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www.casbhc.org                             CASBHC News Winter 2009
In This Issue
The State of Reproductive Health Services in Colorado's SBHCs
Governor Ritter Considers Health Care Surcharge
By the Numbers
Health News
People, Resources and Events
Quick Links

From the Executive Director

 
CASBHC Moves to New Office Space
 
Having outgrown its old space, CASBHC moved into new offices in November.  CASBHC is now located at 1801 Williams Street, Suite 400, Denver, CO 80218.  Staff can still be found at the same telephone number and email addresses.  The new FAX number is 303-350-4296.
 
January is Annual Membership Renewal Time
 
CASBHC memberships run from  January through December each year.   CASBHC has three levels of membership: Sponsoring, Collaborating and Associate.   A sponsoring organization is a primary sponsor of an operational school-based health center. Membership dues are based upon the organization's budget. A collaborating organization has an affiliation with an operational school-based health center and the annual dues are $100.  An associate is an organization or individual supportive of the mission and goals of CASBHC.  Annual dues for an organization at the associate level are $100.  Annual dues for an individual at the associate level are $35.  CASBHC also accepts donations.  You can download a membership application by clicking here.  Please mail your dues or donation to our new address: 
 
CASBHC
1801 Williams St, Suite 400
Denver, CO  80218
 
or call 303-399-6380 for more information.
 
CASBHC's Strategic Plan for 2009
 
CASBHC's mission is "keeping children healthy, in school, and ready to learn".  To achieve this mission we pursue four strategies:
 
* Advocacy
* Training and Technical Assistance
* Quality Assurance and Evaluation
* Organizational Development
 
CASBHC is in the process of developing specific and measurable objectives within each of these four strategies for the new calendar year.  To provide input, please attend our annual member meeting on January 20 from 9:30 until noon at the new CASBHC offices.  If you wish to attend, please RSVP to sato@casbhc.org or email your ideas to me at costin@casbhc.org.  I would love to hear from you.
 
Debbie Costin
The State of Reproductive Health Services in Colorado's SBHCs
 
The number of school-based health centers (SBHCs) in Colorado is rapidly increasing.  The discussion about whether or not SBHCs should provide reproductive and sexual health services, including contraception, continues to be a topic of interest and debate. 
 
Since the first SBHC opened in Colorado, schools, parents, healthcare providers, and community members have struggled to define the role of SBHCs in providing family planning services to sexually active teens.
 
CASBHC recently performed a needs assessment in 17 SBHCs serving high school students to determine exactly what services are being provided, what services are lacking, and barriers that prevent SBHCs from providing comprehensive adolescent health care.
 
The findings challenged the notion that few SBHCs are providing reproductive and sexual health services.  In Colorado, SBHCs are regularly providing pregnancy testing and chlamydia and gonorrhea screenings.  HIV testing, although not as accessible, is still provided in the majority of the clinics surveyed.  
 
The numbers become more disparate, however, when discussing contraception.  Of the SBHCs surveyed for the needs assessment, 59% are prohibited from making contraception available on-site, 18% have restrictions that prevent access to a full range of services, and only 23% provide comprehensive adolescent health services.  
 
The challenges providers identified with the provision of reproductive health services include policies, cost, and time.  However, the general consensus among providers in SBHCs is that access to comprehensive services is necessary to prevent unintended pregnancies, prevent sexually transmitted infections, and ultimately graduate more healthy young people. 
 
SBHCs can play a fundamental role in pregnancy and STI prevention when they have the opportunity to provide comprehensive reproductive and sexual health services to adolescents needing access to these services.  To increase understanding, CASBHC is creating a toolkit that can be used by SBHCs to
expand their reproductive and sexual health services.          
 
For more information about this report or the toolkit please contact Melinda Gonzales, Director of Adolescent Health Programs at
gonzales@casbhc.org.  To read CASBHC's position statement regarding reproductive health services, click here.
Governor Ritter Considers Health Care Surcharge
 
Colorado lawmakers are  expected to focus much of their energy on spending cuts, transportation and reinvigorating the economy.  Health care may also cause heated debate during this upcoming legislative season.
 
The Denver Business Journal reports that Governor Ritter is contemplating  proposing legislation to require hospital users and insurance companies to pay a surcharge, or provider fee, to fund health care initiatives.  Though numbers are still tentative, it is expected the provider fee could raise as much as $600 million for the Medicaid program, which includes federal matching dollars.
 
Almost all states have some form of provider fee already in place, though only 15 other states have a hospital-specific provider fee.   The Governor's Office, the Department of Health Care Policy and Financing and the Colorado Hospital Association have been working together for about six months to find an agreeable fee structure.
 
Federal regulations allow for a variety of different structures when creating a provider fee.  For example, the surcharge may be based on gross revenues, net revenues, or "bed-days."  What cannot be factored into the fee structure, however, is Medicaid payments.  Therefore, hospitals which serve few or no Medicaid patients will most likely see a net loss due to a provider fee.  Hospitals serving a high number of Medicaid patients should see a revenue increase.
 
