When Tennille Rushing of Mercy Pediatrics sat down with McCracken County and Paducah school administrators last October to discuss opening two school-based health centers, she had one request.
"Give us your biggest challenges," she told them.
And that they did. Today will mark Morgan Elementary's second month with its new school-based health center, and Rushing hopes the center at Reidland Middle will be ready to open its doors next week. The two schools were identified by McCracken County and Paducah schools as the ones most in need of the services, and they are the first schools in western Kentucky to offer those services.
Though school-based health centers are new to the area, they started popping up in schools across the country in the 1970s and '80s. Today, almost 2,000 school-based health centers are operating in 48 states, according to a report from the American Academy of Pediatrics.
Rushing said one of the biggest challenges they're facing in opening these pilot programs is that so few people in the area even know what a school-based health center is.
The centers at Morgan Elementary and Reidland Middle use a primary care model in which a nurse practitioner provides basic health services inside the school. With funding from Mercy Pediatrics and space provided by the schools, Rushing, advanced practice registered nurse Lisa Oetjen and clinical support staff member Dona Parker are able to add their preventive and acute care services to the critical health services the school nurses already provide. "We will take care of anyone regardless of their ability to pay or their insurance," Rushing said. "The foundation saw this as a staggering opportunity to really make a difference in these communities."
If a Morgan Elementary third-grader comes to school with a sore throat, for example, his teacher can send him to the health center for treatment. If Oetjen and Parker suspect the child may have step throat, they notify the parents and offer to test for a streptococcal pharyngitis infection on the spot. If it is indeed strep, Oetjen can prescribe antibiotics and make sure the child gets home before the infection spreads to other students.
Morgan Elementary parents - many of whom do not have regular access to transportation - no longer have to worry about missing work to get a sick child to the doctor. The child is seen and, if needed, treated right away, not missing any school time unless absolutely necessary.
Some families they serve have insurance, some don't, and that's OK, Rushing said. Their goals are to improve health education, prevent illness, treat illness early on, and improve health care access and convenience for students, staff, teachers and parents.
"It's not the business of medicine," Oetjen explained. "It's seamlessly welding health care with education so that the students and the staff who are actually in the building for a school day have easy access to anything they need. Should a parent need it, it's there for them too."
During the first month at Morgan Elementary's health center, Oetjen and Parker were able to see students, staff, teachers and parents four days a week. They've helped a teacher quell nausea so that she could finish out her school day. They've gotten students caught up on their immunizations. They've administered kindergarten physicals. They've seen an average of about 20 people a day since they started. Though at times they've felt like they were "building the plane as it was flying," they said they're in awe of just how well their pilot program at Morgan has done so far. "When you're very passionate about something, it's a lot easier," Rushing said. "I feel like if we can take the clinic here and make an impact in even a small percentage of students at first, it will snowball."
Once the school-based health center opens at Reidland Middle next week, Oetjen and Parker will have to split their time between the two centers - two days a week at Morgan, two at Reidland. Rushing said she hopes to hire more staff so that they can spend more time in each school. They've also heard from several local dentists, optometrists and mental health professionals who are interested in getting involved and offering their services.
Oetjen said a few people have expressed concern that the school-based health centers are "stealing" patients from area doctors, but Oetjen stressed that simply is not the case. Any time they treat someone from the community, she said, they reach out to that individual's primary care provider if they have one. If someone doesn't have a primary care provider, they are able to fill that need.
School-based health centers in western Kentucky are still very young, Rushing said, but as more people in the community begin to understand what they are and what they offer, more people are offering support and expressing interest. Over 90 percent of Morgan Elementary parents signed consent of care forms for the health center. In the Cincinnati area, Mercy's sister district with years of experience with school-based health centers, only about 56 percent of parents sign on average.
Rushing has already had a few nearby school districts contact her about starting pilot programs in their communities. She said her dream is to be in every school.
"We've made a lot of impact already in our first month," she said. "If we were only doing it for a month, it would have already been a very successful pilot. But we've got a whole year."