mental health in school health centers in north carolina

MENTAL MENTAL HEALTH HEALTH IN SCHOOL IN SCHOOL HEALTH HEALTH CENTERSCENTERSIN NORTH IN NORTH CAROLINACAROLINA

Brief Overview of State-Brief Overview of State-Funded School Health Funded School Health Centers in North CarolinaCenters in North Carolina

Managed by School Health Unit of NC Division of Public Health

Centers are partially supported by state funds 28 School Health Centers in 15 counties are included in

NC Division of Public Health’s school health center program

25 centers are school-based (most in middle and high schools) and 3 are school-linked

All have community-based advisory councils and strong collaborative support from community partners

Consultation/TA provided by state multi-disciplinary team

Types of School Health Centers• Comprehensive model

– Preventive– Medical– Nutrition– Mental/behavioral health– Health education

Types of School Health Centers• Alternate Model

– Offers Basic Health Services* and at least one of the following services:

• Preventive• Medical• Nutrition• Mental Health

*Includes health risk screening and referral for medical and mental/behavioral risks

School Health Center Sponsors• Local Health Departments• Hospitals• Federally funded Community

Health Centers• 501 c 3 organizations

Benefits of Integrating Health and Mental Health Care in School Setting• Holistic approach to adolescent

health—screening, assessment, treatment and /or referral for health and mental health issues

• Non-threatening setting for addressing mental health concerns

• On-site multi-disciplinary consultation available

Framework for Mental/Behavioral Health in School Health Centers • NC Quality Assurance Standards

– Scope of Services– Provider Qualifications– Documentation Requirements– Content areas for

policies/procedures

Framework for Mental/Behavioral Health Services• Mental/Behavioral Health Performance

Measures– ADD/ADHD– Inappropriate, violent or aggressive

behavior– Social skills/relationships– Depression and/or anxiety– Tobacco– Alcohol/drugs

Mental/Behavioral Health Scope Mental/Behavioral Health Scope of Servicesof Services

Prevention Psychosocial Screening Anticipatory Guidance

Intervention/Treatment (Basic) Case Management Problem Solving/Supportive Counseling Situational Crisis Intervention Consultation to school and school based

personnel Referral/follow-up

Behavioral / Mental Health Behavioral / Mental Health Scope of Services Scope of Services

Intervention / Treatment (Advanced) Crisis Intervention Involving Serious

Mental/Emotional Issues Short-Term Individual Psychotherapy Short-Term Group Psychotherapy

Optional Services Psycho-educational Groups Psychological Testing Substance Abuse Treatment

Mental Health Providers in School Health Centers• Provider qualifications for each level

of service are specified in Standards• Must meet Medicaid and Health

Choice requirements in order to bill • Amount of mental health provider

time varies across centers from 4 hours per week to 72 hours per week

Mental Health Providers in School Health Centers May Be

• Employed by center’s sponsor• Contractual (individual

provider or private mental health agency)

• In-kind contribution (school, LME)

Continuous Quality Improvement in School Health Centers• NC Quality Assurance Standards• Mental Health Performance Measures• Chart Review• Center Multi-disciplinary Team Meetings• Bi-Annual Reports to State• Consultation/Technical Assistance from

State• Credentialing/Re-credentialing

Technical Assistance for School Technical Assistance for School Health Center Behavioral/Mental Health Center Behavioral/Mental Health ProvidersHealth Providers

Clinical Issues CQI Process Credentialing Coding / Billing Policies/Procedures Orientation of New Staff Information about Resources Facilitation of Mental Health

Work Group

Questions/Information

• Contact:Beverly HesterBeverly.hester@ncmail.net or 919-707-

5604OrDan Garson-AngertDaniel.garson.angert@ncmail.net or919-707-5666