Julie Holland, M.D., and Kathy Swartwout, head nurse practitioner, presented the annual report of the school-based health center at Evanston Township High School to the District 202 Board of Education at its Feb. 24 meeting.
“We’ve been here since 1996,” Dr. Holland said; “since the beginning.” The school-based health center – distinct from the ETHS nurse’s office – “provides primary health care to any student who is in need at school,” she said. Such services typically include physical examinations, immunizations, sports physicals and contraception, she said.
Since Evanston Hospital has closed its Child and Adolescent Center (CAC), Erie Family Health Center has filled the gap and more, said Dr. Holland. Rather than seeing a gap in services since the closing of the CAC, she said she has seen services expanded. “Erie has more capacity than CAC – CAC had a waitlist,” she said, adding that the transition from CAC to Erie “has been pretty seamless.”
Data and Demographics
The school-based health center differs from the school nurse’s office in several ways, according to ETHS. Staff at the nurse’s office are employees of ETHS. The health center is funded by NorthShore University HealthSystem, the City’s Health Department, the State of Illinois and ETHS. Most staff are employees of NorthShore.
All students are eligible for services at the health center, but they must be enrolled by a parent or guardian in person. During the high school’s fiscal year 2013, 1,899 students were enrolled – roughly two-thirds of the student body. Of those, 54 percent were female and 46 percent, male; 874, or 46 percent, were black/non-Hispanic; 673, or 35 percent were white/non-Hispanic; and 241, or 13 percent, were white/Hispanic .During that year, there were 3,178 clinical encounters made by 875 students.
Of those students, 288, 15 percent, were uninsured; 755, 40 percent, had private insurance; and 855, 45 percent, were enrolled in Medicaid or Allkids insurance. In 2007, before Allkids, 49 percent of the students enrolled in the health center were uninsured, and the other half of the students had either Medicaid or private insurance (25 percent each).
In the fall, the health center conducts health programs for all freshmen, which include two days of lessons on reproductive health, said Ms. Swartwout. “In April we take students to Springfield for an advocacy day, to make sure our legislators are aware of us. The students meet with students from other school-based health centers,” she said.
April is GYT month – “Get Yourself Tested” for sexually transmitted infections (STIs), a nationwide program that the ETHS center supports, said Ms. Swartwout.
“From your perspective, are there unmet needs that you would like to see addressed since the closing of CAC?” asked Bill Geiger.
“The one area we have a great need for is psychiatric services,” Dr. Holland said. She said although the center can generally connect students to a social worker or a psychologist, “there are not many child and adolescent psychiatrists,” who can help when a student has depression or another mental illness that requires prescription medication.
Doug Holt asked about trends Dr. Holland and Ms. Swartwout see in their patients. Dr. Holland said what they have observed seems to mirror national trends. “There has been a huge increase in obesity. Numbers of STIs and of pregnancy have “slowly inclined downward, as the national rates have. Substance abuse – of alcohol and marijuana – continues to be an issue,” she said. “We try to educate students about them,” she added.
Jonathan Baum asked whether the ETHS Health Center staff had ever considered expanding to School District 65.
“That would require two things we don’t have,” said Dr. Holland; “space and money.”
Board members thanked Dr. Holland and Ms. Swartwout for their report.