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.’”

 

Extra sleep

Two Colorado districts shift to later high school start times — for very different reasons

PHOTO: planetchopstick/Creative Commons

The 22,000-student Greeley-Evans school district in northern Colorado will join the 55,000-student Cherry Creek district in suburban Denver in adopting later high school start times this fall.

But unlike in wealthier Cherry Creek, the change in Greeley was not the result of a lengthy process to review research and solicit community feedback. Instead, the move came out of a very different conversation: How could the cash-strapped district tighten its belt?

After Greeley voters rejected a district tax measure last November, a chronic bus driver shortage loomed larger than ever. With no additional money to beef up driver salaries and more than a dozen driver vacancies, district officials needed to reduce the number of routes. They decided to discontinue busing for most high school students — part of a package of cuts that will save the district $667,000 a year.

That decision divorced the start time debate from the common concern that pushing high school bell times later requires more bus routes and more money.

“We were only able to move the high school start time by seriously limiting — in fact, almost eliminating — bus transportation for our high school students,” district spokeswoman Theresa Myers said.

She noted that all district students are eligible for free transportation on city buses. About two-thirds of district students qualify for free or reduced-price meals, a proxy for poverty.

Later middle and high school start times have gained traction in Colorado and nationally in recent years with mounting evidence that teens are hardwired to go to bed later and wake up later. When school schedules align with sleep patterns, research shows students are healthier, attend school more regularly and do better academically.

Nationally, Seattle Public Schools is one of the largest districts to embrace later start times — pushing high school and most middle school start times to 8:45 a.m. last year, with plans to shift to 9 a.m. this year. Also, in what could be the first statewide start-time mandate in the country, California lawmakers are currently considering legislation that would prohibit the state’s middle and high schools from starting before 8:30 a.m.

In Colorado, the move to later start times has been relatively slow. Until March, when both the Cherry Creek and Greeley-Evans school boards voted on the schedule changes, only a few smaller districts had made the switch. They include Montezuma-Cortez in southwest Colorado and Harrison in Colorado Springs.

Both Denver Public Schools and Boulder Valley considered later high school start times in the last couple years, but ultimately shelved the idea. Boulder Valley officials said the prospect of increased transportation costs was one of the reasons they didn’t move forward.

In Denver, which currently doesn’t provide district busing to most high school students, administrators expressed concern about complicated transportation logistics, after-school sports schedules and conflicts for students with after-school jobs.

Cherry Creek officials say the change in start times this coming year won’t cost the district more money.

In both Cherry Creek, the state’s fourth-largest district, and Greeley-Evans, the 13th largest, high school start times will shift 45 minutes to an hour later this year. In Cherry Creek, high schools will start at 8:20 a.m. and middle schools will start at 8:50 a.m., and in Greeley-Evans, high schools will start at 8 a.m. and middle schools will start at 8:30 a.m.

Other changes in Greeley-Evans include greater walk distances for students at all levels. That means high-schoolers won’t qualify for busing unless they live more than three miles from school, middle-schoolers won’t qualify unless they live more than two miles from school, and elementary kids won’t qualify unless they live more than 1.5 miles from school.

Myers said the new start times haven’t caused much consternation among parents.

“It’s more the transportation issue (that’s) causing some angst for some of our families,” she said. “We’re really going to watch and see how this impacts attendance and tardiness at our schools.”

shot down

Boys & Girls Clubs unlikely to open soon in Memphis schools as SCS funding plan collapses

PHOTO: Boys & Girls Club
The Boys & Girls Club provides after-school programs for children and teens.

If there’s a downside to the improved financial condition of Shelby County Schools, it’s the challenge of getting additional funding for a new initiative, even if everyone agrees it’s a good idea.

That scenario played out this week as some county commissioners balked at a request for an extra $1.6 million to open Boys & Girls Clubs inside of three Memphis schools.

The decision was close, just one vote shy of approval, demonstrating the tension among commissioners wrestling over how to invest in a community with big needs, limited resources and a desire to keep property taxes in check.

In many ways, the proposal to open school-based clubs felt like a slam-dunk. Boys & Girls Clubs have programming. The district has empty space. Neighborhoods near schools have young people in need of enriching afterschool activities.

“We talk everyday about crime, and this is a safe haven,” Chairman Melvin Burgess told his fellow commissioners on Monday in arguing for the investment. “What people don’t know is that an afterschool program is a place for kids to go instead of an empty home.”

But even as the district’s $985 million spending plan sailed through the board, several commissioners questioned the need for anything extra.

“I really support Shelby County Schools spending their own money to do it,” said Commissioner David Reaves. “They have $80 million sitting in a savings account, and we gave them a huge bump last year. Here’s the reality: I was on the school board and I know how it works. They need to spend their own money.”

The decision kicks the proposal back to district leaders, who have been in talks for months with Boys & Girls Club of Greater Memphis.

A district spokeswoman said Wednesday that Shelby County Schools has no plans to fund the initiative at this time.

Keith Blanchard, the president and CEO of the Boys & Girls Clubs, agreed that it’s now unlikely for new clubs to open inside of Dunbar Elementary, Riverview School and Craigmont High by 2018.

“This process has drug out so long, we don’t know what next steps will be yet,” he said. “If we can secure funding at this point, maybe we start in just one school in the fall. Maybe we try again next year. We’re not giving up.”

Shelby County Schools began its 2017-18 budget season without a shortfall for the first time in years, allowing the district next year to provide teacher raises, hire new guidance counselors and behavior specialists, and make new investments in struggling schools.

But Superintendent Dorsey Hopson says the school system still doesn’t have enough money to propel students to academic success in a community challenged by high poverty and mobility.

Such concerns are among the reasons that school-based investments in Boys & Girls Clubs made all the more sense, according to the idea’s backers.

“(The commission vote) was really disappointing,” said Blanchard. “We thought we had the votes going in. I think it was most disappointing for the students who were there, and for them to have to listen to the reasons why this didn’t pass.”