School Based Health Center

Cumulative Outcomes Data

The overall goal for the School-Based Health Center is to Improve Child Health. To show that goal was accomplished, four indicators of child health were examined across the grant term.

Indicator A: Students enrolled in the SBHC have a medical home (connection with a primary care physician). Increase will occur by 10% each year.

Cumulative Data	2003	2004
Had a medical home in both years.	119	131
Did not have a medical home in base year, but does in year two.	20
Does not have a medical home in either base or year two.	5	3
Did not have a medical home in third year.		22
Increase in the number of children who had medical home.	75%	10.2%

The SBHC met its objective in both years. It was necessary to eliminate from the pool all children who did not have data across all three years, including students who transferred into the district or out of it and Kindergarten and Preschool children.

Indicator B: 50% of students who have visited the SBHC
four or more times report an improved health status.

Parent Survey – Parents of children who received services four or more times over the year were asked to rate their child on improvements in physical health, behavior and attendance. The chart below illustrates the response by question. The SBHC met the stated objective in both year 2003 and 2004.

Teacher Survey - In April of 2003 and 2004, teachers were asked to report on their impressions of randomly selected students who had used the services of the SBHC. Teachers were asked to rate the previous three month’s experience of the student’s health, behavior, absence from school and academic progress on a five point scale. The table below shows the percentage of teachers who rated these children positively or negatively. In 2003, only 20 students were selected; in 2004 this increased to 50 students due to increased use of the SBHC services. The table shows that over the two years, the teachers rated the children higher on absence and physical health.

Indicator C: Increase attendance due to illness of children who are seen by the SBHC four or more times by: 5% in year one, 10% in year two and 20% in year three.

The SBHC improved absence rates for children who were served four or more times, by any combination of staff, in 2003-04 school year. These 12 students spent sixty more days in class than they did in the 2002-03 school year. This is significantly more than the three more days the 11 elementary children we tracked in the 2002-03 spent in school.
While we would like to correlate our services with this reduction in absence, it is impossible to know if this change is due to the SBHC or not. Because of the variety of reasons children are absent, not just for illness, but family illness, deaths, and other reasons parents keep children out of school, we cannot directly attribute this increase in attendance to our intervention.
To delve into this a bit more, the table below shows the cumulative absences of children who we have served since the SBHC opened. Note that the type and number of services vary from child to child and year to year, but a positive trend is noticeable.

	Absence 00/01 - No SBHC	Absence 01/02 (SBHC Opened 4/02)	Absence 02/03 - SBHC Available All Year	Absence 03/04 - SBHC Available All Year	Difference from 00/01 to 03/04
1 Caucasian Female	Not in School	17 days	13 days	13 days	N/A but + 4 days from entering school
2 Caucasian Male	16 days	16 days	18 days	3 days	+ 13 days
3 Caucasian Female	46 days	11 days	6 days	0	+ 46 days
4 Caucasian Male	22 days	10 days	10 days	6 days	+ 16 days

Indicator D: Students enrolled in the SBHC and families are connected to health insurance through CHIP and Medicaid.
- 100% of families who report no insurance on enrollment information will be approached to apply to CHIP or Medicaid.
-75% of eligible families will apply for CHIP or Medicaid.

Over the three year term of the grant, the SBHC staff processed at least 83 applications. In our initial year, we were commended by Applied Data, which coordinated Hamilton County’s CHIP program, on the number of applications we processed, however the record of the number is no longer available. We met our objective of connecting families to health insurance.

2002 Not recorded
2003 56 applications
2004 27 applications
Total 83 applications

Accomplishments

Enrollment has risen each year from 329 in 2002 to 611 early in 2005, an increase of 53.5% over three years. We enrolled approximately 55% of students in the past two academic years.

Students in all three schools, and the preschool, are enrolled in the School-Based Health Center. The table below shows enrollment as of February 7, 2005. Overall, 55.3% of students in the district are enrolled.

	Total Number Enrolled in SBHC	% of all Enrolled	Number Attending School	% of Attending Enrolled in SBHC
Preschool	29	4.7%	38	76.3%
Elmwood Place Elementary	207	33.9%	269	77%
St. Bernard Elementary	181	29.6%	307	58.9%
Middle - High School	194	14.8%	490	39.5%

Services Provided - Over the course of three years, the SBHC staff provided 7,337 services to students, including medical and mental health care, case management and triage of minor accidents and illnesses.