Keeping Kids in School
Community Health’s Solution: School-based Health Care
In 2020, any child with any symptoms of sickness was sent home from school and needed to be tested for Covid-19. “That put a halt to school-based telemedicine,” said David Schneider, DO, a pediatrician and associate medical director at Community Health Pediatrics.
In the fall, Dr. Schneider plans to reinstate the school-based medicine and Telehealth program that he started in 2019 with the Slate Valley Unified School District. “The concept of school-based care is to increase access to medical care and to keep kids in school,” he said.
The pandemic made telemedicine more familiar and an accepted mode of medical care in general. “Parents will be much more at ease to support the visits,” Dr. Schneider said. “Those who were hesitant are much more comfortable. Covid has pushed the acceptance of telemedicine to the forefront.”
The pandemic protocol had another unexpected benefit to school-based medicine. “Schools were required to create isolation rooms and more space was created for nursing care in the school,” Dr. Schneider said. Schools allocated an enlarged space to sequester potentially sick students, an area that now could possibly be used for school-based medicine.
Before Covid, Dr. Schneider said discussions were underway with Slate Valley to expand school-based medicine to include on-site visits by providers for conducting physical exams, immunizations and follow up visits that are better done in person than through telemedicine.
“We had received support from the Vermont Department of Health to give immunizations, and the nurses in the Slate Valley district were so on board and excited,” he said. “Then Covid came, and we had to put it all to rest.” But in the meantime, the federal government came out in support of expanding school-based medicine through telemedicine or in person.
Community Health is awaiting approval of a funding proposal for expansion of the school-based system they made to the federal Health Resources and Services Administration (HRSA). “We hope to have weekly school-based clinics at three schools alternating between primary care and behavioral health clinics,” he said. “Our plan would be to spend the entire day and go to each school, depending on the need, about two hours at each school.”
Adding behavioral health care is also part of Community Health’s plan for the coming school year, something Dr. Schneider said the area school nurses anxiously support.
“School-based behavioral health care is well accepted and is quite successful throughout the country for getting students to appointments and to follow up sessions, and parents can conference in by telehealth,” Dr. Schneider said. Schools will need to provide private spaces for the sessions. “It’s going to be a priority making sure protocol and safety measures are in place.”
Prior to the pandemic a group of school nurses met to review, train and practice with the telemedicine equipment. Because of the interest expressed by schools in the region, Dr. Schneider said the intent is to proceed with some form of school-based medicine and scale the size of the program with what funding becomes available. This past year, he said, there was a lot of communication and planning to expand the school-based programs.
“Our hope is to prepare for the fall, where it will get up and running and we can start adding more schools to the districts,” he said. “Hopefully by next year we are going to be immunizing the kids as part of our school-based programs.”
Dr. Schneider said there is considerable interest in participating in school-based health care from other pediatricians at Community Health who are embracing the concept.
“We can hopefully go back to the model of keeping kids in school and decreasing absenteeism.”
David Schneider, DO, is pediatrician and associate medical director at Community Health Pediatrics. A graduate of New York College of Osteopathic Medicine, Dr. Schneider completed his residency at Schneider Children’s Hospital, Long Island Jewish Medical Center in New Hyde Park, N.Y., and in 2020 received a Master of Science in Health Care Transformation from the University of Texas. He joined a private practice in Vermont in 1993 and joined Community Health in October 2011.
Community Health is Vermont’s largest Federally Qualified Health Center (FQHC), a network of primary care, pediatric, behavioral health, dental and pharmacy services with offices in Rutland, Brandon, Castleton, West Pawlet and Shoreham. Community Dental offices are located in Rutland and Shoreham, Community Health Pediatrics is in Rutland and Behavioral Health services are available at all of our locations. Community Health Express Care Centers, open 7 days a week, are located at the Rutland and Castleton Community Health Centers.