Current Status of State Policies That Support School-Based Health Centers

Abstract

Objectives. This study explored the current status of the role of state school-based health center (SBHC) initiatives, their evolution over the last two decades, and their expected impact on SBHCs' long-term sustainability. Methods. A national survey of states was conducted to determine ( 1) the amount and source of funding dedicated by the state directly for SBHCs, ( 2) criteria for funding distribution, ( 3) designation of staff/office to administer the program, ( 4) provision of technical assistance by the state program office, ( 5) types of performance data collected by the program office, ( 6) state perspective on future outlook for long-term sustainability, and ( 7) Medicaid and the State Children's Health Insurance Program (SCHIP) policies for reimbursement to SBHCs. Results. Nineteen states reported allocating a total of $55.7 million to 612 SBHCs in school year 2004–2005. The two most common sources of state-directed funding for SBHCs were state general revenue ($27 million) and Title V of the Social Security Act ($7 million). All but one of the 19 states have a program office dedicated to administering and overseeing the grants, and all mandate data reporting by their SBHCs. Sixteen states have established operating standards for SBHCs. Eleven states define SBHCs as a unique provider type for Medicaid; only six do so for SCHIP. Conclusions. In 20 years, the number of state SBHC initiatives has increased from five to 19. Over time, these initiatives have played a significant role in the expansion of SBHCs by earmarking state and federal public health funding for SBHCS, setting program standards, collecting evaluation data to demonstrate impact, and advocating for long-term sustainable resources.