The doctor is in

Big year for school-based health in Colorado

Physician's Assistant Elizabeth Madrid chats with Jade-Marie Burgess and her son Eli at the school-based clinic at Florence Crittenton High School.

Jade-Marie Burgess lifted her two-year old son Eli onto the beige exam table. He was having tummy trouble so she’d gotten a walk-in appointment at the new clinic.

For 18-year-old Burgess, a senior at Denver’s Florence Crittenton High School, the appointment was a cinch. With the clinic just down the hall from her second-hour class and across the courtyard from Eli’s child care room, travel time was about two minutes.

Last year, it was a very different story. When her son was sick, she’d travel with him on two city buses to the clinic at Alameda International High School in Lakewood. The average time away from school was four to five hours.

It was “ridiculously long,” she said.

The clinic—still so new there are no pictures or decorations on its pale green walls—is a major milestone for the school, which enrolls 145 pregnant and parenting teenagers, as well as 109 of their young children.

School leaders believe it will help reduce absences due to illness as well as those associated with long commutes like the ones Burgess experienced.

The clinic, officially called the Alethea D. Morgan, M.D. Health Center, is also part of the reason that school-based health centers are having a red-letter year in Colorado.

Florence Crittenton High School
This new building on the campus of Florence Crittenton High School in Denver’s Valverde neighborhood replaced two cinderblock warehouses and a gravel parking lot.

It’s among five new ones that have opened across the state this fall. That’s an unusually high number for Colorado, which has a total of 61 school-based clinics. The other four new centers are at schools in Aurora, Carbondale, Cortez and Leadville.

The clinic at Florence Crittenton is also the first school-based health center in the state to offer routine obstetric services—everything but ultrasounds and delivery.

Given the population served by the school, it was “a no-brainer to add that component,” said Suzanne Banning, President and CEO of Florence Crittenton Services.

A big lift

Advocates of school clinics in Denver and elsewhere readily admit that establishing such facilities isn’t easy. It takes years of planning and the costs are formidable.

At Florence Crittenton, the clinic is part of a new $8.8 million school building. About two-thirds of that money came from a Denver Public Schools bond issue and one-third from fundraising by Florence Crittenton Services.

Operating costs will run about $200,000 a year, to be covered initially by grant funding and dollars from Denver Health, which operates the clinic.

Currently, the state has a $5.3 million budget line that provides planning, start-up and operations grants for school-based health centers.

“That is enough right now, but as the number of school based health centers grows and that pot is divided among more locations, that won’t be enough,” said Deborah Costin, executive director of the Colorado Association for School-Based Health Care.

Kids in the early childhood education program at Denver's Florence Crittenton High School play on a new playground that was part of a construction project that added a new health clinic, gym and classroom space.
Kids in the early childhood education program at Denver’s Florence Crittenton High School play on a new playground that was part of a construction project that added a new health clinic, gym and classroom space.

Still, there’s evidence that school-based clinics improve health access for kids, particularly those who face the greatest barriers in getting care.

Such barriers are often higher for Florence Crittenton students, who have to manage health care decisions for themselves and their children. Without the same-day appointment Burgess got for her sick toddler at the school clinic, it could have easily turned into emergency room visit, said Banning.

Getting students to make and keep health appointments at off-campus clinics has often been struggle at Florence Crittenton.

“We’ve always seen the challenge the girls had in navigating the health care system,” she said. “We’ve always seen that we set the appointment, but unless we gave them money and a taxicab to get down there, which we often did, they wouldn’t go.”

“Now, they’ve got nirvana,” Banning said as she led a tour of the new brick building that houses the clinic, high school classroom space and a gymnasium.

More clinics on the way

Two more school-based clinics are slated to open in Colorado next year — one on the Boulder Valley district’s Arapahoe Campus and one at a yet-to-be-determined location in the Adams 12 district. The clinics will be the first school-based health centers for both districts.

For many districts, the addition of school-based health centers represents the growing awareness about the link between health and achievement.

The idea is that students with health problems—whether asthma, tooth decay, depression or something else—miss out on learning.

