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This Program information provided by the Adolescent Health Section of the Office of Family Health Services.
School Based Health Centers: Funding and Operations
Funding
Oregon’s School-Based Health Center program (SBHC) has benefited from 20 years of support by the Oregon Department of Human Services and the Oregon Legislature. What began with an initial commitment of $212,000 to partially fund four SBHCs grew to a commitment of $3,100,000 to support 47 SBHCs in the 2005-2007 biennium.
Prior to July 1 2005, SBHCs were historically funded through a competitive grant process wherein the successful SBHCs in the state received grants of $52,619 per SBHC, while the remaining 24 that grew over the years received no direct state funds. All centers maintained similar levels of care, but without State compensation. This created considerable inequity statewide. However, when there was a legislative interruption of funds in February 2003 due to the failure of Measure 28, state-funded SBHCs were more severely impacted than those clinics that were less reliant on state dollars. As state dollars were fully reinstated in Fall 2003, the opportunity arose to re-evaluate the funding formula. After discussions with the Oregon School-Based Health Care Network and the Conference of Local Health Officials, a new funding formula emerged that aligned SBHCs with the public health delivery system for stability and ongoing support, while leveling most inequities.
Each county that has a State certified SBHC is eligible for State dollars through their local public health authority (LPHA). The LPHA is provided funds to support their efforts based on the number of SBHCs in the county and the availability of legislatively approved dollars. For example, if there are 1-2 SBHCs the LPHA receives $60,000/yr, 3-5 SBHCs they receive $120,000/year, 6-9 SBHCs they receive $180,000, and over 10 centers they receive $240,000/year. Each of these state dollars is used to leverage $3-4 local dollars. The funding formula requires an increasing local investment in the development of an SBHC system as the total number of centers increase. Local dollars may come from schools, school districts, county health departments, county commissioners, hospitals, community providers, local businesses and individuals, grants, and general fundraising. Stable sources of ongoing revenue and operational funds remain a significant concern for most SBHCs. Operations
The average SBHC in Oregon costs an estimated $150,000-250,000/year to operate. Remaining budgets needs are met through billing and supplemental dollars from local sources. Current data systems do not allow for detailed budget summaries. However, the State Program office is involved in a nationwide cost-modeling project to assist with the identification of all dollars that go toward SBHC operations. This will provide a better understanding of SBHC financing and help identify ways to maximize efficiency and strategically plan for improved sustainability. Efforts may include advocating for reimbursement of early intervention and more prevention services as provided in SBHCs, and identify best practices for public/private partnerships supporting SBHCs.
For more information about the School-Based Health Centers Phase I Planning Grants , please view the School-Based Health Center RFP. |
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