community
School Based Health Clinic continued from page 14
home school families. “If you want to keep a student
healthy and in class and the younger siblings all have a
contagious something, then you want to treat them all,
not just the one in the district,” explains Ford.
Another policy decision was about whether to
open the clinic to all members of the community and
attempt to serve more than just the student population.
“We recognize that there is a health care vacuum in the
community,” says the School District’s Bell. Accord-
ing to Bell, the Planning Committee decided it was
best initially to stay with serving just students. “We
can expand later, but we don’t know what the demand
is going to be at the start.”
Of course, a major policy decision was what
services to offer. In addition to primary care treatment,
the clinic will offer screening services that include
blood pressure, vision, hearing and scoliosis as well as
minor dental screenings and preventive treatment. The
clinic will have the capacity to write prescriptions and
administer over the counter and prescription medica-
tions.
In addition the clinic will provide reproductive
health services including pap exams, pelvic exams,
testicular exams, pregnancy testing and counseling.
They will also provide Sexually Transmitted Disease/
Sexually Transmitted Infections (STD/STI) treatment
and prevention including condom availability for STD/
pregnancy prevention use. According to state law there
is no Self Consenting Age restriction for students seek-
ing reproductive health services.
Ford says the Planning Committee has decid-
ed that the clinic will not provide birth control as a fam-
ily planning method, but will not restrict the medical
treatment scope of the provider if birth control pills
need to be prescribed for a medical intention, such as
hormone therapy.
What will happen, says Ford, if a patient is re-
questing family planning service or has questions about
using birth control pills, is the provider will have a con-
versation with the student about who is a responsible
adult in their life. “The provider will talk about respon-
sible choices and decisions and people they may want
to talk with about this decision,” says Ford. “In the
end that patient will walk away with a list of resources
about where they can go to get more information about
this decision that they are making, but we cannot pro-
vide the contraceptive method here.”
As far as distribution of condoms, for patients
who come to the clinic and are talking about participat-
ing in sexual activity, the clinic will offer condoms for
the purpose of disease or pregnancy prevention, along
with the same discussion with the provider about re-
sponsible choices and decisions, and what adults in
their life might be available to discuss these important
decisions. “They will be taught how to use it effective-
ly, what it prevents, what it doesn’t prevent and about
health risks,” says Ford.
According to Ford, the state requires a SBHC
to provide STD/STI treatment and prevention, but
it does not require providing condoms on site. “Our
Planning Committee wisely looked at that and asked,
‘How do you tell people to prevent STD/STI and only
give them one option [abstinence],when you know
medically you have this other option, condoms, which
is effective in preventing those,’” says Ford. “So by
providing condoms, we can say we are doing every-
thing we can to prevent STD/STI.”
Bell says students themselves through Healthy
Teen Surveys have indicated there is a health concern
about this issue and have expressed a need for disease
prevention. The SBHC provides an opportunity where
students are in an environment where they are comfort-
able and can ask questions of a medical professional
and receive accurate information.
Ford agreed with Bell that the data in-
dicates that Vernonia, the county and the state
has a percentage of students who are sexually
active with one or multiple partners and who
aren’t using condoms because they don’t have
access to them or they don’t know how to use
them. “We see that there are already students
who are sexually active and our goal is to give
them the skills to stay healthy if that is the deci-
sion they are choosing.”
A SBHC has been in the works for Ver-
nonia for several years. It was being consid-
ered in the fall of 2007, but the flood in Decem-
ber and the resulting lack of adequate school
facilities forced the project to be put on hold.
“Public Health stayed involved with the Well-
ness Team and we just kept working and keep-
ing a health focus for the district,” says Ford.
“We worked together on a Tobacco Free Cam-
pus policy, we worked on a school wellness
policy and together just kept health at the fore-
front of the school population.” When it came
time to build the new school campus, Ford and
the Wellness Team got back to planning for the
SBHC.
The Public Health Foundation received
a $60,000 grant from the state for startup, and
according to Ford, what-
ever is not used for equip-
ment and supplies can be
used toward operations
costs. “We have a busi-
ness model that runs in the
black,” says Ford.
Initially the plan
calls for the nurse practi-
tioner to be in the office
for twelve hours each
week. The clinic will be
open an additional eight
hours each week to offer
mental health services, for
Better Parenting: continued from page 13
might be fun or cool, but could lead to
trouble. Make sure they write out real life
situations with real words on sheets of
paper. Problems like shoplifting, break-
ing windows, drinking alcohol, smoking,
using drugs, sex, etc.
Then have your kids list some
of the bad things that could happen and
write them out. Things like, we could get
caught, we could get a referral or sus-
pended, we could get grounded; someone
could call the police, etc.
One child can act out the part of
the one who resists the temptation with
the parent doing the pressuring to do
something wrong, and then trade off. You
might have the kid’s pair up and practice
together also.
The more the kids have to say and do the
more they will learn.
You might begin by practic-
ing one step at a time with each family
member as the resister and each doing the
pressuring.
To get the most out of your prac-
tice consider starting with written role-
plays of what would happen in real life
until the kids get used to using the tac-
tics and words in the proper order. After
they get comfortable with the practices
have them practice without the written
words.
It might be a good idea to have
the kids make up a check list that out-
lines each of the tactics so they can gen-
tly coach each other after each practice.
Pointing out what went well and go back
over the stumbling blocks.
In closing, encourage your
kids to practice and use the strategies
that feel the most comfortable. Try to
have occasional follow up tests to keep
the strategies fresh and the kids “at the
ready” when they are asked to do some-
thing they do not want to.
Resources: Roberts, Fitzmahan & Asso-
ciates, Strengthening Families Program,
Iowa State University, ETR Associates.
november27
2012
19
a total of twenty hours. Ford says that any revenue
from insurance billing will be used to expand services.
In addition to Ford and Bell, members of the
SBHC Planning Committee include Aaron Miller-
WGS principal, Heidi Brown-VSD Nurse, Karen Ladd
-Public Health Administrator, Dr. Ken Cox-VSD Su-
perintendent, Peter Weisel-Vernonia School Counselor,
Bill Langmaid-VSD Board, Marie Krahn-Vernonia
Health Clinic Board, Tara Roberts-Medical Profession-
al, Heather Lewis-Resource Coordinator, VPC, AHEC,
Public Health Board and DeAnna Pearl-VPC Director.
For more inofrmation about the Vernonia
SBHC contact Sherrie Ford at: sford@tphfcc.org.