By the Numbers
 
- Approximate number of students in Colorado's public K-12 schools:   800,000
 
- Approximate number of uninsured children in Colorado:   177,000
 
- Approximate number of Colorado children with untreated emotional, behavioral or mental health problems:   344,000
 
- Approximate number of Colorado children who have not been to a dentist in the past 12 months:   236,000
  
- Colorado's national ranking in teen pregnancy rate:     19
 
- Average number of babies born to teens each day in Colorado:     18
  
Health News 
 
Medical Myths Debunked     Two researchers from the University of Indiana School of Medicine published the results of their investigation into six urban legends in the Christmas 2008 edition of the British Medical Journal.  These myths are: sugar makes kids hyperactive, suicides increase during the holiday season, poinsettias are poisonous, most body heat is lost through the head, eating at night causes weight gain, and hangovers are cured by...(fill in the blank).  Each of these was tested or researched and the "truth" of the matter revealed.  Sugar does not make kids hyperactive; suicides are more common in warm and sunny seasons; poinsettias tend not to harm people; you will lose most heat through your head if it's the only uncovered area in cold temperatures; the time of eating does not appear to affect weight gain; the only known "cure" for a hangover is drinking in moderation.  You can read the complete press release from the University of Indiana by clicking here.
 
Talking Dirty to get the Message Across     The University of Denver recently issued a press release in the fall edition of the Journal of Communication in Healthcare.  The press release describes the efforts of DU professor Renee Botta to encourage undergraduates to wash their hands after using the bathroom.  She found traditional admonishments had little or no effect in changing their behavior.  It wasn't until she began hanging posters with messages such as, "Poo on you, wash your hands," or "You just peed, wash your hands," accompanied by graphic images, that students took notice.   Botta found handwashing increased by 26 percentage points for females and 8 percentage points for males during the four week poster campaign.  During the same time period, observations in dormitories without the posters found a 2 percentage point decline in handwashing with females and a 21.5 percentage point decline with males.  Botta recommends 20 seconds of vigorous handwashing to adequately clean the hands.  Singing the ABC song  while washing your hands takes about 20 seconds.
 
Pediatricians Found to be Under-Diagnosing Obesity     The January 2009 edition of the journal Pediatrics reported on an analysis of over 60,000 electronic medical records of patients aged 2 through 18 between 1999 and 2007.  The records indicated 19% of the children were overweight, 23% were obese, and 8% were severely obese as measured by their Body Mass Index (BMI).  While 76% of severely obese children and 54% of obese children had their conditions diagnosed, only 10% of overweight patients received a diagnosis.  In addition, females were more likely to be properly diagnosed than males and black and Hispanic patients were more likely to receive a diagnosis than white patients.  Read the full text article by clicking here.
 
Childhood Anxiety Disorders can lead to Academic Under-Achievement     An editorial in the December 25, 2008 edition of the New England Journal of Medicine states that childhood anxiety is under-recognized and therefore under-treated, leading to a host of problems.  Dr. Graham Emslie of the University of Texas Southwestern Medical Center writes that various anxiety disorders affect up to 20% of the nation's children and adolescents.  He says that research shows failure to identify such disorders early leads to educational under-achievement and increased rates of anxiety disorders, depression and substance abuse later in life.  Dr. Emslie goes on to say that
anxiety disorders in children are often unnoticed because the child might complain of physical aches and be unable to verbalize "worry" or "fear."  To read a press release from UT Southwestern Medical Center, click here.

PSSST...Be Happy, Pass It On       The Harvard Medical School issued a
press release on December 4, 2008 describing research reported in the British Medical Journal.  Nicholas Christakis and James Fowler have found that happiness spreads through social networks up to three degrees of separation (friends, friends' friends, and friends' friends' friends) and the happiness can last up to a year.  Using data from almost 5,000 individuals participating in the Framingham Heart Study over a 20 year span, the researchers found that you can be influenced by the emotions of somebody you do not know.  In the recent past the same two researchers reported that behaviors, such as over-eating and smoking cessation, can travel through social networks, but this is the first study to show that emotions can also travel in much the same way.  They also give us another reason to be happy...sadness does not spread through social networks nearly as well as happiness does
.
 

People, Resources and Events

School-Based Health Centers: Integrating Mind and Body     CASBHC's annual conference will be held on April 23-24 at the Embassy Suites Hotel at the Denver Tech Center in Centennial, CO.  This year's conference, titled "School-Based Health Centers: Integrating Mind and Body," will focus on providing SBHC clinicians and program administrators practical methods to improve patient care using an integrated model.  The cost of the 1 1/2 day conference will be $125 for CASBHC members if payment is received by March 20.  Registrations received after March 20 will be $175 for CASBHC members.  For more information, contact Todd Soderberg at 303-399-6380 or soderberg@casbhc.org.  Registration materials will be out soon.

Grant Deadline for The Colorado Health Foundation        The Colorado Health Foundation grant deadlines occur quarterly. The next deadline is April 15.  To speak with a TCHF program officer, please call the main number, (303) 953-3600, or toll-free at (877) 225-0839, and you will be directed to the most appropriate person.  To see the guidelines and to apply for a grant online click here.
 
Telehealth Symposium 2009      This important conference, presented by the Colorado Rural Health Center and the Colorado Neurological Institute, with the lead sponsor Caring for Colorado, will be on March 27, 2009 at the Sheraton Denver West Hotel in Lakewood, CO.  This one-day symposium will highlight current telemedicine and telehealth opportunities and obstacles in Colorado. For more information, contact Shelly Collings at 720-233-5590 or sc@coruralhealth.org.   Registration materials will be available soon.

Grant Deadline for the Caring for Colorado Foundation      The next deadline for grant applications to Caring for Colorado Foundation is March 13, 2009.  To see grant guidelines or to obtain a grant application, go to the foundation's website at
www.caringforcolorado.org
 
Sign Up to be Notified of New Funding Opportunities by The Colorado Trust     To be automatically notified of RFPs offered by The Colorado Trust, sign up on line.  You may also request to receive a variety of other updates from The Colorado Trust at the same time.
 
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