Have you heard the term “school-based health care” and wondered what it meant? Or maybe you thought it was just a case of the school nurse taking temperatures or dispensing over-the-counter remedies for upset stomachs or headaches.
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.