Nuts and Bolts #3Nuts and Bolts #3
Funding for School-Based Funding for School-Based Health CentersHealth Centers
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ObjectivesObjectives
The participant will be able to:The participant will be able to:
Identify local, state and federal Identify local, state and federal opportunities and models of fundingopportunities and models of funding
Identify common community partners Identify common community partners involved in funding optionsinvolved in funding options
Identify foundation support for SBHCsIdentify foundation support for SBHCs
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Maslow’s Hierarchy of NeedMaslow’s Hierarchy of Need
It’s hard to focus on best practice standards when your needs are rooted in basic survival.
School health clinics fight for lives
Karina BlandThe Arizona RepublicMarch 12, 2001
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Multiple Funding Sources/ Multiple Funding Sources/ Models for School-Based Health Models for School-Based Health CentersCenters
Federal grantsFederal grants State grantsState grants Local fundingLocal funding Community Community
partnership partnership contributionscontributions
FoundationsFoundations Patient Patient
RevenueRevenue Mixing several Mixing several
or all funding or all funding sourcessources
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Foundations
Federal Public Grants
Local Funding/Community Partners
State Public Grants
SCHIPMedicaidPrivate insurancePatient fees
Federal entitlement programs administered at the state level MCHB/Title VCDC HIV/AIDS PreventionSAMHSA/Title XIX (substance abuse and mental health screening and early intervention)Title XX/ Soc Services Block Grant (TANF, daycare, child neglect and
abuse) State FundingState General RevenueTobacco Tax/SettlementEducationNCLB /ESEA (Title I improving academic achievement of the disadvantaged and Title IV safe and drug free schools) IDEA (health-related special education services)
BPHC/FQHC (Section 330 of the Public Health Service Act)Title X of the Public Health Service Act: Family Planning
Figure 1 School-Based Health Center Funding Models
Patient revenue
Foundations that commonly supports school-based health careRobert Wood Johnson FoundationKB Reynolds Charitable TrustWKKF Kellogg FoundationWelborn FoundationMcKesson FoundationDuke EndowmentHealth Foundation of Greater CincinnatiVisit the Grantsmanship Center at http://www.tgci.com/ and the Foundation Center at http://fdncenter.org for other foundation funding opportunities
Local FundingPublic and private grants (e.g., universities, United Way)City/county fundsLocal businesses (e.g., banks, insurance companies)
Community PartnersIn-Kind Contributions from schools, hospitals, health departments, community health departments, and community agencies (e.g., staff, facilities, supplies)Examples of PartnersParents’ employersParents’ health insurance agenciesLocal businessesSchool districtsUniversities
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Federal public grantsFederal public grants
BPHC /FQHC (Section 330 of the Public BPHC /FQHC (Section 330 of the Public Health Services Act)Health Services Act)
Title X of the Public Health Services Act: Title X of the Public Health Services Act: Family PlanningFamily Planning
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Core Funding ModelsCore Funding ModelsFederalFederal
330 Federally Qualified Health Centers330 Federally Qualified Health Centers
Entirely federally dependentEntirely federally dependentFairly stableFairly stableLimited community Limited community Limited funds for expansionLimited funds for expansion
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State public grantsState public grants
Federal entitlement programs administered at Federal entitlement programs administered at state levelstate level
– MCHB Title VMCHB Title V
– CDC HIV/ AIDS PreventionCDC HIV/ AIDS Prevention
– SAMHSA/ Title XIX (substance abuse and mental SAMHSA/ Title XIX (substance abuse and mental health screening and early interventionhealth screening and early intervention
– Title XX/ Social Services Block Grant, Temporary Title XX/ Social Services Block Grant, Temporary Aid to Needy Families Programs (TANF) job Aid to Needy Families Programs (TANF) job training, pregnancy prevention, daycare, child training, pregnancy prevention, daycare, child neglect and abuseneglect and abuse
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State public grantsState public grants
EducationEducation
– NCLB/ESEA (Title I improving NCLB/ESEA (Title I improving academic achievement of the academic achievement of the disadvantaged and Title IV safe disadvantaged and Title IV safe and drug free schools)and drug free schools)
– IDEA (health-related special IDEA (health-related special education services)education services)
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State public grantsState public grants
State FundingState Funding
– State General RevenueState General Revenue
– Tobacco Tax SettlementTobacco Tax Settlement
– Juvenile Justice FundsJuvenile Justice Funds
