2023 Oregon Revised Statutes › Volume : 11 - Juvenile Code, Human Services › Chapter 413 - Oregon Health Authority › Section 413.223 - School-based health centers; certification; best practices; rules.

The division of the Oregon Health Authority that is charged with public health functions:
(1) Shall develop and continuously refine a system of care that:
(a) Meets the developmental needs of adolescents;
(b) Promotes evidence-based practices for children; and
(c) Prioritizes public health through activities such as:
(A) Establishing certification and performance standards;
(B) Collecting and analyzing clinical data;
(C) Conducting ongoing assessments and special studies; and
(D) Defining a statewide planning and development process.
(2) Shall adopt by rule the procedures and criteria for the certification, suspension and decertification of school-based health centers. The procedures must allow certified school-based health centers a reasonable period of time to cure any defects in compliance prior to the suspension or decertification of the school-based health center.
(3) Shall convene work groups to recommend best practices for school-based health centers with respect to electronic health records, billing, joint purchasing, business models and patient centered primary care home identification.
(4)(a) May, in addition to the duties described in subsection (1) of this section, enter into a contract with an entity that coordinates the efforts of school-based health centers for the purpose of providing assistance to school-based health centers that receive grant moneys under ORS 413.225.
(b) A contract entered into under this subsection must require the entity to:
(A) Provide technical assistance and community-specific ongoing training to school-based health centers, school districts and education service districts;
(B) Assist school-based health centers in improving business practices, including practices related to billing and efficiencies;
(C) Assist school-based health centers in expanding their relationships with coordinated care organizations, sponsors of medical care for school-age children and other community-based providers of school-based health and mental health services; and
(D) Facilitate the integration of health and education policies and programs at the local level so that school-based health centers operate in an optimal environment. [2013 c.683 §1; 2019 c.536 §2]
Note:
413.223 was enacted into law by the Legislative Assembly but was not added to or made a part of ORS chapter 413 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.
Note:
Sections 1 and 5, chapter 601, Oregon Laws 2019, provide:
Sec. 1.
(1) The Oregon Health Authority, in consultation with the Department of Education, shall select 10 school districts or education service districts to receive planning grants for district planning and technical assistance. Each district receiving a grant, beginning on or after July 1, 2019, and concluding before July 1, 2021, shall:
(a) Evaluate the need for school-based health services in their respective communities; and
(b) Develop a plan that addresses the need identified in paragraph (a) of this subsection by drafting a proposal for a school-based health center as defined in ORS 413.225 or by designing a pilot program as described in subsection (5)(b) of this section to test an alternative approach to providing school-based health services.
(2) Each grantee shall consult with a nonprofit organization with experience in organizing community projects, or a local organization that coordinates with a statewide nonprofit organization, to facilitate the planning process and to provide technical assistance.
(3) Each grantee shall solicit community participation in the planning process, including the participation of the local public health authority, any federally qualified health centers located in the district, a regional health equity coalition, if any, serving the district and every coordinated care organization with members residing in the district.
(4) The Oregon Health Authority may contract with a statewide nonprofit organization with experience in supporting school-based health centers to create tools and provide support to grantees during the community engagement and planning process.
(5) At the conclusion of the two-year planning process, the authority shall select up to 10 entities in respective grantee school districts or education service districts to receive operating funds to either:
(a) Open a state-certified school-based health center, based on a school-based health center funding formula; or
(b) Pilot, for a five-year period, an approach to providing school-based health services as an alternative model to the school-based health center model. The alternative approach pilot programs may be designed to focus services on a specific community need, such as a need for mental health services, school nursing services, dental services, primary care or trauma-informed services, and may:
(A) Involve a partnership with a coordinated care organization, a federally qualified health center, a local public health authority or another major medical sponsor; and
(B) Identify a process for billing insurance, medical assistance or another third-party payer, or identify other funding, for the cost of services.
(6) By the end of the fourth year of the five-year period described in subsection (5)(b) of this section:
(a) Each school district or education service district piloting an alternative approach to providing school-based health services either commits to establish a school-based health center or proposes an alternative model to the authority and the Legislative Assembly.
(b) The authority may use the data collected and the recommendations of the school districts to adopt rules establishing flexible, outcome-based criteria for certification of the alternative approaches developed and implemented by the grantees piloting alternative models under subsection (5)(b) of this section.
(7) As used in this section, "regional health equity coalition" means a coalition that:
(a) Is independent of coordinated care organizations and government agencies, community-led, cross-sector and focused on addressing rural and urban health inequities for communities of color, Oregon’s federally recognized Indian tribes, immigrants, refugees, migrant and seasonal farm workers, low-income populations, persons with disabilities and persons who are lesbian, gay, bisexual, transgender or questioning, with communities of color as the priority;
(b) May include as member organizations a federally recognized Indian tribe, a culturally specific organization, a social service provider, a health care organization, a public health research organization, a behavioral health organization, a private foundation or a faith-based organization;
(c) Develops governance structures that include members of communities impacted by health inequities;
(d) Has a decision-making body on which more than half of the persons are self-identified persons of color and more than half of the persons experience health inequities;
(e) Prioritizes selection of organizational representatives who are self-identified persons of color or have a role related to health equity;
(f) Operates on a model that honors community wisdom by promoting solutions that build on community strengths and recognizes the impact of structural, institutional and interpersonal racism on the health and well-being of communities of color; and
(g) Focuses on:
(A) Meaningful community engagement;
(B) Coalition building, developing a governance structure for the coalition and creating operating systems for the daily and long term functioning of the coalition led by individuals with demonstrated leadership and expertise in promoting and improving health equity;
(C) Building capacity and leadership among coalition members, staff and decision-making bodies to address health equity and the social determinants of health; and
(D) Developing and advocating for policy, system and environmental changes to improve health equity in this state. [2019 c.601 §1; 2021 c.191 §18]
Sec. 5.
