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.’”

 

student discipline

Frustrated with high suspension rates, Memphis schools shift to restorative justice

PHOTO: Caroline Bauman
Shelby County educators list their reactions to students who act out as part of a discipline training on using restorative justice techniques in the classroom.

Taking a cue from Nashville, Memphis school leaders are working to change the way their educators discipline students in an effort to reduce the high rate of suspensions in Shelby County Schools.

This month, about a hundred educators participated in a day-long training session to learn about restorative justice techniques already used in Metropolitan Nashville Public Schools. The Nashville district, which like Memphis serves mostly minority and low-income students, has seen its suspension rate drop since incorporating the disciplinary approach more broadly in 2014.

“Our goal is to help teachers and administrators see all of the steps they could take before suspension or expulsion. Keeping a student out of the classroom should be a last resort,” said Eric Johnson, the lead trainer and head of youth development for STARS, a Nashville-based nonprofit organization.

The training, conducted in partnership with the Tennessee Department of Education, is part of the culture shift that’s been building for more than a year as Shelby County Schools seeks to move away from exclusionary practices such as suspensions and expulsions, said Randy McPherson, who oversees school culture and climate for Tennessee’s largest district.

It’s also a far cry from corporal punishment, which the district did away with almost 15 years ago.

“There’s this idea that punishment should be immediate. You act out of line, you get suspended. That’s not what our students need,” McPherson said.

Restorative justice is relational and seeks to foster an environment of caring and respect. In order to get at the root cause behind misbehavior, it begins with educators taking into account the backgrounds and experiences that students bring to school, sometimes including hunger, domestic violence or homelessness.

Memphis is working to catch up with cities like Nashville, Chicago, New York and Los Angeles that already are bringing together students to talk out conflict. Suspensions there are on the decline, although there’s little research to show whether embracing such techniques reduces school violence and benefits students in the long run.


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District leaders acknowledge that changes are needed in Shelby County, where suspension rates are some of the highest in the state and disproportionately skew high for boys of color. During community meetings last fall about how to build better schools, parents also made it clear that the district should prioritize school climate, which includes how students are disciplined.

About two-thirds of district schools have sent some educators to either an in-house session about restorative practices or one co-presented with Facing History and Ourselves, a nonprofit organization that works with teachers and students in Memphis. McPherson is hopeful to get that number up to 100 percent during summer trainings.

Then comes the even harder part: Getting the schools to buy in to using restorative justice practices every day.

PHOTO: Caroline Bauman
Randy McPherson (middle) oversees school culture and climate for Shelby County Schools.

“The culture-changing process requires investment, energy and professional development,” McPherson said. “I really believe this approach to discipline works if the whole school is buying into it. If you only pay lip service to the idea, it can actually do more harm than good.”

For now, McPherson is overseeing the shift in discipline that previously was shepherded by Heidi Ramirez, who resigned in February as chief of academics. Her replacement has not yet been named.

“We will continue to focus on key strategies for improving school climate, reducing disruptive behaviors that impact academic progress and prepare students for making good choices,” McPherson said.

At this month’s restorative justice training, educators said they liked the direction that Shelby County Schools is heading — but that more trainings will be essential to lowering the district’s suspension rates.

“We can’t keep doing the same thing and expect different results,” said Brian Clark, a family engagement specialist at Grandview Middle School. “… We’re realizing we can’t handle every child the same way. We have to hear their stories and struggles and respond.”

En pointe

How ballet is energizing one Memphis school — and helped save it from closing

PHOTO: Caroline Bauman
Briana Brown, an instructor with New Ballet Ensemble, prepares her first-grade dance students for a performance at Dunbar Elementary School in Memphis.

Instructor Briana Brown counts aloud as first-graders in pink leotards skip across a classroom floor to practice their leaps and twirls — a weekly highlight for students at Dunbar Elementary School.

In the South Memphis neighborhood, ballet lessons offered through the nonprofit New Ballet Ensemble introduce students to the art of dance at a school with few resources for extracurricular activities.

