The Affordable Care Act and School Nursing: Opportunities in a Transforming Health Care System

Transcription

1 The Affordable Care Act and School Nursing: Opportunities in a Transforming Health Care System May 13, :30am to 11:30am Central presented by Healthy Schools Campaign and National Association of School Nurses In conjunction with the National Coordinating Committee on School Health and Safety

2 Logistics Webinar will run approx. 1 hour A recording of the webinar and the slides will be available online Please take 1 minute to complete the survey at the end presented by Healthy Schools Campaign and National Association of School Nurses In conjunction with the National Coordinating Committee on School Health and Safety

3 Q&A Session Q&A will be held during the final 15 minutes Ask questions through the questions box. presented by Healthy Schools Campaign and National Association of School Nurses In conjunction with the National Coordinating Committee on School Health and Safety

4 Today s Speakers Erin Maughan National Association of School Nurses Nina Fekaris Beaverton School District presented by Healthy Schools Campaign and National Association of School Nurses In conjunction with the National Coordinating Committee on School Health and Safety

5 is presented by About Healthy Schools Campaign

6 Health in Mind: Improving Education Through Wellness

7 Health in Mind Federal agency recommendations around: 1. Professional Development 2. Metrics and Accountability 3. Recognition Programs 4. Institutional Capacity 5. School Health

8 RECOMMENDATION 5 School Health Reduce existing barriers to reimbursement from Medicaid Recognize schools as eligible community benefit Create a new vision to explore full potential of schools as key centers for supporting children s health

9 Implementation Health National Collaborative on Education and Health Free care rule

10 Get Involved Visit to download our report and sign on to our vision.

11 Today s Speakers Erin Maughan National Association of School Nurses Nina Fekaris Beaverton School District presented by Healthy Schools Campaign and National Association of School Nurses In conjunction with the National Coordinating Committee on School Health and Safety

12 Erin Maughan Director of Research National Association of School Nurses presented by Healthy Schools Campaign and National Association of School Nurses In conjunction with the National Coordinating Committee on School Health and Safety

13 Erin Maughan, PhD, MS, RN, APHN-BC NASN Director of Research (Donna Mazyck)

14 Affordable Care Act for school nursing Provide examples across nation Discussion/questions

15 Improves quality and lowers health costs Increase access to health care Provides new consumer protections

16 Access to primary care Emphasis on prevention and wellness Care coordination

17 Medicaid/SCHIP: 45.6% Free/reduced cost health care: 76.1% School-based /Federally qualified health center: 65.5% Local provider who accept insurance: 50.3% (2013 School Nurse Survey) 172

18 Return on Investment Prevention: $5.60 return per $1 spent Depression: $7.00 Substance abuse $4.00-$7.00 Immunizations: $9.9 million direct care School Nursing: $2.20 TFAH, 2008; Wang et al, 2013

19 Montefiore Medical Center: Partners with NYDOE with school-based clinic Removed whole milk from schools (low-fat option only) ASTHMA: 50% hospital and ED reduction; 3-day/year improved attendance

20 Care coordination is especially important and challenging for children who have complex chronic conditions that may be lifelong and require special services (ANA, 2012) School & Community Improved asthma management ( School Nurse Case Manager (Moricca, et al., 2013) Decreased absences due to illness

21 New Funders of School Nurses Healthcare Systems Hospital

22 Seton Healthcare Family contracts with Austin Independent School District (AISD) to provide school health services. School nurses have support of nurse director, physician medical director, and tertiary care pediatric medical center (and their clinical specialists). Focus on wellness, health promotion and prevention

23 Meaningful Use Nemours: School nurse access to provider records Uniform School Nurse Dataset Telehealth Tennessee-School nurse driven

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25 Nina Fekaris School Nurse Beaverton School District presented by Healthy Schools Campaign and National Association of School Nurses In conjunction with the National Coordinating Committee on School Health and Safety

26 School Nurse Opportunity Patient Protection and Affordable Care Act Nina Fekaris, RN, MS, BSN, NCSN National Association of School Nurses/ Oregon School Nurses Association

27 Connections are Key You don t have to be an expert in PPACA You do have to go beyond your school community You do have to attend community meeting You do have to make the connections and cultivate key relationships

28 Patient Protection and Affordable Care Act Goal: Increase rate of health insurance coverage Decrease overall cost of health care Improve health care outcomes Streamline delivery of care

29 Oregon 567,000 student s K school districts 230 school nurses

30 Coordinated Care Organization Changing Health Care Delivery by: 1. Better Health 2. Better Care 3. Lower Cost

31 Pilot Project CCO ADHD follow-up 30 days p medication 6 months 9 months Asthma Management Decrease ER visits School Nurse ADHD follow-up Checklists Document school observation Asthma Management Inhaler use Peak flow Measurements

32 Pilot Project, cont. School Nurses Diabetes Management Communication with physician Blood Glucose Logs Insulin Dosage at school CCO Hemoglobin A1c control

33 Why participate in the pilot? School Nurses should partner with physicians in providing health care for students with chronic and acute health conditions. Health care dollars should be a part of the funding stream for school nursing services.

34 Connections Are Key! Identify friends of school nursing Local Accountable Care Organization State Public Health Organization State Nurses Association Education / Workplace Unions State Centers for Nursing or Nursing Workforce National Improvement Partnership Network Local legislators

35 Embrace your position YOU are the expert in school nursing YOU understand your school community YOU know what your student s and their families need in order for them to be healthy and succeed at school

36 Share your Story Tell your story / it s about students and their health Describe your practice Talk about what you know Don t be afraid to talk about your failures If we are unwilling to say there is a problem, no one will want to help you fix it

37 Students Come First School nurses CAN help lower health care costs by: Providing preventative population based health care Promoting healthy life choices Keeping student s safe at school Planning for chronic and acute health needs AND Leading the transformation of school health!

38 Nina Fekaris, RN, MS, BSN, NCSN Beaverton School District SW 5 th St Beaverton, OR

39 Q & A presented by Healthy Schools Campaign and National Association of School Nurses In conjunction with the National Coordinating Committee on School Health and Safety