1113 Berea health clinic

1113 Berea health clinic

Lemon into Lemonade

Lemon into Lemonade

By Jennifer Wohlleb
Staff Writer

As Kentucky school districts continue to deal with the fallout from the state Medicaid reimbursement funding crisis that cost many of them full-time school nursing, Berea Independent has found a solution that provides more services for the same price.

“Like a lot of school districts this past year, we were notified by the local health department that we were not going to be able to continue at the current service level at the cost we had in the past,” said Berea Independent Schools Superintendent Mike Hogg. The district had been paying $25,000 a year for a school nurse.

PHOTO: Nurse Practitioner Brandy Rose helps a Berea Independent Schools fifth-grader set her correct insulin dosage after counting the number of carbs she had consumed that day.

Hogg said he began looking around for someone to partner with and reached out to White House Clinics, a nonprofit organization that has provided medical, dental and mental health services to underserved people in the region for the past 40 years.

“Knowing that a lot of our families already went to White House Clinics, there was a lot of familiarity with the name and the personnel,” he said. “So it’s really been a great transition.”

The on-campus clinic that opened this fall offers a full array of primary-care services. White House also provides on-campus mental health services, and in the future will do the same for dental needs.

“This year our dental services are being provided by Madison County Health Department, but we’re taking a look at expanding more into the dental in the future,” Hogg said.

Convenience and value
With a full-time nurse practitioner, the clinic can serve as a primary care provider not only for students, but for parents and staff. The clinic is open until 4 p.m.

“I was in last week and we saw a mom and her daughter,” said Stephanie Moore, CEO of White House Clinics. “The mom was dropping off one sibling and she and the other sibling were sick and they were able to come inside, get their care and be on their way.”

While providing quality health care is the main objective of the clinic, a side benefit of having it on campus is less time out of the classroom, for both illnesses and mental health services.

“Instead of a parent coming and checking a child out, maybe 30 minutes before their appointment, going to the appointment, and at the end of the appointment, some saying, “Well, there’s only a half-hour of school left, why don’t we just go home,’” Hogg said. “So what’s happening is that we’re really cutting down on the amount of time that they’re out of the classroom, but they’re also getting mental health services.”

The on-campus mental health services have been so popular Moore said White House is looking at adding a second day for the licensed clinical social worker who provides them.

What it covers
Moore said the clinic can deal with acute illnesses, such as strep throat and respiratory infections, as well as working with students with chronic conditions such as diabetes or asthma.

Hogg said some parents were concerned at the beginning of the year that every time a student was seen by the nurse that the parents, or their insurance, would be billed. He said the district has communicated to them that visits for scraped knees or upset stomachs, for example, would be treated for free just as they had been in the past. And any billable services performed would be done only after getting the parent’s permission.

The nurse practitioner also can write and call in a prescription to a pharmacy, so if parents have to pick up a sick child, they can just swing by and pick up their medication on the way home.

Moore, who staffed the clinic a few days before the regular nurse was on board, said she saw a handful of students who needed to see a provider but did not need to miss school.

“We’ve been able to do those visits and get them back in class,” she said. “I’ve seen the same thing with a couple of faculty visits.”

The nurse, with the help of a support person who was added after White House saw the amount of traffic the clinic was getting, sees an average of 28 patients a day.

The clinic has only been open a short time so there is no financial data yet, but Hogg said so far that aspect seems to be working.

“White House Clinics is nonprofit, so in terms of them being able to make huge amounts of money off the school district, that’s not part of their mission,” Hogg said. “Providing quality care is part of their mission, so there’s not the tension there you might have. There’s tension toward the break even, as you can imagine, but being in partnership is mutually beneficial.”

Board View
Berea Independent school board Chairman Van Gravitt said what began as a difficult situation has turned into a win-win-win for the district, students and White House Clinics.

“We are actually spending the same amount of money and getting more services that we didn’t get before,” he said. “Some of the parents were a little leery, they thought that they weren’t going to get the same quality care but they are actually getting more. They were worried, ‘We’re going to have to pay all kinds of money,’ and that’s not true.”

He said parents will have to pay for billable services like a strep test, but said they still should come out ahead in both money and convenience. “If you take a child to the emergency room, that’s going to cost them a lot more, and unfortunately a lot of our students still don’t have insurance,” he said.

Gravitt said board members were thrilled the district could partner with White House.

“We had some other options, which included paying one of the people we had to let go, but it would have cost us more because we lost our federal funding and we would have got less service,” he said. “We’d like for everyone to be able to do this. If we can be an example of partnerships that are formed in communities, that would be ideal.”

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