Walla Walla School Based Health Center is Essential

Twenty-one percent of Walla Walla’s children under age 18 live in poverty. When I first saw that statistic, I was stunned. It was astounding to me that in an education-rich community like ours, one in five children struggle to have basic food, clothing and housing. Children who are not having their basic needs met often struggle in school. Education research confirms that finishing high school is vital to earning a living. In Walla Walla, 40 percent of people who fail to graduate will live in poverty and need community support. We started the first school-based health center in Eastern Washington in 2009, mainly to address truancy. We discovered that children were missing school because of incomplete immunizations or untreated dental abscesses or sleepless nights related to anxiety. We learned that children were being medicated for attention deficit disorder when what they really had was post-traumatic stress disorder from child abuse or the death of a family member. Once we realized that children in Walla Walla were living with these miseries, we felt the time had come to not just study their heartaches, but to reduce them. The Health Center at Lincoln was established. That was five years ago. We now have a second clinic, The Health Center at Blue Ridge. We see 92 percent of the 180 students at Lincoln High School and 68 percent of the 400 children at Blue Ridge Elementary. Adverse childhood experiences cause a child’s nervous system to pump out adrenaline and cortisol. When the developing brain is repeatedly exposed to these neurochemicals, the structure and connections of neurons is altered. Early-life abuse and neglect, especially when coupled with stress, chaos and inconsistent parenting, creates adults who have poor anger control, bad decision making, early onset of sexual activity, depression, relationship problems, even heart disease and diabetes. School-based health centers are designed to keep children healthy and in school. Discouraged learners are expensive for our community. SBHC’s can reduce truancy and increase reimbursement for schools because more students are in seats. By reducing out-of-control anger, SBHCs can decrease Juvenile Justice Center incarcerations and foster care referrals. SBHCs reduce inappropriate use of hospital emergency departments. Surveys of Lincoln students reveal that 34 percent have gone to The Health Center instead of an ER. The acceptance and empowerment students receive at The Health Center can reduce the longing for protection that drives some students to become gang members. The demand for mental health services in our community remains unmet. The majority of the care we deliver at The Health Center at Lincoln is for mental health, mainly to treat depression and anxiety. Eighty percent of our students have chronic depression. Thirty-one percent have intentionally cut themselves, which is a risk factor for suicide. Suicide attempts can be reduced by appropriate counseling, support and medication. The Emergency room is not the place to treat mental health problems. In Washington state, all children are assured of health insurance. However, there is a vital difference between having insurance and having access to a primary physician — a medical home. Only 30 percent of children on Washington Medicaid can access a dentist. Parents struggling to support their families often cannot miss work to take their child to a medical appointment. Teenagers have fears about confidentiality, or embarrassment about seeking mental health counseling. Twenty-eight percent of our students tell us that if it hadn’t been for The Health Center, their medical needs would have gone unmet. Because of barriers to care, a surprising number of children have a medical home but can’t or won’t go there. Primary care providers who accept Medicaid patients receive a monthly stipend to care for the patient, whether or not the patient gets seen. The Health Center is not the primary provider for children. Our staff provides immunizations, educates students, parents and teachers about health topics, encourages families to establish a medical home and treats small illnesses and injuries. The Health Center makes sure children have the resources to see their primary physician for checkups or complex illnesses. There is nothing else in Walla Walla that does what The Health Center can do, which is to break down health care barriers, improve communication between health care silos and provide timely, on-site emotional or medical care to school children for free. Despite providing this service, there is no reimbursement from Medicaid for an independent SBHC like ours. Funding for Walla Walla’s SBHC is from grants and donations only. There are no public school or county health department funds for The Health Center like there are in Pendleton. Walla Walla’s five-year-old SBHC system is frugal and effective, but will always rely on support from individual donors and grant-makers to achieve improved outcomes for our community’s children. If you believe, as I do, that sustaining and expanding our school-based health centers can result in healthier, more productive students and a safer, more prosperous and vibrant community, now is the time to let us know by supporting The Health Center (thehealthcenterww.org).