July 12, 2013 – Schools in Multnomah County are out of session for the summer, but school-based healthcare is still available.
Just one of the county's 13 health centers – the one located in Parkrose High School and Community Center – is open for the summer, but students enrolled in any school in the area (even privately educated or homeschooled students) can drop in for a visit.
“The care doesn't change, but how the care happens changes during the summer time,” said Shannon Anastasiadis, a pediatric nurse practitioner who works at the clinic.
One of the reasons the clinic stays open is that children with chronic conditions, such as asthma or mental health issues, still need help monitoring those issues, and since the school centers serve as a primary care home for many children, continuing to work with providers in that system makes sense.
Often, though, care is delivered in the form of telephone consults – with students or their parents calling to ask questions, or care providers calling families to check in on students with certain diagnoses and ask how they're feeling and whether they're taking their medication.
“People have a variety of needs, and it doesn't need to look like the traditional model,” Anastasiadis said. “They don't necessarily need to figure out how to get here on the bus.”
Children do come into the clinic during the summer months, though, and they visit from all over the Portland area – some as far away as Troutdale. Most are enrolled in public schools, though Anastasiadis said she also sees a fair number of students who attend private schools or are being home schooled, during the summer as well as the school year.
The school-based clinics are funded by third-party insurance, Medicaid, grants and public funds – and families are not billed for out-of-pocket costs incurred during the visit, so copays are not an issue, making them an affordable option for families who struggle to make ends meet. The clinics also use electronic health records to ensure they have access to patient information from other clinics, inside and outside the school-based healthcare system.
Jill Daniels has been involved with school-based health centers in Portland since the first one opened at Roosevelt High School in St. Johns in 1984. She said the drive to open school-based clinics – where care went beyond what a school nurse could deliver – came out of the recognition that consistent access to healthcare helped students succeed academically, and that academic success in turn improves long-term health outcomes.
Anastasiadis talked about a student she saw in the clinic a few years ago who was getting ready to graduate, but was hamstrung by one requirement – a physical education credit. The student was uncomfortable participating in class due to a physical health issue she didn't feel comfortable discussing with her physical education teacher. Anastasiadis said she talked to the student about what she would feel comfortable discussing with the teacher, and after that consultation the three of them worked out a plan that enabled the student to complete the class – and she graduated.
“That's the kind of thing I never would have been able to do in primary care,” said Anastasiadis, who has worked for the Multnomah County Health Department – which staffs the school-based health center positions – since 1992, but came to the Parkrose health center in 2004 after working in the county's primary care clinics. “We do these very integrated things that will hopefully have a large impact on their future.”
Adults with a high school diploma are much more likely to earn a living wage, which also increases the chances they'll be able to live in safe neighborhoods and make healthy choices as an adult, Daniels said. “We're doing it for that trajectory, of taking care of the community.”
TO LEARN MORE:
To learn more about the school-based health centers, click here.
Christen McCurdy can be reached at [email protected].
