January 7th , 2003
By
Ames Boykin
Daily Herald
Patients at a new health
center opening soon in suburban
Chicago will need no insurance to see the
doctor.
They'll also escape the hassle of
dodging red lights to make it on time to the doctor's office only to be asked
to browse through magazines for an hour.
Instead, getting in to see the
doctor will merely require a hall pass.
Maine
East High School in Park Ridge will join the growing class of schools that have
health centers when it opens its clinic in late January. The project is a
partnership between the school and Advocate Lutheran General Hospital, located
just down the street from the school.
An underused storage space in the
lower level of the school, after months of construction, is becoming a clinic,
with examining rooms and a staff equipped to go beyond the work of a school
nurse in treating students and helping them stop bad habits that could land
them in serious trouble later in life.
With parental permission, Maine
East students can get an examination, immunizations, pregnancy tests,
prescriptions for commonly used medicines and mental health counseling.
There already are about 20
school-based health centers in
Chicago and its suburbs. Maine East's will be the
first in the Northwest suburbs.
School-based health centers are
still uncommon, yet their numbers have grown since the first ones opened in the
1970s. Only about 5 percent - or 1,500 - of
U.S. schools have one. Illinois is in the top 10
with about 40.
Critics who ask why educators are
interested in health care can expect the same answer.
"In order for kids to do well, they
have to be well," said Maine East Principal David Barker.
That's the link for educators.
Healthy students make better learners and, for them, it's that simple.
"A student who is feeling ill can
go to the health center and go back to class, and not miss a day of school,"
said Judy Redick, Illinois Department of Human Services' administrator for
school health program.
Though there are limited federal,
state and local resources to start and operate such clinics, more communities
over the past three decades have recognized the need to offer students health
care down the hall.
Filling a void
American schools have long
emphasized the importance of good health.
At the turn of the century,
pediatricians were stationed at
U.S. schools. Today, it is the school nurse who is
in charge of encouraging good health.
But it wasn't until the early 1970s
that schools began opening health centers. The first ones, in
Denver, Dallas and St. Paul,
Minn., were founded after schools recognized a need for community clinics, said
John Schlitt, executive director of National Assembly on School-Based Health
Care.
Educators realized at that time
that students might not take the next step once they left the school nurse's
office.
Without health insurance, a child's
prognosis for accessing adequate health care looked grim.
"It was (a feeling of) 'We have
nowhere to send these kids to,'æ" Schlitt said.
Illinois
schools joined the trend in the 1980s and five school-based health centers
operated until more state funding became available in 1996.
Illinois
distributes about $4 million a year toward the 33 centers and others are in the
planning stages, such as Maine East's was last year, according to the Illinois
Department of Human Services. Nearly $2 million of the available money stems
from Illinois' settlement of its class-action lawsuit against tobacco
companies, the state agency's Redick said.
Maine East will get nearly $500,000
from the state over the next three years, including $200,000 in the first year.
A full-time nurse practitioner,
part-time medical director and medical office assistant will staff the school's
health center.
Students who visit Maine East's
health clinic - scheduled to open Jan. 21 - can get a school physical,
immunizations, treatment for mental health, pregnancy tests and nutrition
counseling.
In addition, they can enter a
program to stop smoking.
Mental health counseling is the
most common reason students visit school-based health clinics, statistics show.
School-based health centers in
Illinois were
involved in preventing 32 suicides this year, according to the Illinois
Department of Human Services.
Offering counseling and treatment
at schools is among the most valuable services school centers offer because the
services are convenient, safe and anonymous, supporters say.
"No one knows why you're there, and
you can get any services," Schlitt said. "They could be there for a cough, a
sports physical or mental health counseling. So, there's no stigma."
What Maine East students won't be
able to get at the clinic is the reason people most often attack school-based
health centers: contraceptives.
"It's more rare that they do offer
(contraceptives)," Schlitt said. "It's a battle that communities aren't willing
to take on. In reality, even when you do offer those services, it's a miniscule
reason that kids come in for."
Students will not be able to get
contraceptives at the Maine East center when it opens, but school officials
have not ruled out the possibility the clinic might decide to change that
policy in the future with the consent of the school board and the community.
Why
Maine East?
A walk through Maine East is like
lifting the lid on
America's melting pot.
Some 50 languages can be heard in
the halls. Seventy percent of its 2,100 students are minorities.
The barriers blocking Maine East's
minority students from health care are equally as diverse, ranging from
language to cultural differences.
Unfortunately, that reflects the
trend in Illinois
and across the United States, said U.S. Rep. Jan Schakowsky.
Schakowsky, an Evanston Democrat
whose new district will include the high school, believes the demographics of
Maine East make it a prime location for a clinic.
Maine East's clinic will serve all
students, but it hopes to cater to its large immigrant population and other
students without health insurance.
In
Illinois, statistics show 10
percent of children are not covered by health insurance. Twenty-six percent of
Hispanic children, 16 percent of black, 14 percent of Asian-American and 22
percent of low-income children have no coverage.
A
U.S. surgeon general's report
found 78 percent of black and 86 percent of Hispanic children don't get access
to mental health services, compared to 69 percent of whites.
Navigating the American health-care
system can be difficult when someone doesn't speak English. Even if a family
does have insurance, working parents cannot take off work to take their
children to a doctor, or teens might be asked to take care of siblings after
school while parents are at work.
Those without insurance tend to
flock to the most expensive place they can go.
"Right now with the culture - when
they're sick they go to the emergency room," said Karen Moore, director for
Advocate Medical Group. "The emergency room shouldn't be used for strep
throat."
