School health centers keep kids healthy, improve learning

Kim Redinger, a physicians assistant, is checking the tonsils of 2-year-old Jesse Martinez.  Even after the exam, he keeps sticking out his tongue and gurgling “AAAHHH.”

“Good boy,” says Redinger. “All done.”

Jesse and his 4-year-old sister, Carla, are getting their yearly checkup.

But this is no typical doctor’s office. This is Entrada Health Care Center at Carmel Middle School. It serves Harrision School District 2 students and their siblings from infancy to age 21 who don’t have access to affordable health care.

Entrada opened five years ago as a 400- square-foot clinic that eventually was crammed with up to 300 patients a month. To handle the growing demand, a 1,600-square-foot facility recently opened down the corridor from the old center. Construction was financed with a $215,000 grant from the Colorado Health Foundation.

Development of school-based health care clinics are on the rise, with more than 1,900 nationwide and 46 in Colorado.

Studies have found that such clinics not only improve students’ health, but increase student achievement. There is also decreased absenteeism and discipline problems, and increased parental involvement in children’s education, according to a report by Colorado Association for School- based Health Care.

“If a child is sitting at a desk sick and in pain, they are not learning,” said Deborah Costin, association executive director.

She notes it costs an average of $206,000 to run a typical school-based clinic, which generally are funded through state and federal programs, private grants and sometimes private insurance and patient fees.

The Health Care Reform Bill recently passed by Congress provides $200 million over four years to increase and expand school-based health centers.

“We got involved in health care because health directly affects a student’s classroom performance,” said Richard Price, a Harrison school board member. He was Carmel’s principal when the clinic was conceived by a district and community committee whose vision was to bring the doctor’s office to the school district.

More than 70 percent of the district’s 11,400 students are impoverished.

The clinic is vital because low-income families often have no transportation to clinics and no health insurance or money to pay for medical services, Redinger said. Many do not know about community health programs and so defer medical care.

The new clinic has three fully-equipped examination rooms, a laboratory, a medical records office and a behavioral health office. There’s also a new outside entrance so that parents don’t have to traipse through the school. With the expansion, the clinic will be open five days a week, including in June and August.

The Entrada clinic is a partnership between District 2 and the nonprofit health organizations Peak Vista and Pikes Peak Behavioral Health Group. Peak Vista provides $75,000 to pay for three clinic employees and supplies. Pikes Peak Behavioral Health provides a mental health care professional. The costs are underwritten by patient reimbursements from Medicaid and Child Health Plan Plus, part of the Colorado Indigent Care Program.

District 2 pays for utilities and custodial care. It also receives grants, including $65,000  from Colorado Department of Public Health and Environment, to help run the clinic.

“We’ve seen everything from nosebleeds to pregnant girls,” said Redinger, who works with Peak Vista primary care doctors who are a phone call away for consultation or referrals. There’s also a medical assistant at the clinic, and a mental health counselor. If necessary, patients are referred to other Peak Vista specialists, including dentists.

The new clinic will have expanded mental health services. “There’s a huge disconnect when school counselors suggest that parents get mental health care for their kids. Now we can tighten that,” said Cayth Brady, District 2 coordinator of student services.

Such clinics have a track record of bridging health care gaps. The School-based Health Care Association report notes that two studies conducted in Denver found that those using school clinics were more likely to have made more than three primary care visits during the year, were less likely to have used emergency room care, were more likely to have received a comprehensive well-child exam and flu, tetanus and hepatitis B vaccines, and were 10 times more likely to make a mental health or substance abuse visit.

One parent particularly thankful for the Entrada clinic is Jill Martinez, mother of Jesse and Carla. Because an older daughter is in a district school, the two younger siblings get free care.

“This is heaven sent,” Martinez said.

She began taking her children to the clinic two years ago after seeing a poster at her daughter’s school. They have been treated for such things as asthma, eczema, and a broken finger, and have received childhood vaccinations and well-child checkups.

“We feel comfortable here. It’s like having a family doctor.”

School-based health care in Colorado

Entrada is one of three school-based clinics under the Peak Vista umbrella. The others are the Cripple Creek-Victor Mountain Health Center at Cresson Elementary School in Cripple Creek-Victor School District RE1, and the Fountain Family Health Center at Fountain-Fort Carson School District 8’s Lorraine Secondary School in the Lorraine Community Center.

Peak Vista is working with Colorado Springs School District 11 to develop a clinic at Lincoln Elementary School.

There are 46 health centers in 18 school districts in Colorado, serving 27,468 students, according to the Colorado Association for School-based Health Care. There were more than 82,000 visits to the centers.

The Colorado Health Foundation last year started an $11 million program to create 20 more school-based clinics.