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School-based health clinics a 'game changer,’ especially for rural students

Phoebe Taylor-Vuolo
Chelsea Doig is a physician's assistant at Delaware Academy in Delhi. She works out of the school-based health clinic there.

Chelsea Doig is a physician’s assistant at Delaware Academy, a K-12 school in the Village of Delhi in Delaware County.

She has worked at the “school-based health center” since September, and sees anywhere from five to 20 kids a day at the clinic. Students go there when they’re sick and for routine check-ups, immunizations, even dental care.

Lately, Doig and her colleagues at the clinic have been busier than usual, dealing with RSV, COVID and the flu. She grew up in Delaware County, and is glad to be providing care in the area.

“This is a region that’s definitely lacking in care, so it’s definitely a rewarding position. And the kids feel safe here, they know they can come here, and that’s been a really nice thing to see too,” Doig said.

It’s been just over 30 years since “school-based health” first came to Delaware County. Bassett Healthcare Network opened its first site in 1992, at Delaware Academy in Delhi. Now, Bassett runs the largest school-based health network in rural New York. It has locations inSchoharie, Chenango, Otsego and Broome counties.

Phoebe Taylor-Vuolo
Jane Hamilton, School-Based Health Practice Manager for Bassett Healthcare Network, stands in Delaware Academy's dental office.

At school-based health centers, children can get check-ups, shots, and basic health care, all inside the school building. When COVID first hit in 2020, New York’s schools shut down, but many of the small doctor's offices inside of them didn’t.

“Kids still needed their immunizations, they still needed their physicals, they still were grappling even more so with anxiety, depression, obesity, ADHD, all those things didn’t go away because COVID came around,” Jane Hamilton, school-based health practice manager for Bassett, said.

Some parents were more comfortable bringing their kids to a place they were familiar with. Many were afraid to take their children to regular doctor’s offices, or their providers were simply too busy to fit them in.

Hamilton said some school-based health clinics closed along with the schools, depending on what school districts felt was best. But many school-based health centers were able to keep preventative care going. They give immunizations for flu, COVID, and HPV. They provide annual checkups, and even offer mental health counseling services.

The clinic even has its own dental office. Students can get their teeth cleaned and checked by a dental hygiene specialist. If they need a filling or extraction, the program has a dentist on staff as well.

Parents enroll their children for the clinic’s services when the school year starts, and un-enroll anytime. There’s no co-pay.

Phoebe Taylor-Vuolo
A fridge for storing vaccines at Delaware Academy's school-based health clinic, run through Bassett Healthcare Network.

Kelly Zimmerman is the superintendent of Delaware Academy. She said school-based health helps make doctor’s appointments less disruptive for kids.

“It’s a game changer, especially in rural communities, where oftentimes there might just be one provider; a parent has to take hours off work for, a child misses a half day or a full day of school, for one appointment. Again, all of that is mitigated,” Zimmerman said.

Chris Kjolhede, an attending pediatrician, works at Bassett’s school-based health clinics. He said that especially after potential learning loss during the pandemic, and the issue of absenteeism in general, school-based health means kids don’t miss as much class.

He said adolescents are also sometimes more comfortable speaking to clinic staff who they know from seeing them every day in school.

“If they've been cared for in a pediatrician's office where, you know, they were a baby, and Mickey Mouse is on the wall. And then you're asking about, you know, ‘Do you always use a condom?’ They're just not going to be as forthcoming,” Kjolhede said.