Healthy Kids Make Better Learners

Connecticut Association of 
School Based Health Centers
Coordinator's Manual Download PDF Here!

Table of Contents

Appendix

                    3

Introduction

4

Connecticut Association of School-Based Health Centers

5

DPH & State Programs Call List

6

Advantages of a School Based Health Center

7

Certificate of Need Process

8

Outpatient Clinic Licensing Requirements

10

Outpatient Clinic Inspection

11

Definition of School-Based Health Centers

15

Procedure for Obtaining Medicaid Provider Number

18

Procedure for Obtaining a National Provider Identification Number

19

Medicaid Contracting

20

Private Insurance Contracting

21

Clinical Laboratory Improvement Amendments

22

Minimum Primary Care Services Provided by School Based Health Center

25

School Nurse Agreement

27

Community Planning

29

Establishing a Community Advisory Committee

30

Management Structure for a School-Based Health Clinic

31

SBHC Staffing Options

32

Minimum Contents for Policy and Procedure Manual

49

Guidelines for Client Records

52

SBHC Management Information System Requirement

55

Recommendations for Electronic Health Records

62

Quality Assurance Plan

60

Quality Improvement vs. Quality Assurance

61


Appendix

 


Appendix A: SBHC Directory 

- HIPPA 




Appendix C: Clinical Laboratory Improvement Amendment Documents 

-CLIA


Appendix D: Standards for Mental Health Practice 


Appendix E: APRN Regulations


Appendix F: Sample SBHC Forms 

-SBHC Permission Form

-HIPPA

-SBHC Enrollment Form

-Physical Exam and Mental Health Screener

-Physical Exam Encounter Form

-Medical Visit Encounter Form

-Psychosocial Visit Encounter Form

-Sample Procedure for Billing Request

     -Form A

     -Form B

-Diagnosis Codes


Appendix G: Reporting Requirement Forms 

-Report of Suspected Child Abuse/Neglect

-Result Based Accountability 

-RBA Report Card Template

-State of CT Reportable Disease Confidential Form

-Student Satisfaction Survey


Appendix H: SBHC Standard Model 


Appendix I:Health Care Reform and SBHCs 


Appendix J: Program Operations Check List 


Appendix K: SBHC Definition, Standards, and Quality 


-Public Act No. 15-59 (An Act Concerning SBHCs)

-Quality Standards for CT SBHCs 

-SBHCs and Patient Centered-Medical Homes


Appendix L: Mental Health Screening in SBHCs

-Mental Health Screenings at CFA's SBHC

-Patient Health Questionnaire-9

-Behavioral Health Screens


Appendix M: Immunizations 

-School Flu Immunization Requirement Q+A

-State of CT School Immunization Requirements 2017-2018 School Year