A School-Based Health Center Gives Children a Healthy Place
The Plainfield Health Center, operating under the Plainfield Neighborhood Health Services, established a comprehensive school-based health center at Washington Elementary School in Plainfield, N.J., in 2000.
Called The Healthy Place, the center offered health care services and screenings to more than 1,600 students at Washington and three neighboring elementary schools.
- Project staff provided 968 primary and sick care visits and 1,560 screenings from 2000 to 2002.
- They immunized 550 students at Washington Elementary School.
- They collaborated in developing a health education curriculum for the four schools.
- They provided technical assistance to other communities interested in replicating The Healthy Place model.
RWJF supported this project with a grant of $375,000 from November 1999 to October 2002.
Washington Community School in western Plainfield, N.J., is located in a Medically Underserved Area (an area designated by the U.S. Department of Health and Human Services as having a shortage of primary care professionals).
Other barriers to health care access include low family incomes (more than 90 percent of the students live in households with incomes at or below 200 percent of the federal poverty level), lack of health insurance coverage, lack of transportation and language and cultural issues (students are predominantly African-American and Hispanic). Immunization rates were low, and students had high rates of uncontrolled asthma that could be prevented or managed with proper intervention and education.
The Plainfield Health Center, a Federally Qualified Health Center operated by the Plainfield Neighborhood Health Services Corporation, has provided community-based primary health care services in the Greater Plainfield area since 1969.
As a Federally Qualified Health Center, the Plainfield Health Center: operates as a nonprofit corporation governed by a board of directors composed mostly of users of the health center, serves a medically underserved population and provides comprehensive services to patients regardless of their ability to pay. In 1994, Plainfield Health Center established an adolescent school-based primary health care center at Plainfield High School.
New Jersey Health Initiatives, established in 1986, recognizes RWJF's special responsibilities to New Jersey, its home state. The program, with projects throughout the state, seeks to improve health and health care for New Jersey residents through innovative, community-based health services.
New Jersey Health Initiatives projects span RWJF's four goals: to assure that all Americans have access to quality health care at reasonable cost; to improve the quality of care and support for people with chronic health conditions; to promote healthy communities and lifestyles; and to reduce the personal, social and economic harm caused by substance abuse tobacco, alcohol and illicit drugs. This project meets RWJF's access goal.
The Plainfield Health Center established a comprehensive school-based health center The Healthy Place at Washington Community School and provided outreach services to Jefferson, Clinton and Stillman elementary schools.
The Healthy Place staff consisted of a pediatric nurse practitioner, a registered nurse case manager, a billing clerk, a health educator, a nutritionist and a social worker, overseen by a Plainfield Health Center pediatrician. The center shared space with the school nursing program until September 2001, when it moved to its own quarters, which consisted of two exam rooms, two offices, a conference room and a waiting room.
The School-Based Youth Services Advisory Board provided guidance on implementation and operations to project staff. Over the course of the project, the Plainfield Health Center collaborated with the school nursing program and administration at Washington Community School and the Plainfield Coalition, which promotes healthy behaviors and lifestyles for adolescents.
The project also attracted funding from the federal Bureau of Primary Health Care of the U.S. Department of Health and Human Services ($70,000), Van Housten Foundation ($50,000) and Grassman Foundation ($10,000). The Central New Jersey Perinatal Consortium and the American Lung Association provided patient education packets on safety/nutrition and asthma care, respectively. Schering-Plough Pharmaceutical Company donated asthma start-up kits, peak-flow meters and refreshments for World Asthma Day.
The project accomplished the following:
- The Plainfield Health Center opened The Healthy Place, a state-licensed, school-based health center at Washington Community School in Plainfield, N.J., on January 1, 2000. The Healthy Place offers primary care services to more than 1,600 students at Washington Elementary School and three neighboring elementary schools Jefferson, Clinton and Stillman from 8:00 a.m. until 4:00 p.m. on school days. The center is staffed by a full-time pediatric nurse practitioner, a registered nurse case manager and a billing clerk; a health educator, a nutritionist, a social worker and a pediatrician work with the center part time. Services include:
- Comprehensive pediatric services, including well-child physicals and sick care; early and periodic diagnosis, screening and treatment screenings for vision, hearing and scoliosis; immunizations; risk assessments; and case management for children with asthma.
- Dental services at Washington and Jefferson elementary schools (added in 2001).
