School-Based Health Center (SBHC) / Managed Care Organization   (MCO) Project

The SBHC/MCO Project is an agreement between the MCOs, the Department of Health Office of School and Adolescent Health, and the Medical Assistance Division School Health Office. SBHCs are clinics on or near school grounds that provide physical health and behavioral health services to the students at that school. Many of the SBHCs also see students from other schools in the district, as well as staff and community members. Dental services are also offered at some SBHCs. There are 78 SBHCs in NM, and 52 are contracted with Department of Health (DOH) Office of School Adolescence Health (OSAH). The 52 SBHCs contracted with OSAH are allowed to bill Medicaid through this project.

The SBHCs provide onsite primary, preventive and behavioral health services to students while reducing lost school time, removing barriers to care, promoting family involvement, and advancing the health and educational success of school-age children and adolescents. SBHCs play an important role in increasing access to primary and behavioral health services among vulnerable, hard-to-reach or at-risk children and adolescents, particularly in rural and other medically underserved areas of New Mexico.

The partnership between the SBHCs and the Medicaid MCOs has allowed for the development and implementation of several best practice clinical guidelines to direct SBHCs in providing Early & Periodic Screening Diagnosis/Treatment Program (EPSDT) health screens; identifying and managing asthma, depression and obesity/type-2 diabetes; communicating with primary care providers; and working with the MCOs to coordinate and manage recipient care.

SBHCs may be sponsored by Federally Qualified Healthcare Centers (FQHCs), Hospitals, and/or Regional Education Cooperatives.

SBHC / MCO Project Resources

Standards and Benchmarks for Participation
SBHC Scope of Service Billing Guide
Medicaid Fee Schedules
SBHC Encounter Form
SBHC Medicaid Site Readiness Review Checklist

Apex Eval

Envision NM – Quality Improvement Initiatives

NM Alliance for School-Based Health Care

NM Department of Health – Office of School & Adolescent Health