Tormohlen: Keeping kids healthy at school
October 11, 2016
Recently, we've devoted this column to individuals working to effect positive change in the Aspen-to-Parachute region. This week, we're speaking with Haidith Ramirez-Leon, program director for the Roaring Fork School Health Centers. Originally from Colombia, Ramirez-Leon earned a degree in international business but decided to use her passion for translation (Spanish-English) and communication to help under-served students in the Roaring Fork Valley.
Aspen Community Foundation: Please explain the notion behind the Roaring Fork School Health Centers. Why do they exist and how old are they?
Haidith Ramirez-Leon: The original reason for a school-based health center was the health disparities we have in this valley. Family nurse practitioner Lisa Robbiano asked me to support her with the program and we opened the first center at Basalt High School in 2008. Lots of students don't have health insurance or access to quality health care. What better place to reduce those barriers? By having a medical provider come to the schools, we could serve every single student, regardless of their ability to pay, gender or ethnicity.
We started at Basalt High School and later opened at Basalt Elementary, Basalt Middle and Roaring Fork High School, as well.
The school-based health center model has been in the United States for 40 years, bringing quality health care into the schools for every student. That care needs to be comprehensive — not just a Band-Aid for their knee but the whole picture of a child's health. It also has to be affordable and accessible. That's why we have providers here in the schools every day.
ACF: Describe a typical scenario in which a student is referred to you.
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HRL: Our work typically starts where the school nurse's work ends. For example, when a student comes to the school nurse complaining of a headache, she might give him some Tylenol, but she will also ask if that headache is recurrent. What exactly is going on? Is it something to do with the child's eyesight? Maybe he needs to see an optometrist, or maybe he is acting up in class and didn't sleep so well. This is when a referral to our program is made.
The family might be able to just go and get some glasses, or it could be that the student cannot apply for Medicaid and doesn't have health care coverage because of the cost or their status in the country. Then we'll try to support that student through the Family Resource Center so he can get the financial help he needs.
But that's not all. It may turn out that this student just arrived from a war-torn city in Central America, he's faced a lot of trauma and he's never seen a dentist or doctor in his whole life. In addition to addressing medical needs, the program has a dental hygienist and a licensed clinical social worker trained in trauma, and we'll try to help students with all the support systems that we can.
So, it's not just about treating the headache. It's asking what else can we do with all the resources we have available in the schools to support students and families.
ACF: How are you funded? You're located at the individual schools but are separate from the school district, correct?
HRL: We raise all of our own funding. It's diverse; a variety of donors, including the town of Basalt, the town of Carbondale, Pitkin and Eagle counties, local foundations, state foundations and the state government. Since we are located in the schools, the school district provides in-kind contributions such as our clinic space and covering the cost of utilities.
Beginning in 2010, we started using electronic health records and a billing system that enabled us to become more like an actual medical practice. That was key for us to become more sustainable. We have improved our insurance and patient revenue during these past few years but it only accounts for 10 to 15 percent of our total budget. We waive most of our fees for patients who don't have insurance. Grants and other contributions allow us to do this and still make our budget.
ACF: What's in store for the health centers? Are there any changes or improvements in the works?
HRL: As of now, we have four centers. We have one inside each Basalt school, and last year, after a year of planning, state funding allowed us to open a center at Roaring Fork High School in Carbondale. We hope to expand in the future. At Roaring Fork High, we are able to provide some services to the other Carbondale schools but still the distance between schools is a barrier for many of the families. School-based health centers have a bigger impact on student performance when they are located in each school.
Tamara Tormohlen is executive director of the Aspen Community Foundation.
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