As the end of summer nears, two things happen with great reliability in southern Indiana. The corn gets tall, and my phone starts ringing with parents who need a physical signed by Friday.

I understand completely. The summer gets away from all of us. But if I could give parents one piece of advice before the first bell rings, it would be this: the annual well-child visit deserves a spot on the back-to-school list, right up there with the new backpack, as well as the shoes that fit in June and mysteriously do not fit in August.

Why the well-child visit is important

A yearly physical is more than a signature on a form. It’s a chance to see whether your child is growing and developing the way we’d expect, to make sure vaccinations are current, and to confidentially talk through balanced meals, sleep, exercise, and any worries about learning, behavior, or mood. It’s also when we can knock out those annual forms, the ones that always seem to turn up in a folder the night before they’re due.

As a reminder on vaccines, Indiana requires certain immunizations for school attendance, with additional ones at key grade levels. These include kindergarten, sixth grade, and twelfth grade. That list generally includes DTaP/Tdap, polio, MMR, chickenpox, hepatitis A and B, and the meningococcal vaccine for middle and high school students.

Since they don’t come up every day, that may sound like a lot, and parents oftentimes have questions. This is one of the reasons it’s good to have a direct conversation with a qualified medical provider.

Addressing physical issues that can inhibit learning

Vision and hearing are worth a look, too. In three decades of practicing medicine, I have never once had a child walk in and announce in a voice that only children have, “Doctor, I believe I need corrective lenses.”

What I hear instead comes from parents: “he squints,” “she gets headaches,” or “he asks us to repeat everything,”

The point? Sometimes the difficult issue that seems to come across like a school problem is really an eyeglasses problem.

When you should connect with the school nurse

If your child manages asthma, diabetes, allergies, or seizures, please connect with the school nurse before the year starts. Send updated medication orders, refresh emergency contacts, and check the dates on inhalers and epinephrine auto-injectors. Expired rescue medication in the nurse’s office does nobody any good.

School issues:  simple worry, or attention-sapping anxiety?

Mental health belongs on the list as well. Going back to school brings excitement and, for plenty of kids, a knot in the stomach. Ask how they’re feeling about it. Ask about friendships, about bullying, about what they do when something feels like too much. If you notice changes in sleep, appetite, mood, or behavior that stick around more than a couple of weeks, a one-on-one talk with your provider is a good idea.

The rest is old-fashioned and still true. Think about starting bedtimes and wake-ups a week or two early, because nobody adjusts to a 6:30 alarm overnight. Children ages 6 to 12 need nine to twelve hours of sleep; teenagers need eight to ten. Eat breakfast. Move every day. Put the screens down before bed. Wash hands, cover coughs, skip the shared water bottle, and stay home with a fever or a stomach bug.

And you athletes: drink a lot of water, wear the gear, and tell a coach immediately about any head injury.

Finally, don’t wait. Schedules usually fill fast as summer comes to a close, and the calendar always wins. Call now, and help your child start the year healthy, confident, and ready to learn.

Board-certified in family medicine, Curtis Thill M.D. has seen multiple generations of children at Southern Indiana Community Health Care on their way back to school.

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Ready to have a great summer with your kids? When it comes to enjoying life, many can remember their fathers or mothers saying, “Health is your greatest wealth.” As a long-time practicing physician in the area, I know that if you are blessed with good health, your options are many, including having summer fun.

Since I see them in my practice, I think a lot about the kids in our area. Many different choices lie before them, especially the choices that promote good health. Here are some basic principles that can promote a great summer.

Summer is time for spontaneity, for surprise, for discovery and immersion into something special, a time for play and to have fun. Our young children and teenagers learn important lessons in this time: how to get along with others, to be a team, to share,  to create and experience special days, including day camps or summer camps, and in the family vacation. 

Sound health is key to enjoying all of them. 

How can your child  have a fun, safe, and healthy summer?

Sound sleep is fundamental

Here’s a surprise: number one on our list is good sleep. Set your child up for good and active days by helping them get a good night’s sleep, night after night. 

It takes planning, especially with daily work schedules, but keeping up a routine that features meals with healthy food and good snacks can give a child’s body the necessary nutrition to grow while they are pushing the limits of flat-out daylight to dusk high-energy activities. 

For many families, ensuring good nutrition can be challenging from both time and financial perspectives, especially in an era of rising food costs. Perfection is not the goal, but where possible, making a good, sustained effort is.

Eat healthy where possible

I know from experience that a child’s idea of a meal is often a double cheeseburger with a side of hot dog, washed down with a chocolate shake or mega-sized sugary drink. With a little planning, we as parents can substitute more healthy options, like yogurt with fruit for breakfast; a lunch with lean meat on good whole-grain bread (hold the chips), and some raw carrots or celery; and a dinner with plenty of vegetables and protein like fish, chicken (without the skin) or other lean options (including a bean dish). Think about having healthy snacks like unsalted nuts or seeds available in between meals to satisfy cravings (depending on their age, children can need anywhere from 1,200 to 3,200 calories a day).

Drink plenty of water

Related to good nutrition is a key point from the sports gurus: hydration. An important foundation of good health is drinking plenty of water (not sugar-dense sodas or over-sweetened fruit drinks). Encourage their children to drink a glass of water first thing in the morning and remind them to keep hydrated throughout the day. 

