School-based health centers gain traction in Missouri

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JOPLIN, Mo. (AP) — It’s been common for a child who needs a flu shot or who is feeling unwell to miss class because he needs to be seen by a medical provider.

But several school districts and health care providers in Southwest Missouri want to change that by putting basic health services directly in the schools.

“We’re thinking it’s an opportunity to get health care more immediately to our students,” said Carl Junction Superintendent Phil Cook, whose district is one of at least three in the region currently pursuing or considering a school-based health center.

School-based health centers began cropping up during the 1970s in elementary schools for those who could not afford or access primary care. There are now more than 1,900 health centers and programs connected with schools nationwide, according to a 2010-11 report from the School-Based Health Alliance. They exist in all types of schools — urban and rural, public and charter — and serve all ages of students with many types of health care services, according to the report.

There are only a handful of school-based health centers in Missouri, but if work continues this summer as planned, there will be two new health centers in Carl Junction and Webb City schools by the fall, while Joplin is considering a proposal.

Carl Junction is working with Freeman Health System to provide on- and off-campus health services to students and staff. According to their agreement, a nurse practitioner at a Freeman clinic on Main Street, just a few blocks from the schools, would be available for health care needs and would collaborate with the school nurses via video. Students could also be transported by the school to the clinic if needed.

Stacey Whitney, nurse for Carl Junction schools, said available health services would be similar to those offered by a family practice office, such as physicals, treatment of minor illness or evaluations. Parental consent would be required for all services, she said. The district would be responsible for providing the space for an onsite wellness center, which will be converted from an old weight room at the high school, as well as the staff to drive students to the Main Street clinic.

“It’s one of those deals that’s a no-brainer,” Cook said. “If we can do this to help kids and help families at no expense to the district, then why wouldn’t we?”

Tracy Godfrey, president of Mercy Clinic for the Joplin, Carthage and Kansas divisions, said the school-based health care model is not designed to replace families’ pediatricians or primary care physicians. Instead, it would offer care when and where it was sought by those who need it, she said.

“It really is all about putting care out in the community where it is needed,” she said.

The concept of school-based health centers has also attracted the attention of a Missouri lawmaker. Legislation from Rep. Jay Barnes, R-Jefferson City, which passed out of a House committee during the recently ended legislative session but did not make it to the House floor, would have encouraged the construction of school-based health care clinics in high-poverty districts.

Barnes’ office said school-based health centers provide several benefits to schools and communities, such as decreasing visits to emergency rooms and increasing access to primary care and immunizations.

Other area districts, however, have turned to mobile clinics.

The Community Health Center of Southeast Kansas operates a mobile clinic in Pittsburg, Kansas, with its van visiting each of the district’s six schools once per week. The clinic is staffed by the health center with a nurse practitioner and medical assistant who see students who have been referred to them by the school nurse.

The clinic acts as an “urgent care” center, treating ailments such as sore throats and earaches and offering immunizations and sports physicals, said Dawn McNay, director of development. Parents are given the option at the beginning of the school year to enroll their children in the program and are notified before and after a child is treated, she said.

McNay said services are available to all students, regardless of their family health insurance coverage. Uninsured students would fall under the health center’s financial assistance guidelines, she said. The program itself is financially self-sustaining, with the school district providing only a space at each school for the van as well as necessary utility hookups, she said.

The Jordan Valley Community Health Center in Springfield first launched its mobile dental clinic for local schools in 2007 and later added mobile medical clinics. Altogether, the mobile units provide care to 17 elementary schools and three middle schools in the Springfield school district and 12 rural school districts in surrounding counties.

The mobile clinic provided 7,000 flu vaccines in Springfield schools during the 2013-14 academic year and saw1,846 patients. It also administered a total of 913 vaccinations to students over the course of the year, according to data provided by the community health center.

Between 7 percent and 10 percent of Missouri, Kansas and Oklahoma children younger than 18 weren’t covered by health insurance in 2011, according to Kids Count, a data collection and reporting project from the Annie E. Casey Foundation.

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