Children’s Defense Fund – New York

A series of challenges, including certain State regulations and reimbursement rules, have impeded the expansion of school-based health centers (SBHCs) across New York State.

SBHCs provide an affordable source of primary care to underserved children, but face difficulties in contracting with health plans, including those that serve children covered by Medicaid or Child Health Plus. As a result, care can be fragmented and may leave providers without compensation. The Affordable Care Act promises to create new opportunities for improvements among SBHCs, and will allocate $150 million in capital funding to establish or expand SBHCs nationwide. With support from NYHealth, CDF-NY explored these and other opportunities to preserve and expand SBHCs as a model that contributes to healthy outcomes for children and youth in New York.

CDF-NY worked with key partners—the New York State Coalition for School-Based Health Centers and expert consultants in financing/reimbursement—to develop an actionable report that supports new SBHC reforms. CDF-NY and its partners compiled and analyzed existing research to characterize the sector in New York and developed new ideas to address identified problems. CDF-NY also contracted with a reimbursement consultant to assess current models of care and financing, as well as regulatory and fiscal barriers that confront SBHCs. Expansion opportunities were identified by exploring barriers that impede access and growth in the sector, and other states’ approaches to addressing these barriers. CDF-NY used its findings to consult with New York State and City officials to inform the development of policy recommendations.

Read the report associated with this grant, “School-based Health Centers in New York State: Ensuring Sustainability & Establishing Opportunities for Growth.”