“I think educators are becoming more cognizant of that,” said Costin, even as they work to raise test scores.

“Many of them are saying, ‘Well wait a minute, health is such a big part of this. Even though we’re in the education business, we need to be in the health business too, to move the needle on these measures.’”

 

one hurdle down

Bill to ban corporal punishment in schools get first approval from Colorado House

PHOTO: Nicholas Garcia
Students at the AXL Academy in Aurora worked in pairs or small groups to solve math problems.

Colorado’s House of Representatives gave initial approval Monday to a bill that would ban corporal punishment in public schools and day care centers that receive state funds.

The bill, sponsored by Denver Democrat Rep. Susan Lontine, would forbid adults from using physical harm as punishment for students.

“It’s not OK for adults to hit each other,” Lontine said. “It should not be OK for adults to hit children — ever.”

Colorado is one of 19 states that has not outlawed the practice. However, reported incidents of corporal punishment are rare.

That’s one reason why some Republicans who disavow corporal punishment still oppose the bill.

“We’ve heard there is not a problem,” said Minority Leader Rep. Patrick Neville, a Douglas County Republican. Schools are “already dealing with this. Let’s let our local school districts do what they’ve been doing.”

Lontine’s bill won bipartisan support from the House Education Committee. Given the Democrats’ wide majority in the House, the bill is expected to win final approval Tuesday. But it’s unclear what sort of reception the bill will receive in the Republican-controlled Senate.

Senate Majority Leader Sen. Chris Holbert, a Douglas County Republican, said he hasn’t read the bill yet. But he said he is always concerned about education policy violating local school districts’ local control.

catching some zzzzs

One Colorado district moving toward later high school start times — maybe — while another shelves the idea

PHOTO: Chellseyy, Creative Commons

Of the two large Colorado school districts that were actively exploring later high school start times for the 2017-18 school year, one is moving ahead and one has dropped the idea for now.

The 55,000-student Cherry Creek district — the state’s fourth largest — continues to consider proposed start- and end-time changes at all school levels. While the district is still collecting community feedback, the current proposal would set elementary school start times at 7:55 a.m., middle school start times at 8:50 a.m. and high school start times at 8:15 a.m.

Currently, Cherry Creek elementary schools start about 9 a.m., middle schools start about 8 a.m. and high schools start about 7 am. A recommendation will go before the Cherry Creek school board this spring.

Meanwhile, the 31,000-student Boulder Valley school district won’t change school start times next year because of the complexity of managing school bus schedules and the prospect of higher transportation costs, district spokesman Briggs Gamblin wrote via email.

Changes are still possible for the 2018-19 school year if the district can find a way to keep transportation costs at their current levels, he wrote.

The push for later high school start times has gained steam nationally with increasing evidence that when school schedules match with teen sleep rhythms, students are healthier, more focused, attend school more regularly and do better academically. In the last two years, both the American Academy of Pediatrics and the Centers for Disease Control and Prevention have come out in favor of start times of 8:30 a.m. or after.

In districts that have considered changing high school start times or actually changed them, the logistics of bus schedules and after-school sports are typically the biggest hurdles.

In Colorado, some smaller districts, including the Montezuma-Cortez district in southwest Colorado and the Harrison district in Colorado Springs, have pushed start times to 8:30 a.m. or after for some or all secondary schools.

But large districts have been slower to join the club. Denver Public Schools, the state’s largest school district, briefly explored later start times for some high schools a couple years ago, but the effort did not lead to any changes.

In the Boulder Valley district, a task force spent the 2015-16 school year researching later high school start times, with one of the group’s leaders saying last August she hoped the district could move forward with changes in 2017-18.

In Cherry Creek, where changes to school start and end times have also been under consideration over the last year, a November survey on the topic drew 25,000 responses.

Seventy-three percent of respondents said they wanted high school start times to align more closely to the American Academy of Pediatrics recommendation. When respondents were asked to pick between six high school schedule scenarios, the 8 a.m.-3:30 p.m. scenario was most popular — garnering more than 7,000 votes.