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Core Funding ModelCore Funding ModelState GrantsState Grants
Louisiana – MCHBG; Tobacco Louisiana – MCHBG; Tobacco settlementsettlement
Connecticut – MCHBG, state fundConnecticut – MCHBG, state fund
Delaware – state fundDelaware – state fund
Fairly stableFairly stableLimited growth; targeted fundingLimited growth; targeted fundingRequires legislative/administrative advocacyRequires legislative/administrative advocacy
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Local FundingLocal Funding
Public and private grantsPublic and private grants (universities, United Way(universities, United Way
City and county fundsCity and county funds
Local businesses Local businesses (banks, insurance (banks, insurance companies)companies)
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Core Funding ModelsCore Funding ModelsLocal GovernmentLocal Government
Portland/Multnomah County (OR)Portland/Multnomah County (OR)
Seattle/King County (WA)Seattle/King County (WA)
Great community buy inGreat community buy in
Fairly stable incomeFairly stable income
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Community partnersCommunity partners
In-kind contributionsIn-kind contributions (staff, facilities, (staff, facilities, supplies) from supplies) from
– Schools,Schools,
– Hospitals,Hospitals,
– Health departments, andHealth departments, and
– Community agenciesCommunity agencies
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Community partnersCommunity partners
Examples of partnersExamples of partners
– Parents’ employersParents’ employers
– Parents’ health insurance agencies,Parents’ health insurance agencies,
– Local businesses,Local businesses,
– School districts, andSchool districts, and
– Universities Universities
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Core Funding ModelsCore Funding ModelsCommunity PartnershipsCommunity Partnerships
Denver SBHCsDenver SBHCs
Baltimore County Public Schools, MDBaltimore County Public Schools, MD
Healthy Kids, Lexington, KYHealthy Kids, Lexington, KY
Indianapolis CollaborativeIndianapolis Collaborative
Collaboration has inherent difficultiesCollaboration has inherent difficulties
Built over long-termBuilt over long-term
Requires perseverance, leadershipRequires perseverance, leadership
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FoundationsFoundations
Robert Wood JohnsonRobert Wood Johnson
WK Kellogg FoundationWK Kellogg Foundation
KB Charitable TrustKB Charitable Trust
Health Foundation of Greater Health Foundation of Greater CincinnatiCincinnati
McDonald FoundationMcDonald Foundation
Welborn FoundationWelborn Foundation
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FoundationsFoundations
For other foundation funding For other foundation funding opportunities visitopportunities visit– The Grantsmanship Center at The Grantsmanship Center at
http://www.tgci.com
andand
– The Foundation Center atThe Foundation Center at
http://fdncenter.org
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Core Funding ModelsCore Funding ModelsFoundationsFoundations
Indianapolis SBHCsIndianapolis SBHCs
Cincinnati, Ohio SBHCsCincinnati, Ohio SBHCs
North Carolina SBHCsNorth Carolina SBHCs
Miami SBHCsMiami SBHCs
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Patient RevenuePatient Revenue
SCHIPSCHIPMedicaidMedicaidPrivate insurancePrivate insurancePatient feesPatient fees
SBHC and Billing InsuranceSBHC and Billing Insurance
From the 2004-05 From the 2004-05 CensusCensus
Insurance Billing by TypeInsurance Billing by TypeCensus 2004-05Census 2004-05
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Core Funding ModelCore Funding ModelPatient RevenuePatient Revenue
West Virginia – FQHC rateWest Virginia – FQHC rate
New York – Medicaid institution rateNew York – Medicaid institution rate
Commitment to specific sponsor typeCommitment to specific sponsor type
Leadership necessary at Medicaid levelLeadership necessary at Medicaid level
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Mixed Funding SourcesMixed Funding Sources
Denver School-Based Health Centers Denver School-Based Health Centers
Baltimore County School-Based Health Baltimore County School-Based Health CentersCenters
Healthy Kids CentersHealthy Kids Centers
Indianapolis CollaborativeIndianapolis Collaborative
Non Patient RevenueNon Patient Revenue Census 2004-05Census 2004-05
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Follow the Income StreamsFollow the Income Streams
Education
Mental Hlth/Sub
Abuse
PublicHealth
HealthCare
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Funding Service Funding Service ComponentsComponents
Medical/nursing servicesMedical/nursing services
Public health/promotionPublic health/promotion
Mental health/behavioral healthMental health/behavioral health
Case management/social services Case management/social services coordinationcoordination
Education supportEducation support
FundingFunding
Challenges:Challenges:– ConfidentialityConfidentiality– Provider typeProvider type– Insurance typeInsurance type– Keeping true to the modelKeeping true to the model– Finding the mix that worksFinding the mix that works