OLD TOWN, Maine — By the end of March, Penobscot Community Health Care (PCHC) will open three school-based health care clinics in RSU 34 Old Town schools after receiving $700,000 in grant funding from the Health Resources and Services Administration (HRSA).
Mainers face several roadblocks when they are seeking care as the state's fragile health care system continues to struggle with challenges like widespread low staffing for healthcare providers, low appointment availability, and lack of easy access to care.
Program manager for PCHC school-based health centers Kacy Leeman said onsite school clinics like the full clinic that will be available at Old Town Elementary will give parents who have children who attend Old Town schools a break.
"I think if you call any doctor office right now—I think it's quite a wait to get into an appointment," Leeman said.
Mental health services will be provided at the elementary, middle, and high school in Old Town, but the elementary clinic will be home to a full health clinic that will be open to all students who attend RSU 34 schools and all staff who work in the district.
A doctor and an examiner will work in the clinic, and Leeman said there will also be a lab and a waiting room.
Leeman said the clinic will be open from 7 a.m. to 3 p.m. during the school year, during scheduled school breaks, and throughout the summer. She said students or staff who need services throughout the day after becoming sick can attend the clinic as needed.
Leeman said having the clinic onsite helps remove barriers, allowing staff members to get the care they need without taking off work and also allowing parents to get their children seen by a doctor or provider faster without having to travel too far or miss too much school time.
She said having one extra place to turn to also helps people living in the district avoid limited appointment availability.
"I think one of the common misconceptions, things that I hear back from parents, is that they already have primary care providers," Leeman said. "School-based health centers work alongside primary care providers, although we can also certainly provide primary care to students who don't have a primary care provider. Our goal is to be here for students for things such as sports physicals, immunizations—any acute illness or injury."
Leeman said the clinic will offer various services, including acute care, well-child checks, asthma checks, chronic disease management, sick visits, and more.
Superintendent Matthew Cyr said he believes having the clinic available will bridge the gap that many parents and staff members suffer the brunt of.
"This partnership is providing more equitable access to health care resources for students," Cyr said. "It's one thing when we send a child home with a concern from the school nurse indicating that there might be an earache—there's a sore throat that should be throat swabbed. But some of our families unfortunately don't have transportation, or they don't have a PCP, or getting that child to that recommended appointment from the school nurse might be just an insurmountable challenge. And having that primary care option right here in the school is just going to be a game changer for our students and their overall well-being."
According to Cyr, there are some 500 children who attend Old Town Elementary, and hundreds of other students who attend the high school and the middle school.
"A school nurse can only go so far with identifying that there is a problem, and usually the next step is a recommendation to be seen by the next level of care providers," Cyr said. "With PCHC, we're going to have that next-level care right here in our building," Cyr said.
Principal of Old Town Elementary Jeanna Tuell said there is only one school nurse who provides care for all the children who attend the elementary school, and she said the large provider-to-student ratio makes caring for all the students who need regular care a strain.
"We have some very medically-challenged students here who demand a lot of time," Tuell said.
Tuell said the school nurse sees an average of 60 students per day for various reasons, explaining that mental health care is a dire need in any academic environment.
Leeman said when analyzing utilization at other school-based clinics in Bangor and Brewer school districts she finds that 70 percent of utilization comes from mental health services.
Cyr said he feels like the mental health needs of children have been often overlooked or overshadowed by the ongoing mental health crisis observed in adults in the state.
"It's no secret that our society has a mental health crisis," Cyr said. "And a lot of the press right now is with adults because of behaviors and actions that are extreme and concerning, but mental health doesn't just onset as an adult. It starts in the youth."
Cyr said the full clinic will be complete by the end of March, but because there was already a standing wait list for students who need mental health services, a mental health provider was able to start seeing patients in all schools on Dec. 29.