implementing a sexual health services referral system in ... · based referral system for sexual...
TRANSCRIPT
Implementing a Sexual Health
Services Referral System in
Your Priority Schools
Logistics
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• Live questions
• Typed questions/chat
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Meet the SHS
Capacity Building Assistance Team
Sandra Leonard, CDC DASH Project Officer
Amanda Brown, CAI Project Director
Anna Williams, CAI Project Evaluator
Dawn Middleton, CAI Principal Investigator
Polling Question #1
Where do you work?
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Materials Needed
• CDC DASH 1308 Program
Guidance Document
• Referral System Framework
• BPS Referral Tracking Form
Learning Environment
Learning Environment
Goal
Introduce the core components
of a school-based referral system for SHS
and to inform LEA activities associated with
establishing or adapting referral systems in
your own districts.
Objectives
• Identify the core components of a school-based referral system for sexual health services (SHS)
• Describe key considerations and activities for addressing each of the core components of an SHS referral system
• Examine LEA experiences to date in establishing an SHS referral system consistent with the core components
Background
Referral
A process of assisting students in obtaining
preventive health services through a variety
of activities, including but not limited to,
connecting students to adolescent friendly
providers on the basis of an identified need.
Referral System
A set of resources and processes that
when combined produce an outcome.
Referral System Framework
7 Key Sexual Health Services
• HIV testing
• STI testing and
treatment
• Pregnancy
testing
• Condoms
• Contraceptive
methods other
than condoms
• Condom
compatible
lubricants
• HPV Vaccine
LEA SHS Process Measures
Funded LEA has assessed its SHS-related policies
Funded LEA has monitored the implementation of SHS-related policies in priority schools
% of priority schools that received assistance on SHS
1
2
3
LEA SHS Performance Measures
Funded LEA has a system to refer students to youth-friendly off-site providers for key SHS
% of priority schools that provide students with on-site services or referrals to healthcare providers for key SHS
# of referrals made by school staff to youth-friendly off-site providers or SBHCs for ANY of the 7 key sexual health services
1
2
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Referral System Implementation Kit
Semi-Structured LEA Interviews
During September - November, 2014
CAI conducted semi-structured
interviews with 17 LEAs.
Core Components
Referral Staff
What Staff Make SHS Referrals?
29%
41%
59%
65%
88%
88%
0% 20% 40% 60% 80% 100%
Health Resource Center Staff
Youth
Other Staff
Teachers (e.g. Health, PE)
Counselors/Social Workers
School Nurses
Percent by LEA (N = 17)
Training for Referral Staff
What? Who? How?
• Epidemiology • State, district,
and school policy
• Referral guide • List of providers • Basic
information about SHS
• Based on the particular job function and role of referral staff member
• Periodic in-person PD
• Web-based learning
• Follow-up support
Referral Staff
•Nurses, SBHC & health resource center
staff, social workers and counselors
•Health & PE teachers, other teachers,
coaches
•Students
Popular Referral Staff Training Topics
29%
47%
82%
88%
88%
88%
0% 20% 40% 60% 80% 100%
Other
Evidence-Based SHS
Referral Guide
Epidemiology
Minor Access Laws
Written Procedures
Percent by LEA (N = 17)
Polling Question #2
How helpful would access to a
set of web-based modules be
in supporting your efforts to
train school staff to make
referrals?
Written Procedures
Referral Procedures
Existing referral
procedures can be
adapted for SHS, 53%
Referral procedures developed,
for SHS 41%
Percent by LEA (N = 16)
16 of the 17
LEAs have
some type of
Referral
Procedures in
place
Chat-In
What do you see as the
greatest CHALLENGE to
implementing district-wide
procedures for SHS referrals
in your priority schools?
Referral Guide
Philadelphia Referral Guide
http://imatterphilly.org/
NYC Referral Guide
http://www.nyc.gov/html/doh/teen/html/sexual-health-pregnancy/clinics.shtml
Referral Guide
Using or updating an
already existing referral guide, 71%
Created a new referral
guide for SHS, 29%
All 17 LEAs
have an
existing
Referral Guide
Percent by LEA (N = 17)
7 Step Guide Development
Decide what information to include in the guide for each provider: service provided, target population served, access information
Gather a list of potential SHS health care providers
Identify services provided by SHS providers
Finalize SHS provider list
Design, produce, and disseminate guide either electronically and/or hard copy
Update and Maintain Referral Guide at minimum every 12-16 months to ensure the guide is relevant and current
Train and Disseminate
Step 1
Step 2
Step 3
Step 4
Step 5
Step 6
Step 7
7 Step Guide Development
SHS Providers
Adolescent Friendly Assessment
• Self
• Facilitated
• Youth-led
How would you rate your level
of partnership with your city or
county health department
partners?
Networking and
Communication
Cooperation
Coordination
Coalition
Collaboration
National Network for Collaboration’s Levels of Partnership http://www.uvm.edu/extension/community/nnco/collab/framework.html#framework
Polling Question #3
Share information
Working together
Sharing Resources
Long-term commitment
One system
Marketing & Communications
Marketing for Students
•Poster and Flyers
•Classrooms
•Social Media
•School Events
Marketing for School Faculty
• Website Promotion
• Staff meetings
• In-person and virtual PD
• Email Blasts
Chat-In
How has your district engaged
youth in the design and
distribution of the referral
guide?
Monitoring & Evaluation
Monitoring and Evaluation Basic Moderate High
School referral staff count # of referrals made.
Community-based SHS providers count # of priority school students served.
Schools and community-based SHS providers count # of referrals completed.
• Types of referral tracking systems:
– Logs (paper-based and electronic)
– Databases
– Individual (student-level) referral sheets
– Survey Monkey
Referral Tracking
Referral Tracking:
Lessons from the Field
• Collaboration between the Health & Wellness
and Health Services Departments
• Feedback from SHS nurse liaisons
• Next Steps
– Training for referral staff (nurses)
– Engaging community SHS providers
Patricia Dao-Tran, Boston Public Schools
Policy
Policy
• Access to school-based health care
• Leave school premises to receive community-based medical services during school hours
• FERPA/HIPAA
• State laws on minors right to consent for SHS
Policy: Lessons from the Field
•School Nurses
•School Counselors
•Principals
•Health Teachers
•Students
•Community Partners
Rachel Miller, San Diego Unified School District
Management & Oversight
Management & Oversight
• Key staff, partners or school groups
• Minimum, 1 school champion or a
sub-committee of a larger school
health team or council
Management and Oversight
• Persons responsible for overseeing all
the referral system work include:
– Key 1308 Project Staff
– Health Services Staff
– Health Department
– Community-based health care providers
– SHAC
Key Tasks
• Update protocols
• Designate and train
referral staff
• Maintain
partnerships with
SHS providers
• Update &
disseminate referral
guide
• Implement marketing
plan
• Measure, monitor,
report and improve
• Share successes
Polling Question #4
How interested are you in
participating in occasional topic-
focused webinars?
Polling Question #5
How interested are you in
joining an ongoing virtual
learning group?
Polling Question #6
How interested are you in
receiving on-site technical
assistance?
Next Steps
• On-site and remote individualized
follow-up TA on request
• Virtual learning opportunities
– One-time
– On-going
• Dissemination of the Referral System
Implementation Kit
Questions
[email protected] 212.594.7741 ext. 294
This webinar was supported by Cooperative Agreement Number, 5U87PS004164-02, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services. Human Services.