Kalkaska Memorial Health Center - Teen Health Corner

Overview

The Teen Health Corner is a collaborative project initiated by Kalkaska Memorial Health Center, a district hospital and critical access hospital, and coordinated with Kalkaska Public Schools and Forest Area Community Schools. The school-linked adolescent program in Kalkaska, now in its sixth year, and a new school-based program in Fife Lake that opened in October 2011, provide health care services to youth ages10 to 21 years of age. The schools are located in a rural, medically underserved community. Clinical staff connect with students both at the clinic and at the middle and high schools. Along with providing health care services, it is common for clinical staff to assist students with other needs such as community resources (i.e., food, shelter, other needed services, and transportation to appointments).

Medical care is provided at the Teen Health Corner clinics. The school-linked site is located on the hospital campus but in a separate facility just for adolescents, and the school-based site is located on the Forest Area High/Middle school campus. Payment for services includes billing family health insurance plans, offering a sliding-fee scale for the uninsured, and assisting those without insurance in enrolling for State Medicaid or MIChild. No youth is turned away for lack of insurance coverage or inability to pay.

Impact

The majority of youth seek care for minor problems such as sore throats, illness or injury, but a few seek treatment for chronic conditions such as asthma or diabetes. For those who want to participate in sports, the Teen Health Corner offers an inexpensive “comprehensive physical” as opposed to the standard “sport physical.” A health risk assessment is performed for each patient, including screening for depression.

Challenges/success factors

Each year, the program helps 30 to 40 students enroll in MIChild or Healthy Kids, the state’s Medicaid program, and helps many others connect with social services:

• Vaccination status is reviewed at every clinic visit, and the clinic partners with the local health department to offer vaccinations at area schools three times per year. More than 300 inoculations are administered annually.
  
• During students’ health assessments, it has been determined that many could benefit from behavioral health care services. Initially, the clinic provided mental health counseling four hours per week; they now provide that service one day per week at the Kalkaska site and two days per week at the Forest Area site.
  
• Questions about reproductive health or sexually related issues are common, and some students seek confidential treatment. In the state of Michigan, anyone over the age of 14 may be treated in a health care setting for sexual, mental health, or substance use/abuse issues without parental consent. To ensure confidentiality, private insurance claims are not submitted for minors seeking confidential care.
  
• Both Teen Health Corner sites have a Community Advisory Committee made up of teens and parents, community members, local agency representatives, school staff, and clinical staff. The Community Advisory Committees advocate for services that are youth focused, approve the THC service plans, and offer input on in-school programming. Parental involvement is encouraged for every teen seen at the Teen Health Corner.
  
• Clinical staff have established positive, trusting relationships with youth at the clinic and through a presence in the schools on a regular basis.
  
• The hospital Board of Directors is supportive of the Child and Adolescent Health Programs, and the general community has commented many times about how much they appreciate their local community hospital taking a lead in expanding services to area youth.

Future direction/sustainability

The state Department of Education and Department of Community Health have provided $225,000 in funding for the Teen Health Corner Kalkaska site and $120,000 for the Forest Area site for the current five year cycle, beginning October 1, 2011, and contingent upon satisfaction of annual requirements. Kalkaska Memorial and the schools provide approximately $100,000 per year of “in-kind support” (such as office space, computers and supplies and services needed to administer the program) for the school-linked and school-based health clinics.

Advice to others

We began our program with an evaluation of need and with the participation of many community agencies in our planning phase. Strong relationships with your schools, Human Services, Mental Health, and other community services are a must in building and coordinating your services. We have tried many ways of marketing, but have found “word of mouth” the most effective; teens bring their friends, or a satisfied parent recommends us to another parent. While this program requires subsidy from the hospital, we know that “healthy kids learn better.” Our clinic introduces Kalkaska Memorial Health Center at an early age, and those positive relationships will bring people back to our hospital as they age and have families of their own.

Contact: Joanna Durfee
Program Coordinator
Telephone: 231-258-7791 Kalkaska, 231-369-2000 Forest Area
E-mail: jdurfee@mhc.net.