One of the state’s first school-based health centers has closed after receiving nearly $500,000 in state grant money over 3 1/2 years.
The Harrison School District was among nine districts selected in 2010 to participate in the Arkansas School Based Health Center grant program. The district opened its wellness center on the junior high campus in the spring of 2011, but decided in December to shut it down because of lack ofparticipation.
The center is the only one to close since the grant program started, state officials said.
The center provided medical and mental-health services. But it attracted limited interest from the student community and medical community, especially for medical services, district officials said.
The district opted to close it, return all remaining grant money to the state and use district money to continuethe mental-health services, said Susan Gilley, executive director over federal programs and instructional technology for Harrison.
School-based health centers typically have physicians and mental-health therapists, and sometimes also offer dental and vision services. Children are referred to the centers by school nurses and counselors. The centers coordinate with parents and the children’s regular physicians to offer care.
Since the grant program started, the state has awarded a total of $7.6 million to school districts to establish the centers, spending about $2 million on the program each fiscal year, Arkansas Department of Education spokesman Kimberly Friedman said.
And districts continue to apply for the five-year grants to set up the school-based health centers. For the 2014-15 school year, the Education Department is accepting program applications through March 20. Those chosen to participate will receive up to $540,000, with $150,000 in the first year and decreasing amounts of annual funding through the fifth year.
Aside from the Harrison wellness center, 14 schoolbased health centers have opened since 2010. Seven more centers are to begin services this spring at Franklin Elementary in Little Rock, George Elementary in Springdale, and in Cedarville, El Dorado, Siloam Springs, Waldron and Yellville districts.
Grants are funded by the state’s tobacco tax. The program involves the state departments of Education, and Health and Human Services, the Arkansas Center for Health Improvement, Arkansas Children’s Hospital and Medicaid in the Schools.
The centers give children easy access to doctors, especially for families in which parents lack transportation or can’t take time off work to take their children to the doctor, said Tamara Baker, program coordinator.
“The intent of schoolbased services is to maximize students’ chances to succeed academically,” Baker said. Healthier children tend to do better in school. “Health and mental-health care on campus provides the ‘caulk’ at the intersection of education and health that prevents students from falling through the cracks.”
A 2013 report showed that 6,562 students were enrolled as patients in the program across the state, Baker said. In the fourth quarter of 2013, just more than 3,000 students actually visited the centers - 2,042 for medical care, 336 for mental-health care and 643 for dental care.
Harrison Superintendent Melinda Moss said that in 2010 school officials originally applied for the grant because the district needed more mental-health services for students. When the district began implementing the program, however, it learnedthat state officials wanted more emphasis on medical services than the district had planned, Moss said.
“The needs of Harrison didn’t evolve with how the grant evolved,” Moss said. “It just became something that was not a good fit for Harrison.”
Midway through its fourth year of the program, Harrison had received $499,800 for its wellness center, but in January, it returned $82,199 in unspent grant money, Friedman said.
Gilley said Harrison spent $25,000 to renovate an old restroom and concessions building on the junior high campus into a clinic area. Another $10,000 went toward equipment, including exam-room beds. The rest of the money was spent on operational costs, including salaries for the nurse and mental-health professionals, training, conference fees and supplies.
In 2012-13, the center had enrolled 67 patients, but only 30 actually sought services, Gilley said. Most of the patients were receiving mental-health services.
“The medical community preferred offering services in their [own] facilities, which coincided with our patrons’ choices for medical services, as well,” Gilley said. “We realized our population utilized the mental-health services component more; we felt obligated to return the remaining [state] funds.”
The wellness center did allow the district to expand its mental-health services, Moss said. Two of the three mental-health specialists hiredto work in the center remain with the district and now are paid by the district. The district also has a school nurse on its elementary, middle, junior high and high school campuses.
The nurse practitioner who worked at the wellness center is no longer with the district, Gilley said. A doctor had worked at the center once a week and was on call if needed by the nurse practitioner, but because the center had few patients, “You would have a physician sitting there and not seeing patients,” Gilley said.
Before applying for the grants, applicants must have contracts or agreements with health-service partners, including a medical provider and a mental-health provider. The grant program originally required that medical services be provided by the third year of the grant, but it now requires a minimum of 12 hours of medical services in the grant’s second year.
Baker said sustaining the centers requires support from superintendents and school principals, parents and the medical community. The centers also need skilled coordinators to juggle the partnerships and program, she said.
Before applying for the grants, Moss suggested that school districts determine their medical-services needs and make sure that the medical community supports having a campus wellness center, Moss said.
That was what ultimately prompted the Harrison district to close its center, she said.
Northwest Arkansas, Pages 9 on 02/26/2014