Giving Thought: School-based health centers remove barriers to care

If you want to provide health care to young people, especially low-income young people, then it makes sense to deliver it where the kids are.

It so happens the vast majority of our children spend six or more hours of each weekday at school. And a growing network of school-based health centers from Basalt to Glenwood Springs is meeting them there.

Through a partnership between the Roaring Fork School District RE-1 and Glenwood-based Mountain Family Health Centers (MFHC), a full suite of health care services (medical, dental and mental/behavioral) is offered to students at the schools themselves. By placing the centers on school campuses, one of the main barriers to health care — getting kids to the doctor’s office during working hours — is erased.

This need is especially acute for working parents who happen to be single. If their workplace isn’t close to their children’s school, then one medical appointment can mean a lot of lost income.

“School-based health centers try to improve health equity by helping to eliminate as many barriers to health care as they can,” said medical director Kendra Nagey. “It’s all under the umbrella of Mountain Family, so we function as a federally qualified health center. And we do our best to provide care to people who are most at-risk in terms of their economic picture.”

Nagey and her colleagues are especially enthused about a new center at the Roaring Fork Valley’s largest high school.

“Last summer we were able to build out and open a beautiful new clinic at Glenwood Springs High School,” Nagey said. “We’ve seen our numbers grow because we have this space and publicity to gain more attention.”

Other MFHC-operated clinics are also at Basalt Elementary School, Basalt Middle School, Basalt High School, Roaring Fork High School in Carbondale, and Avon Elementary School in the Eagle Valley. The system is growing as awareness grows and families discover the benefits of the conveniently located centers and MFHC’s focus on affordability.

“We see patients with commercial insurance and state insurance, but we also have a very robust outreach and enrollment department,” Nagey said. “We can also offer care on a sliding scale to patients that have enrolled with us.”

Currently, the clinics are staffed for about two days per week, and staff members spend much of their time on the road between clinics. An additional practitioner will join the school-based staff in May, so MFHC looks forward to adding hours and being able to reach more students in the 2022-23 school year. The new full-time pediatric nurse will enable the clinics to open their doors for a solid 16 hours per week at each school site.

“It’s partly driven by demand,” Nagey explained. “As we get busier, we’ll be able to hire more people.”

To a large extent, demand for services at the schools are driven by referrals from teachers, counselors and administrators. But many students come into the clinics for required sports-related physical exams, and those appointments enable broader doctor-patient discussions about dental care, family history and other health-related topics.

“I have had sports physicals in the past two weeks in which students, by way of questioning, have ended up doing a depression or anxiety screening,” Nagey said. There have also been kids who hadn’t had a dental cleaning in years.

Practice director Concepcion (Connie) Ruiz said a new student from Mexico recently walked into the clinic in Glenwood, wondering what a “sports physical” was. He got an answer to that question and much more. Within days he’d received a well-check, gotten his teeth cleaned, and his mother, who signed up for health insurance, was able to make an appointment at a nearby MFHC clinic.

It certainly feels as though the school-based model shows great promise as a way to keep our children healthy. And Ruiz, Nagey and their colleagues see other possibilities too. They already speak with numerous high-school students who have questions about reproductive and sexual health, and wonder if it might help teachers to occasionally bring a health care provider into the classroom. Whether it’s encouraging elementary students to wash their hands, or educating anxious teens about “mental first aid,” our youngsters can always use a helping hand.

“Wherever we can be a resource for the schools, we’re just trying to increase our availability,” Nagey said.

Tamara Tormohlen is executive director of the Aspen Community Foundation.