PHOTO: Caroline Bauman
Ten-year-old Briana Davis is among 40 students receiving dance instruction at Dunbar Elementary School.

Ten-year-old Briana Davis is among the beneficiaries.

Before joining New Ballet’s class, she danced throughout her mom’s house, just a short walk from Dunbar in the city’s historic African-American community of Orange Mound. Now, Briana is among about 40 Dunbar students who jeté and pirouette in a makeshift classroom studio at Dunbar, or after school in a studio at the group’s headquarters in midtown Memphis.

“I want to keep dancing and to be a dance teacher when I grow up,” Briana said. “I think this is really special. If I hadn’t done ballet at school, I don’t know if I ever would have danced for real and not just at home.”

For eight years, New Ballet Ensemble has been teaching classes at Dunbar and offering scholarships to a talented few to continue their dance education outside of school time. Here under the tutelage of teaching artists who are fluent in classical ballet and other styles of dance, they learn to follow instructions, practice new positions, strengthen young muscles and develop discipline, all while expressing themselves creatively and learning about a world beyond Orange Mound.

But the Memphis dance company’s work has gone far beyond teaching students how to plié and fondu. Thanks to grants that New Ballet helped secure, Dunbar now has a community garden and parent resource center.

And when Dunbar was on the chopping block to be closed this year by Shelby County Schools, New Ballet dancers, instructors and supporters showed up en force at school board meetings. The district later reversed its decision and opted to keep Dunbar open. Superintendent Dorsey Hopson cited community support as a reason for his change of heart.

Katie Smythe founded New Ballet Ensemble in 2001 to teach dance, but quickly discovered how her organization’s work was being limited by a dearth of community resources available to public schools in Memphis.

“We came here to find talented kids for dance, but we found that our access to community partnerships and the school board to be the real opportunity point for us,” said Smythe, who also serves as the group’s artistic director. “The school board and administration learned while trying to close this school how valuable community partnerships can be, I think.”

New Ballet became one of the first outside-of-school organizations to have a stake in the Dunbar school community, said Principal Anniece Gentry.

PHOTO: Caroline Bauman
Youngsters giggle as they watch their instructor demonstrate a dance move.

“When students see community partners are invested in their school, they want to achieve more,” Gentry said. “Our relationship with New Ballet is one I will always treasure. They work to do more than anyone else I’ve seen.”

The parent resource center is one of the most valuable additions. Stocked with computers, coffee and books, the room was created for parents with help from a $25,000 grant from ArtsMemphis, a local advocacy and funding group.

“There are computers for parents to use if they don’t have internet at home,” Smythe said. “I’ve seen parents drop their children off, walk to the room and apply for jobs while grabbing a cup of coffee. (For some parents), there was no positive reason for parents to come to school before this, only if their students were sick or in trouble.”

Building parent relationships have become key to New Ballet’s mission at Dunbar, and Smythe wants to take the group’s learnings to other Memphis schools. It’s already helping with arts education in classrooms at Bartlett and Sherwood elementary schools, and Smythe wants to bring Dunbar-style ballet programs to secondary schools that now teach former Dunbar students at Treadwell and Sherwood middle and Melrose and Douglass high.

But that takes money.

New Ballet is dependent on the National Endowment for the Arts, a federal agency that could experience huge cuts under President Donald Trump’s administration. In addition to $15,000 in NEA funding, the group gets money for its school programs through the Tennessee Arts Commission, which also comes from NEA.

PHOTO: Caroline Bauman
New Ballet founder Katie Smythe brought ballet to Dunbar Elementary in 2009.

To remind those who hold the pursestrings about educational ballet programs like Dunbar’s, Smythe recently joined other arts advocates to speak with lawmakers in Washington, D.C. Their message: The arts are more than just concert halls, expensive tickets and paintings that people don’t understand. It’s also about helping students to grow mentally, physically and academically.

For students like Briana, support for New Ballet would mean another year of free ballet lessons and after-school programming.

“I really look forward to performing,” Briana said. “Learning to dance is really fun. But being able to show off how much I’ve learned to my mom? That’s the best.”