Which school in Spokane should get a new health clinic? The school board isn’t sure

Health care in school has evolved, and it continues to do so.

Nurses offices in Spokane Public Schools dole out bandages and ice packs, work with parents to build health care plans, assess sick kids and ensure medicines are properly taken when needed. But some schools are going further.

Three high schools in Spokane Public Schools house school-based health centers, miniature clinics operated by CHAS Health that treat illness, write prescriptions and referrals, and address pretty much anything else for which a student may go to their primary care doctor.

On Wednesday night, the Spokane School Board considered where they will locate a fourth school CHAS clinic.

Rogers, North Central and Shadle Park high schools have health centers, and they’ve been increasingly popular, said Executive Director of School Support Services Becky Doughty, who leads the district’s nursing team.

The center at Rogers, opened in 2020, served 667 patients in 1,921 appointments over the course of a year. Doughty said the Rogers clinic was “booked solid” three weeks ahead of the start of school, logging 500 visits in August.

“One of the many success stories is a student with chronic migraines considering dropping out. CHAS was able to treat the migraines at school, increasing the attendance for the student and improving their grades,” Doughty told the school board on Wednesday in a presentation seeking its advice on where to put the next health center.

Doughty and Greg Forsyth, capital projects director at the district, suggested the one of two remaining high schools: Lewis and Clark downtown or Ferris on the upper South Hill. The board requested more information before making their suggestions to district administration.

Board Member Jenny Slagle suggested exploring the idea of installing a health center in a middle school instead.

“LC is in an area where there is a lot of health care, and Ferris, being a little bit further south, would probably be more likely to be able to access health care versus some of our middle schools, needing more support and more access,” Slagle said.

The board requested data on school demographics from administrators, to determine which areas may be in the most need of a health center, eyeing potential “health care deserts” in other regions of the city.

“Where’s the equitable need?,” Board President Nikki Otero Lockwood said.

Board member Mike Wiser, who works at CHAS Health, suggested they consider which providers may be interested in operating out of their centers before they decide which school it should be built in.

Middle schools may be less appealing to providers as they enroll fewer kids than high schools, Wiser said, and younger kids are less inclined to seek healthcare on their own.

“Before we spent time looking at middle school and comparing that, maybe it would be important to find an interested provider,” Wiser said. “Chicken and the egg, I suppose.”

Superintendent Adam Swinyard said the district would provide the requested information to its board in a later meeting, and he expects then they’ll suggest which school should see the center.

Once they decide, the district hopes to begin construction on the new clinic next summer.

The Spokane City Council directed $200,000 of their remaining federal COVID relief funding to schools for the addition of another health center. Previous centers cost around $300,000 each to retrofit. It’s about a 50/50 split from the city and schools, Forsyth said.

The cost to retrofit the new center will depend on which school it goes into, Swinyard said.

Health care providers fund the staffing of these centers and lease the space from the school district.

The district’s health care offerings through partnerships exist beyond theirs with CHAS in high schools. Two years ago, the school district announced plans to open a learning wellness center at Logan Elementary to be staffed by the Washington State University schools of medicine and nursing.

“We really are taking care of the students’ health needs during the school day; that’s kind of what we’re limited to in school nursing here,” Doughty said. “This is going to be exactly like a doctor’s office.”

A likely scenario, Doughty imagined, involves a school nurse evaluating a sick student and calling parents to pick up their child. They can then walk a few paces to the Wellness center on campus and immediately receive care.

“They can prescribe, they can refer you out to specialty care, anything that you would find in a normal doctor’s office; that’s what this will look like,” she said of the wellness center at Logan.

The clinic will accept Medicaid and be open to the public, though Doughty expects school families will mostly use the center out of convenience.

“When transportation is a barrier, finances are a barrier, this makes a really good answer for families who are struggling,” she said.

It’s a symbiotic partnership between the school district and WSU. Logan families get a full-fledged clinic right on their school’s campus boasting all the convenience the high school centers offer. WSU students get a nearby location to learn hands-on with guidance from the nurse practitioners WSU employs to run the facility.

“The medical and nursing students will come in and they will be able to work with the faculty to provide care,” Doughty said.

The doors to that facility are almost ready to open. It’s completely constructed, with a separate entrance from the school for security purposes.

The space is bigger than the school-based health centers in high schools: it has a reception area, a bathroom, two exam rooms, a room for instruction for WSU faculty and their students, and a multipurpose room for practitioners to discuss treatment with patients that may become another exam room.

Still missing furniture, Doughty hopes it will be ready to open in the winter to steady traffic from Logan students, families and the greater Spokane community.

Also part of the new construction are two preschool classrooms that house toddlers by day, and potentially families and community members by night. Through more partnerships, Doughty envisions the space as a wellness education center for the public. In her wildest dreams, the center has a community garden for Logan families to grow their own food and take classes on how to cook with it.

“We want to be able to teach health and wellness, because this is a little bit more holistic than just the clinics,” Doughty said. “We want to be able to address the whole child, the whole family.”

The wellness center is the only one of its kind East of the Cascades, but Doughty said she can see the model working at other schools, perhaps in schools near other WSU campuses like in Tri-Cities or Vancouver. She hopes when the clinic opens this winter, it sees a “steady” stream of patients getting check-ups, physicals, prescriptions and mental health care.

Health care fits right in the public school setting, Doughty said, whether it be CHAS clinics in high school or wellness centers at Logan.

“If those community needs are needing to be met, we’re ideally positioned to be able to do those sorts of things because we have the kids for most of their week,” Doughty said. “The goal is really to have healthy kids and graduate them, so if what we can do is bring that to them so that we end up graduating healthy kids, then it makes sense.”