Tag: School-based health services

Caught in Bureaucracy – a School Loses both Building and Health Center

Last year, Richwood Middle and High School were damaged beyond repair in historic flooding and the schools moved into temporary spaces for the 2016-’17 school year.

But when the schools moved, the kids didn’t just lose their buildings, they also lost their school-based health center. Now  a bureaucratic quagmire may prevent the middle school families from having a center next year.

Richwood Middle has been sharing a building with Cherry River Elementary, a couple miles across town. It worked, mostly, but was crowded. But when the middle school moved in with Cherry River, there wasn’t enough room for their health center to follow.

“Richwood Middle and Richwood High School actually shared a school-based clinic,” middle school principal Gene Collins said. “We were actually one of the first school-based clinics in the state of West Virginia back in the early to mid-90s. For many of my staff, for many of my students, that was their primary care provider.”

School-based health centers are a big deal in places like Richwood because parents don’t always have transportation, time or money to drive their children out of town for care. So if the kids don’t get care at school, they may not get it at all.

According to New River Health, the federally funded health center that ran the clinic, 99 percent of Richwood’s middle and high school students were enrolled in the clinic.

“We have always anticipated that when we get into our temporary modulars that we would have a school-based clinic moving in,” Collins said.

The modular, semi-temporary classrooms that will become Richwood Middle are being built with federal emergency management assistance money at the back of the Cherry River Elementary property.  

“And in fact, FEMA has paid for a separate modular for them,” Collins said. “There is a separate clinic building, which was going to be very nice. But now with the federal regulations HRSA will not approve the clinic because they’re saying our address is now Cherry River Elementary, which the scope has been assigned to another provider already.”

The Health Resources and Services Administration, or HRSA, is the federal oversight agency that manages the federally funded health centers.

According to HRSA, New River Health applied for a temporary permit to serve the middle school families. When that permit expired, New River submitted a request to make it permanent, but the paperwork they submitted to HRSA was incomplete.

Then there’s another issue. Cherry River Elementary hadn’t had a school-based health center before the flood, but Camden on Gauley, another FQHC, had been planning on opening one there. When Richwood Middle School moved into Cherry River after the flood, though, the middle school took the space the health center would have used. So, for 2016, neither the elementary nor the middle school had services on site.

But Camden is planning on starting one in the elementary school for next year and has permission from HRSA for those kids. Now that the middle school is right next door, who has the jurisdiction to care for those kids?

“And that’s a complicated process, but basically we have to prove a need in the community for those students in order for HRSA to approve us to go into that location,” John Schultz, Chief Executive Officer of New River Health, said.

“And because there’s another FQHC up in that area, HRSA has to look at what services are they providing and are they maxed out basically or can they continue provide services to additional students.” 

Alicia Hamrick is the mother of a seventh-grader at Richwood Middle School. She said for her, the center is much more convenient than driving her daughter 40 minutes to the doctor. For others, it’s a lifeline.

“Lot of the families around here they don’t have vehicles, they don’t have transportation to do that and it needs to come back,” she said.

But unless the health center is able to cut through the red tape, many of those middle school families may not have the care they need.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation, Charleston Area Medical Center and WVU Medicine.

Decades Later, Fluoride Rinse Programs Continue to be Effective in Protecting Against Tooth Decay

School-based fluoride rinse programs have been available to West Virginia schools for decades. Advocates argue they are still one of the cheapest and most effective tools schools have for preventing tooth decay. However, they are not well utilized. Recently, the Bureau for Public Health, which funds these programs, has begun a push to get more schools to take advantage of them.

At Mount Hope Elementary School in Fayette County, health educator Rosalie McCauley passes out toothbrushes and plastic cups of bubblegum-flavored fluoride mouth rinse to students.

“Remember, do not swallow, swish around, and when I say ‘go’ we will begin. Are you ready? Go!” she says to a class of enthusiastic third graders.

The fluoride mouth rinse program is brand new here, and kids and administrators are excited about it. The kids I talked to enjoy “swishing around the mouthwash,” and administrators hope the program will help reduce dental decay (also known as dental caries) in students.

“What the fluoride does is it protects the outer layer, you know the enamel,” says school nurse Jeanne Black. She says the hope is by providing fluoride mouth rinse and oral health education to students, schools can prevent dental decay in the young and teach lifelong oral health habits.

McCauley says she also thinks the program is empowering the students to take charge of their own oral health.

Third grader Hanna Parsons says she has learned “if you want to keep your teeth clean, to take care of them, to brush them and to use mouth wash.”

The most interesting thing she has learned from the program?

“Keeping my teeth clean,” she says, “so [my teeth] don’t fall out.”

Black says that last year she saw a lot of dental caries: ”I mean really bad decayed teeth. The children, they can’t concentrate in school, they just can’t learn, because they are in so much pain.”

McCauley says one of the biggest challenges at Mount Hope is that the community is mostly rural and poor. Most residents use well water that isn’t fluoridated. Administrators also say they suspect that poor nutrition, especially lots of sugary drinks, contributes to the children’s tooth decay.

“Dental health for any population – it contributes to your overall health,” says McCauley. “There is a relationship between poverty and risk for dental caries, and that could be access to dental care, the ability to provide the hygiene you need with the toothbrushes and toothpaste and stuff like that.”

Fluoride rinse programs are voluntary for schools and families. Supplies are free to all elementary schools – but the schools have find someone like McCauley or Black who is willing to do a training and oversee the program – and parents have to sign a permission form for their students to participate.

These programs now reach more than 200 West Virginian elementary schools and 9,600 students. 

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.

Exit mobile version