State of Oregon - School-Based Health Center Program

  • - -
  • - -
  • Section A: Certification Process

    Please read carefully and email a copy of required documents to sbhc.program@state.or.us. Documents should be submitted to SPO within one week of submitting the online application
  • The SBHC Administrator attests that the appropriate center staff read and are familiar with the Standards for Certification. *

    Please see Standards for Certification for additional information. Available online at www.healthoregon.org/sbhc

  • The following documents have been or will be submitted to the State Program Office (SPO) at sbhc.program@state.or.us within one week of submitting the online application. *

    Your application will not be considered complete until these items are received by the SPO.

    The intent of the partnership agreement is to show the roles and responsibilities between the LPHA and any partners involved with the SBHC, such as a medical sponsor (if not the LPHA) and the school/school district. The agreement may be in the form of a memorandum of understanding, intergovernmental agreement or some other agreement form.

    A sample (2-4 weeks) of client data is also required to be submitted:
    For sites using EPIC EHR through OCHIN, these data can be pulled directly by the SPO. If you have not already submitted a release form granting SPO access to your data system, please do so within the next week.

    For all other sites, SPO requires the submission of 2-4 weeks of client usage data.

  • The SBHC Administrator attests that the following SBHC specific policies/procedures have been completed, each are individually signed, and are available for review during the verification site visit: *

    Please review the list of required policies and procedures located in the Standards for Certification. The non-discrimination and HIPAA policies are not required in the certification binder, but the site reviewer may ask to see these and other policies and procedures related to operations and practices during the site visit.

  • The SBHC Administrator attests that the appropriate center staff read and are familiar with the required policies and procedures in the certification binder. *

    Please see Standards for Certification for additional information. Required policies and procedures are located in Section C.
    Available online at www.healthoregon.org/sbhc

  • The SBHC Administrator attests that the appropriate center staff have enrolled and/or received necessary training for: *
  • Section B: Sponsoring agency/facility

  • The SBHC Administrator attests that a sponsoring agency has been identified. A sponsoring agency is an entity that provides the following services for a SBHC or contracts with another entity to provide one or more of the following: *
  • Medical Director: a health care provider with a license to practice independently and who has prescriptive authority. The Medical Director may be employed by the Medical Sponsor or the Medical Sponsor may enter into a contract with a licensed health care provider to provide the required services. The Medical Director provides ongoing oversight of the SBHC, at least quarterly, through clinical oversight, chart reviews and policy/procedure development. The Medical Director must be accessible to the SBHC staff by phone to discuss clinical issues and available to provide clinical assistance as needed.

  • Laboratory Director: The individual assigned as liaison to the entity that holds the CLIA license for the SBHC’s lab (“CLIA License Holder”). Responsible for maintaining current CLIA licensure, documenting laboratory competency training for staff, on-site lab QA, and ensuring the CLIA License Holder provides the SBHC ongoing oversight for complying with CLIA requirements (lab policies/procedures, quality control, instrument maintenance, proficiency testing, etc.)

  • SBHC Administrator: An identified person with administrative duties who is employed by at least one of the sponsoring agencies of the SBHC. The Site Administrator is the primary contact for the SBHCs administrative functions. The SBHC Administrator may share duties with the SBHC Site Coordinator.

  • SBHC Site Coordinator: An identified person with administrative duties who is employed by at least one of the sponsoring agencies of the SBHC. The Site Coordinator is the primary contact and liaison between the SBHC, State Program Office ( SPO), Local Public Health Authority (LPHA) and other SBHC community partners. The SBHC Site Coordinator is responsible for attending SPO meetings and Certification site visits.

  • Quality Assurance Coordinator: The person designated to oversee the SBHC’s quality improvement processes, including conducting the annual chart reviews and reporting of the SPO’s Key Performance Measures.

  • Immunization Coordinator: The individual responsible for oversight of immunizations and compliance with all the requirements of the Oregon Vaccines for Children (VFC) program The Immunization Coordinator oversees the vaccine ordering, storage, temperature monitoring and handling) within the SBHC, acts as the SBHC’s liaison to Oregon Immunization Program and LPHA immunization coordinator.

  • Privacy Official: The individual responsible for health information privacy including HIPAA and Oregon Privacy laws. The Privacy Official is responsible for the SBHC’s privacy policies and procedures and ensuring all staff have completed privacy training.

  • SBHC Administrator attests that a copy of the Student Rights and Responsibilities are posted in a conspicuous place in the waiting/entry area. *
  • Section C:Operations/Staffing

  • Example:
    Monday 8am - 3 pm
    FNP 5 hours
    RN 2 hours
    Support Staff 6 hours


    Please contact us if you have any questions: sbhc.program@state.or.us

  • The SBHC Administrator attests that immunizations are being provided in accordance with Standards for Certification. *
  • Section D: Laboratory

  • The SBHC Administrator attests that the SBHC is in compliance with CLIA requirements and has the following required documentation on site and available during the verification site review: *
  • The SBHC Administrator attests that all required on site laboratory services are being provided in accordance with Standards for Certification. *

    Please review Section D of the Standards for Certification for detailed information regarding the required on site services.

  • Section E: Services

  • The SBHC Administrator attests that all required on site primary care services are being provided in accordance with Standards for Certification. *

    Please review Section E of the Standards for Certification for more detail.

  • Section F: Data

  • The SBHC Administrator attests that the following data requirements have been met: *
  • The SBHC Administrator attests that the following data variables are being collected and the SBHC has the capability to submit: *
  • The SBHC Administrator attests that appropriate staff are aware of the following requirements: *
  • All requirements for the initial application have been met. If you answer no, please submit explanation below. *
  • You MUST submit an explanation of WHY the standard is not being met with a detailed plan and timeline indicating how and when the SBHC will come into compliance with the Standards for Certification.

  • Section G: Billing

  • The SBHC Administrator attests that the SBHC provider is Medicaid enrolled and the SBHC is billing Medicaid.
  • The SBHC Administrator attests that all information provided in the initial application for certification is accurate. *
  • By submitting this application, the county agrees to be the contracting entity with the Oregon Health Authority to support SBHC operations.

    Once you have submitted the online application form please send additional required documentation to sbhc.program@state.or.us.

    The Oregon School-Based Health Centers State Program Office will contact you regarding approval of your application within 30 days of receiving the completed application.

    Contact sbhc.program@state.or.us or 971-673-0249 with questions or comments.