Parents and players leave an athletic event at Gardiner Area High School in June 2023. A proposal to bring a school-based health center to the school will be discussed in a public forum scheduled for 6 p.m. Tuesday at the Johnson Hall Opera House in Gardiner. Supporters of the proposal say such a health center would increase access to health care for district students and help address factors that contribute to chronic absenteeism. Kennebec Journal file photo

GARDINER — Students in Gardiner-area schools may soon have access to free health care through a proposed grant-funded, school-based health center.

A public forum scheduled for 6 p.m. Tuesday at the Johnson Hall Opera House will address the public’s questions and concerns about the center, which would be located at Gardiner Area High School and offer in-house medical care to the district’s students. The health center would be paid for with federal funding and delivered by HealthReach, a Maine-based provider of community health centers.

Nora Diversi, the lead nurse at School Administrative District 11, saw the need for a school-based health center when she started working in the district in 2017. The need only increased during and after the pandemic, when she saw students could not get the help or services they needed due to a lack of access to health care. Even if students had health insurance, she said, they endured the long wait times to get appointments for necessary services.

“Seeing how difficult the changes have been to access health care or primary care in central Maine — and some of the waits are eight to 19 months to get in — I’ve had a lot of students maybe not go to their primary care during the pandemic and now are trying to establish that care. That’s just outside the other barriers of transportation, homelessness, lack of health insurance … all those social factors are at play on top of a system that is not as accessible. It’s the perfect storm,” Diversi said.

A school-based health center can offer services that include physicals, vaccinations and referrals for students from Gardiner Area High School, and serve the students regardless of their insurance status.

To date, 26 school-based health centers have been established in Maine to expand medical access for teachers, administrators and students. Twenty are paid for with federal money and six are state-funded.

The proposal requires the approval of the Gardiner-area school board before any action is taken, but no vote has been scheduled yet.

If approved, the school-based health center would bridge a gap for medical access in Gardiner, West Gardiner, Pittston and Randolph, Patricia Buck-Welton, the coordinator of Gardiner Area Thrives Coalition, said.

“Number one, I think it will take anxiety and stress away from parents when you can’t find a physical or so your kids can get immunized,” Buck-Welton said.

Buck-Welton received a 10-year grant and is the Drug-Free Community coordinator for the Gardiner Area Thrives Coalition, which works with the middle school and high school to prevent substance abuse. The coalition is part of Healthy Communities of the Capital Area.

Records show that during the 2023-24  school year, 22.5% of 580 high school students were chronically absent, or missed 18 days or more of school. At the middle school, 22.49% of 430 students enrolled were chronically absent.

In looking at other districts, Buck-Welton and Diversi found that Lawrence Senior High School in the Fairfield-area School Administrative District 49, for example, had success with the school-based health center by serving 181 students out of 892 students at the middle and high school in the first year, reducing the school’s rate of chronic absenteeism.

“I think a couple of things helped bring it down,” Diversi said. “There are some kids with unaddressed mental health issues like anxiety, and when you have a health provider that can bridge that gap, it’s super helpful. When you have kids absent for unknown medical reasons, and they aren’t feeling good, with the center you can send them to school and they can see the doctor.”

HealthReach is a federally qualified health center that accepts private insurance, but will not turn away students without insurance. HealthReach offers a sliding scale known for those who are not insured.

Lindsay Hammes, spokesperson for the Maine Department of Health and Human Services, said school-based health centers have enhanced the well-being of young people in several ways, including diminishing barriers to access.

In the 2022-23 school year, Hammes said, the school-based health centers provided care to 2,006 students, totaling 9,223 provider visits. Of those visits, 51% were for mental health, 39% were for medical needs, and 9% were for oral health care. Of the students served, 49% were covered by MaineCare, 34% had private insurance, and 17% were uninsured or received non-billable confidential care.

“The school-based health centers enhance educational outcomes for students by limiting missed instructional time for external appointments, reducing absenteeism from chronic conditions, and decreasing disciplinary actions among students needing behavioral or medical support,” Hammes said in a statetment. “The centers also emphasize preventative care and conduct comprehensive health assessments for all students. School-based health center providers can build relationships by spending more time with students, providing health counseling and guidance, and ensuring referrals to meet their needs.”

Diversi said outside health services, including Mainely Dental, Spurwink Behavior Health and Education Services, already visit the school to give students access to dental or mental health services. She said the school-based health center would be more extensive and available.

“To keep the students compliant with the vaccination laws, I have brought in the state public health nurses to do clinics and get kids up to date so they are able to be in school because parents are trying to get kids in and can’t get an appointment,” Diversi said. “That’s really what motivated me.”

The Johnson Hall Opera House is located at 280 Water St. in Gardiner. More information on the proposal can be found at msad11.org.