- Referrals, as needed, to Plainfield Health Center for obstetric/gynecology services; the WIC Program for nutritional counseling and food vouchers (the Special Supplemental Nutrition Program for Women, Infants and Children commonly known as the WIC Program provides vouchers for nutritious food, information on healthy eating and referrals to health care services for low-income women and their children up to age five); the School-Based Youth Service Program for social and mental health services; and Muhlenberg Regional Medical Center for laboratory and radiology services, hospitalization, home visits and case management for children with lead poisoning.
- Provided 968 primary and sick care visits and 1,560 screenings from 2000 to 2002.
- Immunized 550 students at Washington Elementary School, in collaboration with the school nurse.
- Participated in the federal Health Resources and Services Administration's Asthma II Collaborative, which focused on reducing health disparities for minority children. Through this program, The Healthy Place staff received extensive training to redesign patient care for children with asthma. The Healthy Place enrolled 57 children in its asthma care program; children and families received counseling and targeted case management. Enrollees reported that the number of days that "they felt well" over two weeks increased from two to more than 10. The Asthma II Collaborative recognized The Healthy Place asthma program as a best practice model.
- Collaborated in developing a health education curriculum that was used by Washington, Jefferson, Clinton and Stillman elementary schools. The health educator collaborated with the school health and teaching staff to develop the health education curriculum, and taught portions of the curriculum at all four schools.
- Provided health education and screenings to parents at the four schools at parent-teacher organization meetings, back-to-school nights and family nights. This included blood pressure and diabetes screenings for 89 adults and an educational session on asthma.
- Provided technical assistance to other communities interested in replicating The Healthy Place model. Project staff worked with representatives from the State of New Jersey Governor's Office and Jersey City, Newark, North Plainfield and South Plainfield. In 2002, the State of New Jersey pledged to open school-based health centers in medically underserved school districts statewide.
Project staff informed students and their parents about The Healthy Place through brochures, presentations at community meetings and events and educational workshops. Staff also made presentations at the National Asthma II Collaborative forums. See the Bibliography for details. The Star Ledger, Plainfield News and Courier News published articles on the health center.
The project director offered three lessons from the project:
- Working collaboratively with the school nurse, school administrators and the parent-teacher organization is critical to the success of a school-based health center. In New Jersey, school nurses are the focal point for student access to health screenings and health care. The Washington Community School nurse worked collaboratively with The Healthy Place. The principals and the parent-teacher organization presidents of the Washington, Jefferson, Clinton and Stillman elementary schools provided advice to project staff and access to key teacher and parent groups. The school nurse, principals, and parent-teacher organization presidents all championed the health center. (Project Director)
- When working with outside organizations, keep detailed notes on the planning process and early decisions. During this project, school personnel and parent leaders changed frequently; having detailed notes enabled project staff to inform the new staff and parents of previously agreed-upon promises and expectations. (Project Director)
- When working on a shoestring budget, hiring staff who can multitask stretches resources. Early in the project, The Healthy Place's nurse practitioner handled case management responsibilities until the center had enough patients to hire a part-time case manager. (Project Director)
AFTER THE GRANT
The Healthy Place continues to provide primary health care services to students at Washington, Jefferson, Clinton and Stillman elementary schools and has expanded to serve the siblings of students and graduates of the four schools. In May 2004, The Healthy Place initiated a Pediatric Obesity Prevention Program with funding from RWJF also under the New Jersey Health Initiatives program (ID# 051862).
Funds for The Healthy Place come from grants, the Plainfield Board of Education and patient revenue. Support includes a Healthy School, Healthy Communities grant from the federal Bureau of Primary Health Care ($103,300 annually); $50,000 annually from the Plainfield Board of Education for well-child physicals for children in kindergarten and fourth grade, and in-kind support for maintenance, security and utilities; and $75,000 from Boston Scientific for the Pediatric Obesity Prevention Program. Schering-Plough continues to provide asthma educational materials and peak-flow meters.
GRANT DETAILS & CONTACT INFORMATION
Establishment of a School-Based Health Center for Minority Children
Plainfield Neighborhood Health Services (Plainfield, NJ)
Dates: November 1999 to October 2002
Susan Walsh, M.D.
(908) 753-6401, ext. 131
(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)
"Baseline Student Enrollment Questionnaire." The Healthy Place, fielded January 2000 and ongoing.
"Healthy Choices Educational Session," Held bimonthly September 2000 through June, 2002, Plainfield, N.J.
"Childhood Asthma," April 2001, Plainfield, N.J.
Report prepared by: Karin Gillespie
Reviewed by: Lori De Milto
Reviewed by: Molly McKaughan
Program Officer: Pamela Dickson