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RULE §37.538Standards for School-Based Health Centers

(a) Funded applicants shall comply with the following standards for school-based health centers.

  (1) Community-based solutions. The funded applicant shall facilitate collaboration among families, schools, and members of the community to assess and meet the health needs of the community's children and families. The funded applicant shall utilize all the following strategies for facilitating community-based solutions:

    (A) Establish or utilize a local school health advisory council per Education Code, Title 2, Chapter 28, §28.004 to make recommendations on the establishment and operation of school-based health centers and to assist the district in ensuring that local community values are reflected in the operation of each center and in the provision of health education.

    (B) Establish and/or enhance links between school personnel, school-based health center personnel, other health/social services providers and agencies in the community, and other supportive community sectors.

    (C) Enable students and families to be responsible decision-makers in promoting their own health and well-being, making connections with community systems that help to prevent the social isolation and alienation of individuals and families, and using the health care system wisely.

    (D) Require parental involvement in and management of the health care of children receiving services from the center; encourage parental accompaniment of any child younger than 18 years of age at visits to the center; notify the child's parent at least one week in advance or as early as possible of the scheduled appointment; and encourage the parent to attend the appointment.

  (2) Administration. The funded applicant shall plan and administer a school-based health center that meets the health needs of the community's children and families by use of the following strategies:

    (A) Deliver primary and preventive health services to children and families in a school-based setting.

    (B) Establish efficient, client-friendly procedures for utilizing all available sources of funding to compensate for services provided by the school-based health center, including reimbursement from the state Medicaid program, a state children's health plan program, private health insurance or health benefit plans. Funds received through billing for services shall be used for operations of the school-based health center.

    (C) Contract for provision of services at the school-based health center if necessary and appropriate. A school-based health center shall operate under the guidance of a medical director who is licensed by the Texas Medical Board. The medical director shall direct medical services of the school-based health center and be available for consultation, to see referrals, and to review charts.

    (D) Develop and present a specific, detailed plan for funding the school-based health center.

    (E) Research, develop, and implement the forms and administrative procedures necessary to remain in compliance with all applicable and relevant legislation and regulations. Required procedures contained in applicable legislation for operation of school-based health centers include but are not limited to the following:

      (i) provision of services to a student only if the school-based health center has obtained written consent to the services from the student's parent within the one-year period preceding the date on which the services are provided, and the consent has not been revoked;

      (ii) joint identification by school-based health center staff and the student's parent of any health-related concerns of the student that may affect the student's health and/or success in school;

      (iii) provision of neither reproductive services, counseling, nor referrals through the school-based health center receiving grant funds awarded under this subchapter;

      (iv) provision of all services by only appropriately licensed, certified, or credentialed professionals as required by law;

      (v) referral of a student for mental health services only upon notification of and with the written consent of the student's parent, which must be followed by written consent by the student's parent for each treatment occasion(s) authorized by the provider, including informed consent when required for specific services;

      (vi) a good faith effort by staff of a school-based health center to identify and coordinate with existing health care providers;

      (vii) provision of notice by the staff of the school-based health center to the primary care physician of a student who has received services;

      (viii) coordination by the staff of the school-based health center with the primary care physician concerning the clinical treatment of any person who has a primary care physician under the state Medicaid program or another health plan and obtaining authorization before delivering a service;

      (ix) utilization of all available sources of funding to compensate for services provided by a school-based health center;

      (x) conduct client surveys in school-based health centers by funded applicants; and

      (xi) documentation in the student's medical record of the school-based health center's efforts to involve the student's parent in identification of the student's health-related concerns; notification of the student's parent of scheduled appointments and proposed services; coordination with the student's primary care physician; and maintenance of written consent for treatment by the student's parent, including informed consent when required for specific services.

  (3) Emphasis on prevention. A funded applicant shall provide for primary emphasis on the delivery of primary health services and secondary emphasis on the implementation of population-based models that prevent emerging health threats by use of the following strategies:

    (A) increasing substantially the number of children in the community with health-care (medical) homes;

    (B) facilitating access to appropriate primary and preventive care for children;

    (C) educating, enabling, and empowering individuals for healthier lifestyles;

    (D) involving the community in identifying priorities and developing health promotion strategies; and

    (E) relying on the evidence of effective prevention to develop interventions that can demonstrate impact.

  (4) Focus on outcomes. A funded applicant shall focus on the achievement of outcomes that can be documented, using the following strategies:

    (A) delivering primary health services and disease prevention of emerging health threats through access to appropriate primary and preventive care for children through a program designed to achieve the following goals:

      (i) a reduction in student absenteeism with an emphasis on students with chronic conditions that use the school-based health center and drop-out rates;

      (ii) an increase in each student's ability to meet his or her academic potential; and

      (iii) an increase in the health of students through preventive health measures including immunizations, and routine physical examinations including checkups conducted in accordance with the Texas Health Steps program.

    (B) A funded applicant shall research, document, analyze, and evaluate outcomes, including the goals listed in subparagraph (A) of this paragraph, by activities that include but are not limited to the following:

      (i) gathering data and statistics, monitoring outcomes, and producing data by use of quantitative measurement systems to report on project impact as required by the Request For Proposals;

      (ii) providing quarterly and annual reports as required by the department;

      (iii) conducting client surveys and other qualitative measures of client satisfaction; and

      (iv) producing an annual written report that includes but is not limited to a narrative description of goals accomplished, numbers of students served, summary and outcomes of performance measures, results from client satisfaction surveys, any available statistics related to increased academic success, at least one story from consumers describing the impact of the school-based health center, and plan for sustaining the center after the final year of grant funding.

(b) Compliance. A funded applicant shall comply with standards required by Education Code, Chapter 38, Subchapter B, and provide to the department annually a statement signed by a representative of the school district and the local school health advisory council stating that the district and the local school health advisory council have made a good faith effort to meet all requirements of the department.

Source Note: The provisions of this §37.538 adopted to be effective August 16, 2000, 25 TexReg 7699; amended to be effective April 24, 2008, 33 TexReg 3278; amended to be effective March 6, 2011, 36 TexReg 1280

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