Rural SBHCs Increasing in Central Valley

This article appeared in California Healthline on April 13, 2015.

By Alice Daniel, California Healthline Regional Correspondent

LIVINGSTON — Salina Mendoza grew up in a tiny unincorporated community called Oro Loma on the west side of the Central Valley. Her parents were farm workers and resources were scarce, especially when it came to medical care. It wasn’t just that the doctor was a 30-minute drive away in Firebaugh; going there meant losing a day’s work.

“For me, it was growing up in a place where access was always an issue,” Mendoza said. “My dad had the only vehicle so that meant if we ever had to go to the doctor, he couldn’t go to work that day.”

And if he didn’t go to work, he wouldn’t get paid. “You grow up and you really don’t go to the doctor,” said Mendoza, who is now the Central Valley program manager for the California School-Based Health Alliance.

Merced County’s First On-Site School Clinic

It’s a situation Ralph Calderon sees every day. He’s the principal of Livingston High School in this Central Valley town of 14,000 in Merced County. He said more than 90% of his students come from low-income families, typically from homes where both parents work, yet the median family income is below $40,000. Employment is usually in the fields, the packing houses or at the Foster Farms chicken processing plant.

“You either go to work and get paid, or you don’t earn that money,” he said. “Yes, our parents absolutely love their kids and want to take care of them. But if it’s a choice of food and clothing and a roof over their heads, the health problem is always going to come in fourth.”

It’s one reason that Livingston High School will soon be the first site in Merced County to have a school-based health center with its own primary care physician and behavioral health clinician.

“We have a lot of mental health issues, stressors from poverty,” said Calderon. “There are an inordinate amount of students with anxiety disorders that sometimes turn into full-blown panic attacks. These are the things we want to try to get addressed.”

In fact, Livingston High School makes three times the number of ambulance calls as the other high schools in the Merced Union High School District, and it’s the smallest school, with about 1,100 students.

Stakeholders Say Students’ Mental Health is a Concern

The idea for the center evolved last year when the district was working on its Local Control Accountability Plan. Part of the process is to engage a stakeholder group of parents, students, teachers, administrators and staff to determine the needs of the district.

“The largest area of concern was mental health and the overall wellness of students in our district,” said Tammie Calzadillas, assistant superintendent of educational services.

A local clinic that had an active relationship with the high school proposed a partnership. Livingston Community Health, a federally qualified health center, suggested a school-based community health clinic.

Calzadillas said she became convinced this was the direction the district should take after looking at several studies. “Overall attendance rates improve, the health of the family improves,” she said.

According to the California School-Based Health Alliance in Oakland, there are 231 school-based health centers in California. The schools usually provide in-kind contributions. The centers get reimbursed through private health plans, the Child Health and Disability Prevention Program, Family PACT and Medi-Cal, California’s Medicaid program.

Livingston High School will provide the facility, phone lines and parking spaces. Livingston Community Health will provide the services. “This is really about the overall health and wellness of students and taking the services to where the students and parents are,” said Leslie McGowan, chief executive officer of Livingston Community Health.

The on-site center is expected to be open part-time by late summer and running full-time within a few months if approval is granted by the Office of Statewide Health Planning and Development.

“What this will do is provide another point of access to care,” McGowan said. “The needs of our community are definitely ones we feel equipped to address. We’re a 45-year-old organization here.”

Read the full article at California Healthline