Buncombe Health Dept. Evaluates Asheville, Erwin School Health Centers
March 1, 2010
ASHEVILLE — When Mikaela Bartow wasn’t feeling well one recent morning, the sixth-grader visited the health center at Erwin Middle School.
Health center workers were able to do a test for strep throat, get the results back right away and call in a prescription that would be waiting for Mikaela’s mom.
“It’s wonderful,” said Mikaela’s mom Christie Bartow, who had been trying all day to reach the doctor. “She (Mikaela) has seen these wonderful women (at the health center), and they’ve already got her medicine at the store.”
The Erwin Middle School center is one of three comprehensive school-based health centers in Buncombe County.
But as the Buncombe County Department of Health shifts its focus away from that of a health care provider, the department is looking at developing an alternative to these comprehensive school health centers.
Changes were originally slated to take effect at the centers for the start of the next school year, but health department officials now say they are slowing the process down after hearing concerns from school officials who worry about students losing access to care.
“We are going to slow the train down and continue to p rovide the services we are providing,” said Nelle Gregory, school health manager.
The three centers have been serving around 2,000 students at Erwin Middle, Asheville Middle and Asheville High schools. They include a nurse practitioner, who can diagnose and treat students.
School-based health centers
The center at Asheville High opened in 1994. The one at Asheville Middle opened in 1997, and Erwin Middle School’s center came online in 2000.
Initially, the centers included a full-time nurse practitioner, a mental health therapist, and part-time health educator and nutritionist.
At the Erwin Middle School health center, nearly 800 students were registered to participate through December of last year. Students getting treatment must have permission from parents.
“We’ve never been in a position of wanting to replace anyone’s primary care provider,” said Julia Cavender, a family nurse practitioner who works at the health centers. “Our goal is to facilitate children being in school.”
A quick trip to the clinic can help rule out something that might send a child home.
In addition to treating children, the centers have provided sports physicals, immunizations, pregnancy testing and risk assessments for children who have made multiple visits to the clinic.
But the Buncombe County Department of Health began scaling back the centers last year. The nurse practitioner position was reduced to part-time, and the centers also lost their mental health therapists.
School officials were concerned that additional changes could have meant less access to health care for students.
“We certainly are concerned that when students aren’t able to have access to medical treatment. It means the number of days they are absent from school will certainly increase,” said Carol Ray, principal at Asheville High School.
Asheville City Schools Superintendent Allen Johnson suggested the health department consider consolidating the centers at Asheville High and Asheville Middle, with one open three days a week and the other open two days.
“Those services were targeting some of the most at-risk kids in our community,” Johnson said.
Alternative centers
Gregory said for the start of the next school year, the health services available to students now will remain in place.
The health department will take the next six months to look at a possible alternative.
“Let’s not cut out what we have until we can replace it with something that is better or provides some service to more students,” Gregory said.
A team made up of representatives from the health department, school officials and funders including Mission Hospital and the state will look at the pros and cons of the existing centers and an alternative that would feature a more conventional school nurse.
The alternative center could mean workers would no longer diagnose and treat students, but would instead refer them to outside health care providers.
The team will need to find out if funding would be available for an alternative center. Officials will also explore if some other agency might be willing to provide the level of clinical service currently available at the existing health centers.
“It may be that other community partners can step in, and that model (for existing health centers) doesn’t have to change,” Gregory said. “Before we cut the service out, it sure would be easier to see if some other agency can step in and provide it.”
Gregory points out that these comprehensive centers serve students at just three schools. The health department wants to focus more on prevention and on reaching more students.
“Buncombe County has 13,000 children between 10 and 14, and over 12,000 adolescents between 15 and 19,” Gregory said. “The school-based health centers have been serving approximately 2,000 youths a year… What we’d like to do is take the dollars we have and try to serve more students in more schools.”
Gregory said schools are dealing with an increase in the number of students with serious health needs such as diabetes, asthma and cancer. Even has demand grows, most school nurses in the county divide their time between two or three schools.