Section 1, chapter 601, Oregon Laws 2019, is repealed on January 2, 2028. [2019 c.601 §5; 2021 c.619 §4]
Note:
Sections 1 to 3 and 6, chapter 619, Oregon Laws 2021, provide:
Sec. 1.
(1) As used in this section:
(a) "School-based health center" has the meaning given that term in ORS 413.225.
(b) "School nurse model" means a model for providing school-based health services that is in accord with guidance from the division of the Oregon Health Authority that addresses adolescent health.
(2) The authority, in consultation with the Department of Education, shall select up to 10 school districts or education service districts to receive planning grants for district planning and technical assistance. Each district receiving a grant, beginning on or after July 1, 2021, and concluding before July 1, 2023, shall:
(a) Evaluate the need for school-based health services in their respective communities; and
(b) Develop a school-based health services plan that addresses the need identified in paragraph (a) of this subsection.
(3) The authority shall contract with a nonprofit organization with experience in facilitating school health planning initiatives and supporting school-based health centers to facilitate and oversee the planning process and to provide technical assistance to grantees to reduce costs and ensure better coordination and continuity statewide. To the greatest extent practicable, the nonprofit organization shall engage with culturally specific organizations, in the grantees’ communities, that have experience providing culturally and linguistically specific services in schools or after-school programs.
(4) Each grantee shall solicit community participation in the planning process, including the participation of the local public health authority, any federally qualified health centers located in the district, a regional health equity coalition, if any, serving the district and every coordinated care organization with members residing in the district.
(5) At the conclusion of the two-year planning process each grantee shall receive funding to operate a school-based health center or school nurse model in each respective grantee school district or education service district. [2021 c.619 §1; 2022 c.45 §20]
Sec. 2.
(1) As used in this section, "mobile school-linked health center" means a mobile medical van that:
(a) Provides primary care services, and may provide other services, to children on or near school grounds by licensed or certified health care providers; and
(b) Is sponsored by a school district or an education service district.
(2) The Oregon Health Authority shall develop grant requirements and ongoing operations criteria for mobile school-linked health centers and may award up to four grants to school districts or education service districts for planning, technical assistance and operations to implement a mobile school-linked health center.
(3) A mobile school-linked health center operated using grants provided under this section shall comply with the billing, electronic medical records and data reporting requirements established for grantees under section 1 (5), chapter 601, Oregon Laws 2019, but is not subject to the school-based certification requirements or funding formulas established for school-based health centers under ORS 413.225. [2021 c.619 §2; 2022 c.45 §21]
Sec. 3.
(1) As used in this section:
(a) "Distant site" means the site where a physician licensed under ORS chapter 677, or other licensed health care practitioner, who provides health care services through telehealth is located at the time the physician or licensed health care practitioner provides the health care service through telehealth.
(b) "Originating site" means the site where the patient is located at the time the patient receives health care services provided through telehealth.
(c) "School-based health center" has the meaning given that term in ORS 413.225.
(d) "School nurse" means:
(A) A school nurse as defined in ORS 342.455; or
(B) A registered nurse who is an employee or contractor of a school district and who practices nursing in a school setting.
(e) "Telehealth" means the use of electronic and telecommunication technologies to deliver health care services to a patient.
(2)(a) The Oregon Health Authority shall award grants to three school-based health centers to operate pilot projects to expand student access to mental and physical health care services and to improve the health and education outcomes of students through the use of telehealth.
(b) To be eligible for a grant under this subsection, a school-based health center shall enter into a pilot project agreement with a school district. The pilot project agreement must provide that:
(A) The school-based health center is the distant site that provides telehealth in conjunction with a school nurse located at the originating site; and
(B) The school-based health center will allocate to the school district a portion of funds received under this subsection to increase school nurse capacity and assist in offsetting costs incurred by the school district as a result of the school district’s participation in the pilot project.
(c) Funds described in this subsection may be used to:
(A) Compensate the following individuals for services provided pursuant to a pilot project:
(i) A school nurse;
(ii) A licensed health care practitioner located at a school-based health center; and
(iii) Administrative or technical staff at a school-based health center;
(B) Cover the costs of:
(i) Technical equipment necessary to provide telehealth; and
(ii) Technical assistance related to the use and function of equipment necessary to provide telehealth; and
(C) Cover other costs related to the pilot project’s provision of telehealth.
(3) The authority shall:
(a) Assist school-based health centers and school districts that enter into pilot project agreements in the efficient use of funds distributed under subsection (2) of this section.
(b) Coordinate with a statewide nonprofit organization that has experience in supporting school-based health centers and school nurses to carry out this section.
(4) A school-based health center that operates a pilot project shall report, on an interval determined by the authority, to the authority on the progress of the pilot project in a manner that allows the authority to determine the effectiveness of the pilot project.
(5) The authority shall establish a process to evaluate at least the following information regarding a pilot project established under this section:
(a) Billing practices and reimbursements;
(b) Access to health care services;
(c) Impact on student absence from schools; and
(d) Workflow practices.
(6) Not later than December 31, 2025, the authority shall submit a report, in the manner provided in ORS 192.245, to an interim committee of the Legislative Assembly related to health care, on the effectiveness and success of pilot projects established under this section. The authority may include in the report submitted under this subsection recommendations for legislation. [2021 c.619 §3]
Sec. 6.
(1) Sections 1 and 2 of this 2021 Act are repealed on January 2, 2028.
(2) Section 3 of this 2021 Act is repealed on January 2, 2026. [2021 c.619 §6]