Maryland Council on Advancement of School–Based Health Centers

The Maryland Council on Advancement of School-Based Health Centers has issued its annual report for calendar year 2022. Key deliverables of the Council during 2022 included:

Council recommendations helped to inform a number of activities implemented by the Maryland Department of Health’s Bureau of Maternal and Child Health as the SBHC program was moved to the Bureau. These include: increased staffing, implementation of a statewide SBHC Needs Assessment, infrastructure grants to SBHCs, support for SBHCs to become COVID-19 vaccination sites, alignment of program activities with asthma-related SIHIS goals, and supporting more robust utilization of the Chesapeake Regional Information System for our Patients (CRISP) by SBHCs.
The Council worked with the Bureau of Maternal and Child Health to update the Maryland SBHC Standards. Key priorities of the Council include: focusing the Standards on minimum requirements only; developing a series of toolkits and/or appendices to provide supplementary information, recommendations, and helpful resources; clarifying requirements related to mental health and immunization services; clarifying and supporting continuous quality improvement requirements; and eliminating SBHC service “levels.” The Council also contributed to the SBHC program’s vision and mission in the Standards.
The Council developed recommendations to increase SBHC revenues generated through billing. Recommendations that can be implemented in the short-term under the existing reimbursement framework include: training and technical assistance to improve claims submissions and utilize existing codes more robustly; training and technical assistance to support SBHC utilization of CRISP; and facilitating collaboration between SBHCs and Maryland Medicaid Managed Care Organizations (MCOs). In the medium term, the Council recommends a regulatory change to permit SBHCs to bill for sports physicals; guidance to direct Maryland Medicaid MCOs not to send adverse benefit determination letters in cases where there is no member liability, development of an alternative model for SBHCs to provide vaccinations, and support for a potential pilot program to study value-based purchasing. Ultimately, the Council supports an innovative Medicaid reimbursement model in which services performed at SBHCs are reimbursed by Medicaid at a higher rate than similar services performed elsewhere, analogous to the reimbursement structure for Federally Qualified Health Centers (FQHCs); value-based purchasing; and Medicaid reimbursement for care coordination activities.

The Maryland Community Health Resources Commission and the Council on Advancement of School-Based Health Centers partnered with Harbage Consulting LLC to develop a white paper on demonstrating the value of SBHCs in Maryland. Harbage Consulting found that SBHC stakeholders are committed to providing high quality services to children and reducing barriers to care. SBHCs fill a critical role in the health care system by providing needed acute and ongoing physical and mental health services to children in Maryland schools, particularly in underserved areas.

The Maryland Council on Advancement of School-Based Health Centers was created in legislation approved by the Maryland General Assembly in 2015. The purpose of the Council is to improve the health and educational outcomes of students who receive services from school-based health centers (SBHCs). The Council is responsible for advancing the integration of SBHCs into (1) the health care system at the state and local levels and (2) the educational system at the state and local levels. The Council develops specified policy recommendations to improve the health and educational outcomes of students who receive services from SBHCs.

In 2017, the Maryland General Assembly approved legislation that transferred the staffing responsibilities of the Council from the Maryland State Department of Education to the Department of Health. Under the legislation, the Maryland Community Health Resources Commission (CHRC) provides staffing support for the Council and is permitted to seek the assistance of organizations with expertise in school-based health care to support the work of the Council. The Council will report specified findings and recommendations to the Department of Health, the Department of Education and the CHRC by December 31 of each year.

In addition to staffing the Council, the CHRC has provided a number of grants to support SBHCs and school health programs. For more information, click here.

Membership:

The Council is led by its Chair, Kate Connor, M.D., MSPH, and its Vice-Chair, Patryce Toye, M.D. The Gubernatorial appointees to the Council are as follows:

Kate Connor, M.D., MSPH, Chair, representing school-based health care centers

Patryce Toye, M.D., Vice-Chair, representing Maryland Assembly on School-Based Health Care

Cathy Mary C. Allen, representing Maryland Association of Boards of Education

Christina M. Bartz, representing Federally Qualified Health Centers

Sean Bulson, Ed.D., representing Public School Superintendents Association of Maryland

Gabriella Gold, representing commercial health insurance carriers

Diana Fertsch, M.D., representing Maryland Chapter of American Academy of Pediatrics

Joan Glick, representing Maryland Assembly on School-Based Health Care

Jean-Marie Kelly, representing the Maryland Hospital Association

Arethusa S. Kirk, M.D., representing managed care organizations

Scott Steffan, representing an elementary school with a SBHC

Rick Robb, representing a secondary school with a SBHC

Maura J. Rossman, M.D., representing the Maryland Association of County Health Officers

The Council currently has two vacancies: for the parent of a child served by a SBHC and a representative of the Maryland Assembly on School-Based Health Care.

Council Workgroups:

Systems Integration and Funding Work Group, chaired by Dr. Maura Rossman

The Priorities of the System Integration and Funding Work Group are to: (1) Understand local and national models for system integration and funding for SBHC; (2) Identify ways that SBHCs are leveraging resources and coordinating care across state and local agencies and service providers; (3) Identify the funding and service linkages between MSDE, DHMH, DHS, and other public agencies; (4) Clarify the roles and improve the coordination across and within agencies (state and local) making sure systems are aligned to make the SBHC initiative sustainable longterm; and (5) Review current SBHC RFP and application process to identify ways to improve the review and approval of SBHC.

Data Collection and Reporting Work Group, co-chaired by Joy Twesigye and Cathy Allen

The priorities of the Data Collection and Reporting Work Group are to: (1) Establish performance measures to present the impact of SBHCs on health and education outcomes of students; (2) Identify opportunities to link SBHC utilization data to educational outcomes; (3) Identify opportunities to better capture data for substance abuse and behavioral health services; and (4) Develop a trend analysis to understand the impact of SBHC over time by jurisdiction and population served.

Quality and Best Practices Work Group, chaired by Jean-Marie Kelly and Patryce Toye, M.D.

The priorities of the Quality and Best Practices Work Group are to: (1) Revise the SBHC standards; (2) Study SBHC sponsorship models employed in Maryland and nationally; (3) Understand current approaches to coordination of care and determine gaps in the provision of care (somatic, substance abuse and behavioral health services); and (4) Identify effective, sustainable business models – state and national best practices.

Meeting Dates, Agendas, and Meeting Minutes of Council and its Work Groups

Upcoming Meetings

Full Council:

April 25, 2023 12:00-2:00

https://us06web.zoom.us/j/84982954880?pwd=RTdJVmdRN1pOcnBsejZFLzRhWWdFdz09 Meeting ID: 849 8295 4880 Passcode: 973201

CASBHC | Systems Integration and Funding Workgroup [Standing Meeting]
Thursday, April 27 · 3:00 – 4:00pm
Google Meet joining info
Video call link: https://meet.google.com/xvf-gknv-uzf
Or dial: ‪(US) +1 484-841-5074‬ PIN: ‪160 687 602‬#
More phone numbers: https://tel.meet/xvf-gknv-uzf?pin=4634086400586