Integrate Services into SBHC Infrastructures

There is no gold standard for integrating comprehensive oral health services into primary care in SBHCs. However, in fully integrated SBHCs, multidisciplinary care teams (e.g., medical, oral health, mental health, nutrition) are responsible for providing whole-person care for students enrolled in the SBHC. Using a combined electronic medical and dental record, SBHCs have a defined workflow to ensure that all students receive evidence-based screening, preventive, educational, and primary care services. SBHCs are also equipped to monitor students at increased risk, including those with chronic diseases, to provide early intervention and treatment.

Fully integrated SBHCs have structured networks for referring students to health specialists for care that is beyond the scope of the services the SBHC offers. SBHCs have processes in place to ensure that students attend their appointments with health specialists and that information from appointments is communicated to the SBHC and becomes part of students' health records.

With written protocols in place, SBHCs may delegate preventive care (e.g., fluoride varnish application) and monitoring activities (e.g., body mass index calculations) to non-clinician staff. SBHCs also engage students in their own care through shared-decision making and specific activation and engagement techniques such as teach-back, motivational interviewing, and self-management.

  Resources for this Element


Action Steps

  • Streamline service delivery, policies, and practices.
  • Combine electronic medical and dental records.
  • Deliver primary care, including oral health, services using an integrative approach.
  • Integrate programs, services, and practices into the broader community fabric (e.g., via specialty networks and referrals).
  • Train all health professionals to conduct comprehensive health screenings and risk assessments, as allowed under their respective scope of practice laws and regulations; provide anticipatory guidance; and make referrals.

Highlights from the SBCOHS Grant Program

  • Bassett Healthcare Network (NY) incorporated an oral health component into its team meetings and community advisory meetings. The network also included an article on oral health in every SBHC newsletter.
  • Integrated Health Services, Inc. (CT) established an electronic health record that supports its behavioral health professionals, primary care health professionals, and oral health professionals.
  • Lemon Grove Elementary School District (CA) and Health Research, Inc./New York State Department of Health (NY) combined its medical and oral health enrollment forms and decreased the forms from six to two pages.
  • Summit Community Care Clinic's (CO) enrollment form was digitized for the iPad. When the digitized form is completed, it makes an automatic referral for oral health care if the student's last dental visit was more than 12 months before enrollment into the SBHC.

 Next Element