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| School-based health
by Denise Linville At an age when a large percentage of families are uninsured, or underinsured, the opening of the School Based Health Center at Durango High School is a much-needed resource. The center is large and well staffed, and looks the same as any fully functioning health care clinic. In fact, it offers some services that are not provided by a visit to a traditional primary care physician. Mental health care is provided in an adjoining office, and there is an on-site pharmacy as well. Jaynee Fontecchio-Spradling, a registered nurse and one of the driving forces behind the center, says one of the most exciting things about the center is that it is able to provide integrated care for students. “We have the ability to refer back and forth between our dietician, nurse practitioner, health educator and behavior health consultant right here in this health center,” she said. “This is a model of comprehensive care that is hard to access elsewhere in the county.” All services are offered free of charge, and the center is financed by state and federal grants as well as donations. Although the health center officially opened last October, many parents and students are just now discovering it. Prior to last fall, the only health services the school could provide were basic first aid, a few cots for sick kids to lie down on, and a district nurse to consult when needed. On an average day, 60 or more students will pass through the health clinic, although not all are seen for SBHC services. Many just need a band-aid or ice for an injury. In addition to providing immunizations and sports physicals, the SBHC can provide diagnosis and treatment for strep-throat, STDs, and care for minor acute illnesses and injuries. There is an off-site pharmacy to dispense a few basic medications. As a satellite of the family planning clinic at San Juan Basin Health, the School Based Health Center also provides annual pelvic exams, pap smears, and offers the HPV vaccine to prevent cervical cancer in women. The primary focus is prevention and education, but the center will dispense some contraceptives through the federal Title X program to students. All visits are confidential, unless a student is in danger of harming themselves or others. Good communication between students and parents is encouraged, and is strongly supported. The SBHC also offers support for chronic health issues such as asthma and diabetes but tries to get students into a primary care provider. The health clinic will store medicines such as Ritalin so that students can come in and take their medication while at school. The center also offers a tobacco-cessation program and other wellness support groups. There is a dental hygienist who visits the health center twice a year to provide teeth cleanings for students who meet certain financial need requirements. Amie Podolsky, a behavioral health consultant and an employee of Southwest Colorado Mental Health Center, is on staff to work with students on behavioral health issues. Students can come in and make an appointment for an individual session with Podolsky, but they are also encouraged to stop by the center to speak with a staff member whenever they need immediate help. She works with students in a problem-solving capacity, but all students who come through the center are screened for depression and high risk behaviors. Podolsky works with students one-on-one or in group-therapy sessions. Students who come in with more serious mental health issues will be given an appropriate referral. Sherrod Beall, nurse practitioner for the SBHC, comments, “Adolescents are the most under-served population when it comes to primary health care and mental health services.” Jenny Pritchard, a registered dietician, will work with students on nutrition and wellness education. This is an especially important service for students who are dealing with diabetes, obesity or eating disorders. Sherrod Beall, a nurse practitioner, and Fontecchio-Spradling are credited with writing the grants and getting the health center off the ground. However, both women praise former superintendent Mary Barter for standing behind their efforts. Grant funding for this year’s operating expenses is now $215,000, and the facility has forged partnerships with San Juan Basin Health Department, La Plata County Human Services, Southwest Colorado Mental Health Center, and Pediatric Partners of the Southwest. Beall ran a student health center in Cortez for six years before teaming up with Fontecchio-Spradling to bring a similar health center to Durango High School. The pair hopes the next stop will be Florida Mesa Elementary, where they are currently assessing whether or not they can put together a similar program. Fontecchio-Spradling now serves as the grant manager for the health center, and Sherrod works as a nurse practitioner. Beall and Fontecchio-Spradling also credit Paula Schaub, licensed pratical nurse, for developing the crucial rapport with students and giving kids the confidence to come into the health center. Debbie Reed works doing triage, and with up to 1,500 kids coming through the health center a year, her job is nonstop. As a consequence, she has come to know many of the families with kids at the school and welcomes any questions or feedback from parents. The SBHC also welcomes community involvement and has partnered with the Durango High Student Council and other organizations to keep current on how best to serve the needs of students, their parents and Durango High School teachers and staff. The guiding principle of the center is that healthy kids will learn more easily, and that keeping the student population healthy will keep them in school. Parents who would otherwise need to take a day off from work to take their sick child to the doctor will also benefit. In addition, Beall says, “sometimes kids don’t even tell their parents when they are sick. This is a way that they can learn to take responsibility for keeping themselves well.” Students do need to have permission from their parents to be seen at the SBHC (although any student can be seen one time without parental permission) so parents sign a consent form giving the center permission to see their children. For more information on the center, contact Paula Schaub at 259-1630. Ext. 6. •
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The Independent Weekly Line on Durango and Beyond
