, 2016

We have them in the school districts around me, but not in my school. I think they're a great idea here. Though they collect insurance, they don't charge the students anything (I'm not sure if they waive co-pays/deductibles, etc, or don't charge insurance at all or have some other way of handling it though.)
From my understanding, in my state, they're a completely separate entity from the school nurse. They're not going to administer medications prescribed by outside providers and they don't respond to emergencies at the "first responder." They require an appointment, whereas I don't (although I wish I could! :)) They can also do things like pregnancy tests and rapid strep tests (which would be amazing!)
I'm curious how it increases nurse's visits? Since I don't actually have first hand knowledge, I'm interested in your thoughts about that.

At my school, they accept only what the insurance pays. My district also bills medicaid for nursing services at school. One concern is double billing. If a student sees me and then goes to the Health Center the same day, there is concern that we are going to lose medicaid dollars.

As of now, they are a separate entity. There is a cooperation that is trying to change that. I got word recently that a particular CEO of one of the Health Centers is approaching School Boards with a presentation on how having a Health Center at school is cheaper than having a School Nurse. Many districts are drinking the koolaid and getting rid of their School Nurses. Again, this is hearsay, with some evidence to support it.

It increases nurse visits for me, because of a few reasons that I have identified. #1 - when students are seen at the Health Center, they miss anywhere from 1 - 2 hours of class. Many middle school students have figured it out and use this as a way to avoid class. (They must see me before being seen at the Health Center).

#2 - Students that normally would stay home and see their own doctors for illnesses are instead being sent to school by parents and told to see the Health Center if they don't feel better. This is also a concern of mine as far as spreading illness.

#3 - health complaints that I would not normally see in my office, I am seeing because these students want to go to the Health Center.

I am interested in seeing the thoughts and experiences of others.

DEgalRN · Mar 3, 2016

Ah, that makes sense. There's no school nurse triage with the school health centers here. I can see how having that be required would increase the visits, and that would be incredibly frustrating and time consuming! And if it's not one entity (yet), you shouldn't be triaging for them! Talk about abuse of power.

I agree with the sick kids being sent to school instead of their doctors, although I feel like that happens anyway. I regularly see kids who tell me their parents send them to school to "see what the nurse can do for them." Unfortunately, it's Tylenol, Advil, and tums and not much else! I've even had some tell me their parents wanted me to check their throats and see if they should go to the doctor!

I do wonder if you have to worry about doubling billing though since most school nurses are BSN or AS RNs, and in my state health centers are staffed by NPs, and since you're different providers you bill at different levels/services. But, I am not a medical biller, so I admit that I'm pulling that only from what I've heard 2nd hand!

I still really like them when they work, but I can see how the set up you're describing could be problematic! And they absolutely should not be replacing dedicated school nurses!