Trips to the emergency room can
escalate to hundreds of dollars because patients are new so doctors have to
perform expensive tests to get to the root of their problems,
Moore said.
A school-based health center fills
a void another setting could not, experts agree.
"It's an ideal setting," Schakowsky
said. "You don't need to make sure they get to their appointment. There's no
good excuse when the clinic is right there."
The clinic's goal also will be to
focus on preventative measures students can take to improve their health.
Adolescents typically aren't the
picture of perfect health.
"They don't eat right. They smoke.
They ride on bikes without helmets," said Redick, of the Illinois Department of
Human Services. "So, you're trying to teach them good health habits."
Visiting the nurse
Maine East school nurse Jan Leist
rarely has a slow day.
In the last two years, Leist has
logged 18,000 student visits. She estimates between 75 and 100 students visit
her every day.
Students visit her office seeking
treatment for everything from small scratches to asthma attacks.
But Leist will be among the first
to say she can only help them to a point.
In crisis situations, she must call
paramedics to transfer students to Lutheran General, just a few blocks away
from the Park
Ridge school.
She can't dispense medications or
really treat anyone beyond giving ice to someone with a twisted ankle, so she
refers them to doctors.
"But oftentimes they don't go,"
Leist said.
As the school began planning to
open the health clinic, it surveyed students to identify need. The survey of
1,240 Maine East students found that 17 percent don't see a doctor, 13 percent
use the school nurse for health care, 10 percent use emergency rooms and 5
percent use immediate care facilities.
When the school-based health center
opens at Maine East, Leist expects to see just as many students. But she will
be more confident the students will see a doctor because the clinic will be
right down the hall.
"It's going to help me in the way
I'll have a place to refer the students," Leist said. "And I know they'll have
good care."
It's not unusual for a teen to be
sent home because they have failed to get all their immunizations in order,
Leist said.
Until the health center opens,
Leist must send a letter to the parents to notify them their child must be
immunized before they start school. Sometimes she has to send two letters.
Now, Leist will be able to explain
to parents that students can get their immunizations at school.
The clinic at Maine East also is
expected to relieve the burden for parents.
Cook County offers complimentary immunizations for
students, but the closest locations to the Des Plaines and Park Ridge students
are located in Wheeling and Rolling Meadows, Principal David Barker said.
A model
In planning to open its own clinic,
Maine East looked east.
Evanston
Township High School, which opened a clinic in February 1996, has served as a
model for the Maine East center.
Of
Evanston's 3,100 students, 1,800
have permission from their parents to use the clinic and half of those students
use the center, said Kathy Swartwout, the center's nurse practitioner.
Students visit the health center
for everything from a sore throat to acne to a pap smear. They also can vent
their problems and concerns in the office of a mental health counselor.
The true success of the
Evanston high school's
clinic can be measured in the students it has helped.
One female basketball player who
came to the clinic for a routine sports physical found out she had a serious
heart problem that could have killed her.
"She was feeling fine and we picked
up (an aortic aneurysm) on exam," Swartwout said. "Who knows?"
The teen could have ended up in the
headlines as another young athlete killed on the court because of an unknown
condition, Swartwout said.
Evanston
also has significantly cut the number of freshmen who miss class because they
never had the required physical. As many as 60 students would miss the first
day of school before the clinic opened.
Because students can get a physical
at the school clinic, that is not a problem anymore.
Other things as simple as giving a
teen clear skin can greatly improve their mental health.
"We've gotten their skin to clear
up and their whole outlook has changed," Swartwout said.
Like Maine East, the clinic at
Evanston Township
High School gets the bulk of its funding from the state. Evanston also gets
strong support from a local hospital, Evanston Northwestern Healthcare.
One of the biggest surprises since
the center opened has been looking at who's using it. Just as Maine East hopes
to serve students who have no insurance,
Evanston also started out seeking to fill that need.
What the clinic is finding,
however, is that all students are wandering into the center, Swartwout said.
More than half of the students, 52
percent, who use the
Evanston clinic have private insurance.
A clinic in every school?
School-based clinics have seen
their numbers mushroom over the past few years.
About 10 years ago there were 200
nationwide. Today, there are 1,500.
Maine East will be the first new
school-based health center to open in
Illinois in 2003. Others are expected to open in
Aurora and Champaign.
Why aren't there more school-based
health centers?
They are expensive, said Karen
Berg, who heads the Illinois Coalition for School Based-Linked Health Centers
in Chicago.
Maine East plans to spend $200,000
in its first year to staff it part-time. Staffing one with full-time employees
would at least double the cost.
Thanks to the tobacco settlement
Illinois reached,
nearly $2 million became available to fund the centers, but grant money seems
to dry up quickly.
"It's the battle we face right
now," Berg said.
Even supporters who want to net
more federal and state money to open more health centers at schools acknowledge
they have no plans to see one at every school.
Berg calls that goal "unrealistic."
Redick, of the Illinois Department
of Human Services, said health officials are targeting specific schools - those
with a student body like Maine East's.
Besides, supporters say having a
student-based health clinic will save money for both patients and the
health-care industry.
Preaching prevention is an
investment with a great return rate, officials said. It can save lives and
money.
They favor the example of a man who
has to undergo two or three heart procedures for something he could have
avoided if he had changed his lifestyle years earlier.
Instead, he has to miss work and is
stuck with thousands of dollars in medical bills.
"If you eliminate one heart attack,
you're saving money," said George Lesmes, vice president for Advocate Medical
Group.
Clinic:
Maine East using tobacco
settlement to fund first year.
|