Region 9 Education Cooperative

school-based health services

Region 9 School-Based Health Centers (SBHCs) provide physical and behavioral healthcare and promote health awareness for students in the Region 9 member schools. The SBHC offers students medical attention when they need it, catching problems like asthma and depression now, preventing bigger problems later. Most importantly, they keep students healthy and in class so they can learn what they need to know to succeed in life. The SBHC is staffed by a multidisciplinary team of providers including nurse practitioners, behavioral health counselors, social workers, alcohol and drug counselors, psychiatrists, and other health professionals. These comprehensive, accessible and high-quality services add measurable value to the health of students.

Funding and Service Sites

The SBHC coordinates the use of Medicaid reimbursement funds, as well as various grant awards, to provide a broad range of preventive and acute health care services for all school-aged children in the seven member school districts that include Capitan, Carrizozo, Cloudcroft, Corona, Hondo, Ruidoso and Tularosa. The original Region 9 SBHC is located on the Ruidoso High School campus between the gym and the football field and is open from 8:00 a.m.–4:00 p.m., Monday–Friday. Staff based at this site provide services including sports physicals, health education, substance abuse prevention, and counseling for all of the Ruidoso schools as well as the other member school districts. The funding stream for the school-based health services includes partnerships with:

  • The New Mexico Department of Health (NMDOH) Office of School and Adolescent Health
  • The New Mexico Public Education Department (NMPED)
  • The National Substance Abuse and Mental Health Services Association (SAMHSA)
  • Various other health and education organizations

Access

The SBHC brings the doctor/counselor to the school, improving access to critically needed care right where children learn and grow. Furthermore, research shows that adolescents are at least 10 times more likely to come to a SBHC for behavioral health services than to visit a community health provider. Students may access physical, behavioral, or substance abuse services at the SBHC either on their own or by referral from their school nurse, counselor, a teacher, or a parent/guardian. Although the SBHC asks parents to sign written consents for their children to enroll in the SBHC, according to New Mexico State Law:

“Parental consent is not required for, and lack thereof shall not bar children from receiving the following services: pregnancy testing, diagnosis and treatment of sexually transmitted diseases, family planning services and Human Immunodeficiency Virus testing, pursuant to Section 24-10-2, Section 24-1-13.1, Section 24-8-5, and Section 24-1-9 NMSA 1978, and 42 USC Section 300 et seq., Section 59, Section 1201 et seq., and Section 1396 et seq. New Mexico state law also permits students over 14 years old to consent to mental health counseling on their own, pursuant to Section 32A-6-14 NMSU 1978.”

The SBHC recognizes the increasing number of children and adolescents who not only lack access to health care but also need care that is culturally and age-sensitive, confidential, safe, and affordable. All of the SBHC services are provided on a sliding fee scale, but no one will be denied services regardless of their ability to pay, insurance coverage, or lack thereof. Region 9 SBHCs are contracted with Medicaid Managed Care Organizations and will bill Medicaid if appropriate.

Academic Outcomes

Students perform better when they show up for class healthy and ready to learn. Research shows that SBHCs help students avoid health-related absences and offers support to help them succeed in the classroom. It is well-accepted that healthier children make better students.

The collaboration of the physical and behavioral health providers contributes to the overall health of each individual student that comes to the SBHC by treating acute and chronic illnesses along with addressing any identified behavioral health issues.

Services

Students access services at the SBHC when they:

  • Need a sports physicals for participation in a school sponsored activity
  • Need treatment for an acute illness (e.g. sore throat, earache, cough, etc.)
  • Want help with smoking or spit tobacco cessation or other substance abuse/use
  • Think they may be experiencing signs of depression or have other behavioral heath concerns
  • Want testing or treatment for sexually transmitted diseases, pregnancy testing
  • Require other confidential services
  • need treatment of injuries

Primary Care Services

The SBHC provides primary health care in collaboration with other health care agencies including the student’s primary care provider (PCP). Services include well-child checks, sports physicals, diagnosis and treatment of acute illnesses or injury, health education, some lab work (e.g. rapid strep testing, urinalysis), and referral to community providers. A signed parental consent form must be on file at the SBHC for the student to receive primary health care, and the student’s parent/guardian will be contacted concerning any diagnosis or treatment including any administration of prescription or over-the-counter medications.

The patient’s PCP will also be notified of the visit and outcomes unless the patient requests otherwise. Our SBHC is committed to sharing information about current medications and pertinent medical history among providers who are seeing the same patient in order to ensure quality health care. The student may be referred to his or her PCP or to a specialist for any necessary follow-up care. Confidential services such as family planning and STD testing are also available and can be provided with only the student’s consent. Please know that the SBHC makes every effort to encourage discussion between the student and parent/guardian regarding these issues.

Behavioral Health Services

The SBHC offers a variety of on-site services including behavioral health and substance abuse counseling, psychiatric evaluations, and telebehavioral health services in collaboration with the University of New Mexico Department of Psychiatry Center for Rural and Community Behavioral Health (CRCBH). The SBHC contracts with the CRCBH for the services of an on-site child psychiatrist that comes to the SBHC once a month, as well as additional child psychiatry services through the telehealth conferencing equipment on a weekly basis.

The providers offer a variety of therapies, including: one-on-one counseling, group counseling, family therapy, consultations, and case management. These services are comprehensive and fully address their individual behavioral health needs. The interdisciplinary team of providers is enhanced by an inclusive partnership between community providers, the Department of Health, universities, and local school staff. This partnership provides for optimal collaboration, oversight, supervision, and backup for both physical and mental health providers as well as an opportunity to offer a full spectrum of behavioral health services.

Prevention, Education, and Awareness 

The SBHC presents a range of prevention, education, and awareness programs throughout the school year. These programs are designed for target audiences, are presented by peers, SBHC staff, or invited guests and may be incorporated as a part of the regular school day. The goal is to provide fully integrated prevention and early intervention for youth and families helping them to make healthier choices in their everyday lives.

Medicaid in the Schools (MITS)
The Region 9 Education Cooperative coordinates the use of Medicaid reimbursement funds to improve health-related services for all children in the seven member school districts including Capitan, Carrizozo, Cloudcroft, Corona, Hondo, Ruidoso, and Tularosa.

Background
New Mexico schools provide a variety of health-related services to students. The Individuals With Disabilities Education Act (IDEA-B) and Section 504 require schools to accommodate students who have a disability and who are in need of services. The expense of these services is managed by the school districts through a combination of federal, state, and local funds.

The Medicare Catastrophic Coverage Act of 1988 (MCCA) and the Omnibus Budget Reconciliation Act of 1989 (OBRA '89) gave state Medicaid programs the authority through the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) initiative to reimburse schools for the expenses of health-related services including screening activities and related services provided to Medicaid eligible children as part of an Individual Education Program (IEP) or an Individual Family Service Plan (IFSP). This program does not affect the Medicaid status of families in any manner.

Reimbursement Provides Health Services for all Children
Schools receive Medicaid reimbursement for providing a broad range of preventative and remedial health care services as described in a plan adopted by the State Human Services Department for the state of New Mexico.

A plan to address regional health care issues was developed by an advisory group of local health care providers, students, parents, and school personnel.

Some of the services/activities funded by Medicaid in the Schools include:

  • Increased school nursing services in all districts
  • Behavioral health counselors
  • School social workers
  • Health-related equipment and materials
  • After school child care program
  • Personnel development and training activities for healthcare providers
  • School Based Health Clinics

Federal Medicaid reimbursements provide the funding for the health-related services described above.