Achieving Certification for a Nurse-Run School-Based Health Center in Nevada

On December 4, 2014, the Joel and Carol Bower School Based Health Center became the first of seven school-based health centers in the state of Nevada to achieve state certification.  This status was accomplished through a focused planning effort, implementing the new State of Nevada Standards for School Based Health Centers.  Only certified school-based health centers (SBHCs) are eligible to receive Nevada Medicaid and Nevada Check-Up reimbursements from the Division of Health Care Financing and Policy at the higher Provider Type 17 level.  Thus achieving certification provides higher reimbursement, as well as evidence of program quality.

The Bower School Based Health Center (SBHC) was founded in 2004 as a partnership between Nevada State College (NSC) School of Nursing and the Clark County School District (CCSD) to address significant unmet health needs of children in Henderson, Nevada.  In 2007 the health center was officially named in honor of Dr. Joel Bower and his late wife Carol, long-standing community supporters.  Operated by the NSC School of Nursing, the center serves children ages 4-19. The CCSD maintains the physical facility (a double-wide portable) on the grounds of Basic High School, 400 Palo Verde, Henderson, NV 89015.  Nevada State College pays staff salaries, purchases medical and program supplies, and oversees programs and activities.  The mission statement is as follows:

The mission of the Dr. Joel and Carol Bower School-Based Health Center is to provide high quality, accessible health care to all children in Henderson schools, especially the uninsured, underinsured, and vulnerable populations. The Health Center is dedicated to treating the whole child; to promote physical, emotional, and social health, effectively manage chronic illness, and minimize health-related school absences.

Nurse practitioners staff the center 4 days per week during the regular school year, and 2 days per week during the summer.  The center also employees a full time coordinator and a certified medical assistant.  A volunteer medical director comes from the community, and the nursing director is a faculty member of the Nevada State College School of Nursing.  Students came predominately from seven schools in the local area, and approximately 70% of students seen are uninsured or underinsured.  Many of these students do not qualify for federal and state insurance programs for children.  Without adequate health insurance, these children often have prolonged absences from school for illnesses which could have been much shorter had medical care been available.  This also impacts the education these children receive. 

Achievement of certification involved a developmental progression, supported by state and community resource groups.  In 2012 the state of Nevada established standards for school-based health centers in Nevada.  The Bower SBHC was awarded a $ 50,000 planning grant from the state, which resulted in establishment of mental health services and re-institution of the clinic laboratory.  An asthma management program was supported by a local hospital foundation.  Mental health support groups for high school students were initiated and received financial support from a local community foundation.  A local health fair was held in 2014 to market the center and celebrate its ten year anniversary.

In 2014, the state developed an official process for certification of school-based health centers.  Goals of certification were to increase emphasis on best practices, reduce site-to-site variability, increase the ability to study clinical outcomes, and increase the potential for insurance reimbursement.  Specific standards, which served as the criteria for certification, were developed in the following areas:  (a) facilities, (b) operations and staffing, (c) laboratory services, (d) clinical services, (e) data collection and reporting, and (f) quality assurance activities.  The presentation will include photos, specific descriptions, and utilization data for the SBHC, to illustrate services provided which met certification standards.