With the Booneville School District exploring the idea of establishing a school-based health center, Dr. Jared Cleveland gave what he called “about a five-minute talk on a 10-hour subject.”
Cleveland, who was the superintendent at the Lavaca School District when it was the first to open such a clinic, did his doctorate dissertation on school based health centers in Arkansas.
Also at the meeting was local doctor, Richard Eccles, who would apparently be the practitioner for such a clinic.
Cleveland told the board to open a clinic there is a $500,000 grant available that is payable on a five-year sliding scale with about $200,000 coming the first year to establish the clinic.
“By the end of the five years you should have a sustainable clinic,” said Cleveland.
The key component of the clinic, Cleveland said, is “you have to meet the health needs of the students.”
Those needs, Cleveland said, are physical, mental, dental, optometric and or audiological.
The needs, Cleveland said, are going largely unmet.
“We have a significant problem in the state. There’s 467,000 kids in the state (and) of those 467,000 kids 66 percent qualify for free and reduced lunch,” said Cleveland. “What we’ve done is we’ve continually gotten poorer.”
Through research for his dissertation Cleveland said he learned that 53 percent of those students who could qualify for medicaid services are not receiving them.
“It’s not that these school based health centers are taking kids who are already getting service from doctors who are already performing them,” said Cleveland. “They are focusing on kids who are not getting anything anyway.”
Cleveland likened those services to routine maintenance of a vehicle.
Speaking to a legislative committee on the subject, Cleveland said he told the lawmakers there would be an increase in Medicaid costs for well-child screenings “but the crisis events that are happening, those really expensive health crisises where they’re at Children’s (Hospital) will be reduced.
“It’s an absolute no-brainier. I had Republicans, Democrats, Green Party and whoever else — they were all excited about the opportunity for kids to receive services that are necessary for our state’s health to improve.”
When health improve a chain reaction starts, Eccles said.
“You cannot underestimate it. When school based health clinics open attendance problems go down, behavioral problems go down, the leaning numbers go up, the scores go up because kids who have a good foundation, parents take them to the doctor,” said Eccles. “They get well, most of the times, in a couple of days, they’re back in class and they’re back on their game.
“But these kids who don’t have access to healthcare, or kids that have the availability to health care that don’t utilize it, they’ll let nagging problems go on for weeks at a time and (if) they’re in the classroom they’re tired, they’re sluggish, they’re snotty and their performance shows.”
Cleveland said the statistics at Lavaca showed an 18 percent increase in student attendance after the clinic opened there. For teachers in increase was over 22 percent.
“Most of our teachers have children. Those children never had to leave because they had a doctor, they had a dentist, they had an audiologist once a month and they had an optometrist there every other Friday,” said Cleveland.
Besides addressing the sickness at hand, Cleveland and Eccles agreed, the preventive care was crucial.
“We got their screenings. We really were focused on maintenance and that sick mentality began to wane,” said Cleveland. “It also infiltrated our classroom. They began to go in the classroom and talk about health. It wasn’t trying to attract kids to come to the doctor, it was trying to educate on how to not be sick, or what to do if you see so-and-so, or if you have a sore don’t scratch. Why? Because it could be staph.
“It’s like a teacher in the classroom.”
“We do a great job in Logan County of getting the smaller kids in for (wellness checkups),” said Eccles. “The appalling numbers I see in Logan County are pre-adolescents, and adolescents, parents don’t bring them.
“The only time I get my hands on these kids is when they finally have something bad enough to leave them and then I can talk to them. Are you making good choices, are you driving with somebody who is drinking, are you smoking, are you making good choices when it comes to sex.”
The teen pregnancy rate, drop out rates are atrocious, Eccles said.
“It’s getting better, but overall in Arkansas, it’s not,” he said.
“I was appalled the other day when I went to a University of Arkansas football game the other day at the number of 20-year old kids smoking,” said Eccles. “We’ve got to do better. The number of kids walking around our campus pregnant. We’ve got to do better.
“School based health centers are when a doctor can get in a classroom. I don’t have an ego complex, but when you put on a white coat, kids listen. Teachers can talk to them but when I show them a slide on a smart board that this is what you’re going to look like if you make bad choices with sex, or this is what your lungs are going to look like if you don’t stop smoking.”
Cleveland added that the Lavaca clinic did not get into passing out condoms and things like that but in the three years after the clinic opened there were zero pregnancies.
“Can it all be attributed to the school based health center? I don’t know.” said Cleveland “I can’t with certainty say that, but I can say without school based centers we could have had some. I don’t think it was because the doctor was prescribing things. I think it had to do with education. I think it had to do with what was going on in the classroom.”
Here, superintendent John K. Parrish said he envisioned turning the administrative building over to Eccles and having a new administration building erected.
Cleveland said that would be okay provided no grant funds were used to construct the new building.
Parrish and board members also asked about opening the clinic to the public at large. Cleveland said the way the clinic in Lavaca was designed, students and members of the public did not interact through places like a waiting area because access to the examination rooms was different.
“There was never any angst a parent might have of ‘oh my kid is over there with somebody,’” Cleveland said.
The same is true in Magazine where a clinic is in its third year and has opened to the public.
But, could the clinic be jointly operational on the first day, Parrish asked.
“There’s absolutely nothing wrong with that,” Cleveland said. “In fact, it’s encouraged by the state, they love to see those community partnerships.”
That, too, is something Cleveland knows well, because he is on the committee entrusted with selecting the winning grants each year. It was a seat to which he was appointed while in the employment of the state’s Department of Education and one he kept when he left the department for a position at the Springdale School District.
School board member Stacey McCollough asked if there were liability issues with having a business operate on campus. Cleveland said there were none.