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District, MetroHealth open second school-based health clinic (video)


Noelia Hidalgo followed Lincoln-West High School nurse Jim Ropas and a Cleveland city worker out of the school doors, climbed up the metal steps leading into a modified motorhome in the school parking lot and stepped inside.

On a recent day, the three joined four MetroHealth Medical Center workers already crammed inside what would be the narrow kitchen area of the former recreational vehicle. Dr. Melissa Lohr-Panzero and her team were performing basic physical exams for students like Noelia, a senior who will be involved in spring athletics.

This is the latest MetroHealth-CMSD school-based clinic, following a similar health center at Mound-STEM K-8 School in the Slavic Village neighborhood. The Lincoln-West clinic will have a grande opening on April 24, although it has been on site one day a week for more than a month already.

The idea: Bring more comprehensive, hospital-linked health care right to the school.

“We’d love for every school to someday have a link to a medical center,” said Dr. Christine Alexander, interim chair of family medicine at MetroHealth and the doctor leading the program and partnership with the District.

So what’s the difference between having a school nurse and a school-based clinic?

“The difference is when you go to the school nurse, it’s essentially triage, but we would be bringing basic health care right to the school,” Alexander said. “We’ll be able to do more disease management with things like diabetes and obesity and more by examining students who may not have seen an actual doctor in some time.”

Alexander said the clinic will work cooperatively with school nurses like Ropas at Lincoln-West.

“They do a great job, and so now we would be there for a hand off if, for example, they determine that a student needs to see a doctor or nurse practitioner,” she said.
Ropas said he welcomes the extra layer of care for Lincoln-West students.

“Kids will always need sports physicals, that kind of thing, and this becomes the vehicle to get them in front of a doctor,” Ropas said. “We’re helping their health no matter how we get there.”

And better health leads to better attendance, which leads to better academic test scores and so on, Ropas said.

Alexander said she would love to see the clinics eventually grow into a place that helps the school better establish its place as “the center of the community, a place where the whole family comes to learn about how to manage their diet, about healthy exercise and more.”

At Lincoln-West, MetroHealth will offer a wide range of health-care services — basic physical exams as well as treatment, by permission for everything from sore throats to the flu and other health concerns, if necessary.

So far, nearly 100 of the school's 1,060 students have turned in the required paperwork to get access to the MetroHealth clinic, which will be open a half-day per week to start.

Those numbers will grow rapidly, Ropas predicted. “It’s like building a business — no, it is building a new business,” he said. “My role, as the ‘boots on the ground’ here, is to to actively get out there and play an active role in helping them access these services, not to sit back and wait for them to do it.”

Inside the mobile clinic, for now an equipped RV borrowed from the city until MetroHealth purchases its own unit, Dr. Lohr-Panzero and Ropas go over student records as nurse Alex Caraballo takes Noelia’s vital signs as part of the physical.

The CMSD-MetroHealth partnership was first announced in November 2013 with opening of the clinic at Mound-STEM K-8 School in Cleveland’s Slavic Village neighborhood. About 85 percent of Cleveland schoolchildren are MetroHealth patients already, Alexander told The Plain Dealer when the Mound clinic opened.

The Mound-STEM health center is paid for by a $100,000 Third Federal Savings & Loan Foundation grant, $30,000 more from the Eaton Corporation Charitable Trust, and individual gifts.
Alexander said costs to run the Lincoln-West clinic are roughly the same and will be covered in part by a $125,000 George Gund Foundation grant.

Both District Chief Executive Officer Eric Gordon and MetroHealth CEO Akram Boutros have heralded the clinics as a key to reaching the city’s children with health care that would help education.

About 60 of Mound’s 400-some students have registered for care at the clinic.

“What we learned at Mound, of course, is that parent engagement is very much a challenge,” Alexander. “Some of them are just so darn busy working their jobs that they don’t have the time to think about it. In other cases, the mom may be deceased and dad or the siblings are running the household.

“But the nurse at Mound (Beverly Parish) is proactive and we’re getting more and more consents every day," she said. "We’ll keep at it until we really get connected.”

Alexander said the situation at Lincoln-West could be different in the long run because students are able to grant consent for certain care at the age of 13.

“Those kids are much more empowered to access their own care,” she said.