MIDDLEBURY — Middlebury Union High School launched a school-based health center Thursday that will allow students to access health care without having to leave campus.
The clinic will be housed within the school’s new Wellness Center and will be staffed by medical professionals from Porter Pediatric Primary Care. It will be open every Thursday from 10:30 a.m. to 1:30 p.m.
Kelly Landwehr, the lead school nurse, said the clinic will treat acute illnesses such as strep throat and ear infections, recurring concerns such as stomachaches and headaches, and coordinate care for chronic conditions such as diabetes and asthma. The clinic will also help students manage sports injuries and concussions, and will offer sexual health services, including STI testing and birth control options.
“Any students can access the clinic, and they can still access it even if they’re not a patient of Porter Pediatrics,” Landwehr said.
In order to sign students up, Landwehr said families must fill out enrollment and consent forms, which include a basic medical history and insurance information. Just a few days before opening, Landwehr said that 65 families had returned enrollment paperwork, and several had set up appointments.
“With the parent’s permission, if the students aren’t a patient at Porter, their information will be shared with their primary care doctors,” Landwehr said, explaining that this will help facilitate communication between the school’s health center and other doctors in the area.
The effort to launch a school-based health center in Addison County has been underway since the 1990s, according to Breena Holmes, the maternal and child health director at the Vermont Department of Health. Holmes, who used to practice as a pediatrician in the Middlebury area, said that while there was always support for the idea, it was difficult to get all the necessary elements to line up.
“You need a convergence of strong administrative support, both the principal and superintendent, you need physical space, you need a community partnership where it is promoted as something from families and kids not just made up in a meeting, and you need strong medical support and leadership,” she said.
Holmes said Vermont has been deliberate in adopting the school-based health clinic model, in part because the state has high quality pediatric health care. She said there are currently around 11 school-based health centers in the state, and she started a peer collaborative through the Department of Health to share resources and problem solve. As evidence builds to show the school-based health model works, Holmes believes more schools will open similar facilities.
With the necessary elements in place in Middlebury, Landwehr hopes that the new center will provide convenient access to health care in school.
“We are hoping to cut down on either absences or having to come to school late or leave school early, and help families to avoid missing work to get their students to appointments,” she said.
As the school nurse, Landwehr will be able to refer students to the center if she believes they need further medical attention. Parents can also make appointments for their children.
“Parents are always welcome to attend appointments, but part of the goal is that having access to health care here at school will help a lot of families by not having to pull their kids out of school or miss work to take your kid to the doctor,” she said.
Students are also able to make appointments for themselves at the clinic. Dr. Francisco “Paco” Corbalan of Porter Pediatrics, who will be helping to staff the clinic, explained that students who are signed up for the clinic will have the right to receive certain medical care without permission from their guardians. Under Vermont law, minors are permitted to receive reproductive health care such as STI testing and treatment, evaluation and treatment for substance use disorders, and evaluation and treatment for mental health without parental consent.
Erika Garner, community coordinator for the Addison Central School District, believes making appointments at the health center will teach kids valuable life skills.
“As our kids are getting ready to graduate, they are beginning to gain skills in taking care of their health on their own,” she said.
In exploring what it would take to open a school-based health center at the school, Garner and other members of the district’s Community Partnership Council visited other centers in Vermont to learn about existing models. She said they found guidance from the Winooski School District, which opened a clinic three years ago, particularly helpful.
“I basically handed them all our templates,” said Elizabeth Parris, the Winooski school nurse. “We were successful and this was the model … here’s copies of everything so you don’t have to reinvent the wheel.”
After visiting other schools, the council contacted Porter Pediatric Primary Care and turned the process over to a steering committee at the high school, which has been working on finalizing details for the center’s launch since last spring.
Monica Benjamin a nurse practitioner at Porter Pediatrics who will be helping to staff the school-based health center, said the last six months have entailed hammering out details on staffing, equipment and paperwork, and finalizing a memorandum of understanding between Porter Medical Center and the high school.
Porter Pediatrics has agreed to supply the necessary medical equipment, from an exam table to gloves to tongue depressors.
“We’re viewing this as an extension of our practice and we’re going to work it into our budget,” Corbalan said. “We’re going to be billing insurance just like we would in the office, but the lab supplies and stuff like that is just going to come out of our general pediatrics budget.”
While employees at Porter Pediatrics and the high school said they have received positive feedback on the center in the months before it opened, Corbalan said there has been some concern expressed about how it will communicate, both with parents and other doctors in the area.
“Some family medicine providers and other people wanted to make sure we weren’t trying to completely replace them in terms of taking care of these kids, as if we were their medical home, which we are not trying to do,” he said. “We’re just trying to provide more care that we can then incorporate into their medical home. That was an early discussion with some folks, just trying to clarify our goals and what our intentions were.”
Corbalan said the main goal with the center is to create more access to health care for high school students who need it.
“The high school years are a really vulnerable time,” he said. “The ability to have access to medical care right in the place where they spend the majority of their time I think decreases and removes one more barrier for them getting the care that they need.”
Although the clinic just opened, staff at Porter Pediatrics and the high school are already considering whether the model might carry over to other schools in the district in the future.
“All kids deserve to have that access to health care, and if they’re not physically well they’re really not going to be available for learning,” Landwehr said, “By taking care of students’ wellness and physical health they will hopefully be more available to learn in school.”
