Editor's Note: This report is co-published with North Carolina Health News.
Health and academic performance are linked, according to some Wake County high school students, and that's why they're pushing to get more students access to health care.
Students part of a nonprofit called Youth Empowered Solutions also known as YES!, are working toward establishing a school-based health center in Wake County -- a project that has been in works for two years.
The group will host the "Hands on School Health Rally" Saturday afternoon at the Wake County Commons Building to help build momentum around the initiative.
Students Make the Case
There are more than 50 school-based health centers across the state of North Carolina, but none in Wake County.
"Not only do we not have a school-based health center -- we do not have a school-linked health center in Wake County," said Dynasty Winters, a junior at Southeast Raleigh Magnet High School and YES! member.
Wake Teens, a school-linked health center, closed six months ago -- an additional reason to push the initiative forward, Winters said.
* A WCPSS report showed that two of the top indicators for student absence in the 2010-11 school year were related to medical reasons.
* A two-year report done by the WCPSS showed the correlation between student absences and academic achievement. The report indicated that students who missed 6-10 days of school scored 8.3 points less (71.6 percent) on the End of Course exams than students who missed 0-5 days (79.9 percent). Students who missed 11-15 days scored 16.4 points less (63.5 percent) and students who missed 16+ days scored 30.7 points less (49.2 percent)
* Wake County has a 1 to 2300 school nurse-to-student ratio according to the North Carolina Comprehensive Assessment for Tracking Community Health (NC - CATCH) -- 3 times what national recommended level.
* The Wake County Human Services most recent Community Health Assessment that states that citizens in this region of Wake County prioritized the need for Health Insurance as the top priority issue for this area. This shows a civic need for, support of, and interest in creating additional access to health care.
Lack of access to centers causes problems for young people, according to Doug Pluta, sophomore at Enloe High School and member of YES!.
"The current school nurses-to-student ratio in Wake County is one school nurse to every 2,300 students, which is three times the nationally recommended level by the CDC. So, having one nurse who has to take care of the 2,300 students is almost impossible," Pluta said. "School nurses are only [allowed] to do limited things. Even if the school nurse is there, and I have a more serious issue like maybe I'm out on the track and I break a bone or something or maybe I have a major asthma attack, I'm not allowed to get the treatment that I need."
"I'm lucky enough where my family has insurance, so I can always go to my doctor,” said Jhana Parikh, another Enloe high school sophomore. “I know a lot of students who either both of their parents are working, so they can't take time out of the work day to pick them up from school or they don't have health insurance, so they can't see a doctor and they end up in the emergency room or places like that."
Pluta said the group has collected data from Wake County public schools, including school enrollment and numbers on free and reduced lunches, and has tentatively pinpointed Southeast Raleigh High School as the school where a health center would have the most impact.
According to YES! project director Parrish Ravelli, while the group is pushing for one center for now, the group has an eye on the larger picture.
Ravelli said he hopes the idea of school-based health centers will gain traction and pique interest for getting more centers established.
"The reality is that there's not just one school that has under-served youth, and so it's really trying to pinpoint where all of those youth are and trying to help build a bridge for those youth," Ravelli said.
The specifics of what the center would offer have not been finalized. Shaquita Williams, senior at Knightdale High School and member of YES!, said community input is an integral part of deciding those details.
"If the community the school-based health center is in needs a nurse practitioner and a dentist there, then the school based health center would have a dentist and practitioner available. If the community feels they don't need a dentist, they need two nurse practitioners to be staffed; it would be formed that way," she said.
Pluta said the centers will be staffed with at least one physician and nurse practitioner, but the rest will be determined by the community members and leaders.
"We also plan to work with local hospitals and other agencies that can help get the staff we need or help us fund the center," he said. "Most school-based centers have labs, exam rooms. They have waiting rooms and receptionist desks with receptionists staffing it."
Making the Health Center a Reality
The John Rex Endowment Fund got the project going two years ago for a three-year span, and the plan is to continue after the three years, expanding the project outside of Wake County and seeking more funding.
"One of the really great parts about health care reform is that school-based health centers became federally authorized as safety net providers, and what this basically means is that now school-based health centers can receive direct federal funding from the federal government to the local center," Raveilli said.
The federal School-Based Health Center Capital Program, granted through the Patient Protection and Affordable Care Act, is a two-phase program, which distributes $200 million to school based health centers, with each center that is awarded funding having a cap of $500,000.
In addition to federal funding, the group is looking for local support. Both WakeMed and Rex hospitals have expressed interest in the project. In a preliminary survey of nearly 300 parents, most overwhelmingly support a school-based health center. The group is now compiling information into a school board proposal to garner support from the school system.
School board member Jim Martin said he has tried to provide the group with information about how to make the project a reality.
"What needs to happen is that there needs to be a clear plan articulated as to what services would be provided, how it would interface with the school system and what's needed," Martin said.
Martin said the group needs to have a solid business plan since the school system has such a limited budget. But he agrees there is a benefit.
"If young people are healthier, they will learn better," Martin said. "And right now we don't have medical care available to much of the population. So you end up getting a lot of emergency care that's higher cost. So if you can get good health education and services available in our schools, I think it’ll be an all around benefit."