Stay active and have fun!

Summer is the time to be active! Turn off the TV and the cell phone and go outside. Go swimming, grab a ball and mitt, shoot some hoops, jump on a bike or skateboard, or take some old sheets and cardboard boxes and build a castle! 

The point? Summer is a time to get plenty of sunshine and fresh air where possible.

Sometimes during summer activities children can sprain an ankle or suffer an injury. Other times children can catch a summer cold. If that happens, always take advantage of the quality healthcare that’s available in our area.

Have a great, safe, and healthy summer!

A board-certified family physician, Dr. Curtis Thill has been practicing in the Crawford County region for more than 30 years. 

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While school-based health care does cover the basics, it really provides so much more for students, especially those who, for various reasons, don’t have access to healthcare providers or specialists. 

This year, SICHC, in cooperation with Orleans School Corporation, has established a School-Based Health Center Service Site (SBHC) to expand patient access to comprehensive, accessible, and continuous community health center services and respond to the needs of the Orange County community. In this post, we talked with Katarina Koch, SICHC’s Fund Development Manager, about school-based health care at Orleans Community Schools in Orange County.

Let’s start with an explanation of school-based health care and how it works. 

The goal of school-based health centers (SBHC) is to meet the needs of students and families in the community by providing a full range of age-appropriate health care services. SBHCs often operate as a partnership between the school and a community health organization, such as a community health center, hospital, or local health department. 

Prevention, early intervention and risk reduction are integral components, with students counseled on healthy habits and prevention of injury, violence and other threats. Nearly 2,000 school-based health centers operate nationwide, with most open every day school is in session.

Why did SICHC choose Orleans Community Schools and Orange County as the SBHC location?

Early this year SICHC began talking to all three Orange County school systems and surveyed parents and staff about their interest in school based health care for their community. We chose Orleans Community Schools because we had already established a partnership with the superintendent and school board to provide mental health services in the high school. Additionally, out of the three school systems in Orange County, Orleans is the most rural with the least industry, resources, and services available within the community.

 Orange County is considered one of the least healthy in the state according to County Health Rankings. Orange County consistently has higher rates of children living in poverty (21%) compared to Indiana (17%) and the U.S. (10%) and higher rates of alcohol, drugs, and prescription opioid use compared to the state. Also troubling is that nearly 30% of Orange County youth already have ACE (Adverse Childhood Experiences) scores of 4 or higher, and 70% of child removals from the home were due to alcohol abuse and/or drug abuse by parent(s).

Orange County is also considered a Medically Underserved Population, and Orleans is considered a primary care and mental health National Health Provider Shortage Area (HPSA), meaning the population to provider ratio is substantially higher compared to the state and the nation. All these factors showed a dramatic need for collaboration. When the schools, health care teams, including behavioral health, communities and parents work together, we all can promote healing and resilience.

SICHC does not currently have a clinic located in Orleans. Having a SBHC will help counter community challenges related to accessing healthcare during and after school hours and provide children and their families with the medical and psychological care they need.

What are some of the services that will be provided?

SICHC began mental health and tele-medical services in Orleans Jr. Sr. High School this August, with plans to begin a SBHC for medical care in the elementary school the summer of 2022 at a building donated by Orleans Community Schools. Mental health at the elementary school is already provided by a Youth First Social Worker, with SICHC mental health providers at the high school collaborating with Youth First for support at both locations.

Once the elementary school SBHC is open, high school students needing medical care will be transported to the clinic there, while still able to access in-person mental health care at the high school. Telehealth for general primary care will be available, connecting students and school staff to an SICHC primary care provider at one of our four SICHC offices. 

By 2023, services will be available to the broader population at the in-person health center. Patients needing services that aren’t available at the SBHC will receive a referral to appropriate care that can be made directly from the school site.

In general, SICHC will provide all the comprehensive services that are offered at our other primary care clinics located in Paoli, West Baden, English, and Marengo. We’ll also be working with local partners including Lifespring Health System and the Indiana University School of Social Work. These types of collaboration and partnerships enable us to offer continuous and comprehensive care and make health care more accessible to the community and underserved vulnerable populations. 

How many students do you expect will use SBHC?

Based on reports from other health centers, we expect about 40% of the student body will use SBHC services for both virtual and in-person visits. The nearest SBHC to Orleans is West Washington Schools in Campbellsburg; they shared their experience, best practices, and utilization data with SICHC as we planned our program. In addition to providing all the comprehensive services that are offered at our other primary care clinics, SICHC will also have a sick bay, where sick children can rest, thereby reducing the risk of exposure to other students and help parents and guardians who can not leave work early.  

Why is having school-based health care so important?

A SBHC can address the under-utilization of healthcare services. Research has shown that 60% of people on Indiana Medicaid do not take advantage of child wellness exams and 34% of Orange County kids do not have proper preventative care or immunizations. 

In Orleans, some of the barriers parents cited included the difficulty in getting a medical appointment, the inability to take time off from work, and the cost of healthcare itself. With a SBHC, an ill child can see a provider and have any needed medication delivered directly to the school, without the parent having to leave work to take the child to the doctor’s office.

Having a SBHC increases access to these types of services—both primary care and mental health—while reducing barriers for families and the community.

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