In a clinic tucked away off Rangeline street, young patients get their check ups in colorful exam rooms, under a canopy of handmade construction paper decorations put together by the medical staff.
It’s not the only thing that makes this clinic unique, as it serves an exclusive population: Columbia Public Schools students.
The Scholar Clinic, opened by Clarity Healthcare and Columbia Public Schools in January, is a school-based clinic that’s available exclusively for students enrolled in CPS. It offers primary care services like check-ups, basic lab tests, vaccinations, sports physicals, mental health assessments and more.
Although the Scholar Clinic serves CPS students and is located in a CPS building, the staffing, funding, and operations management are provided entirely by its partner: Clarity Healthcare.
According to the district, Clarity has invested more than $400,000 dollars to build and outfit the clinic with the equipment it needs — at no cost to CPS. Mathew Gass is the central region president for Brightli, the parent company of Clarity and community mental health center Burrell Behavioral Health.
Gass said the main goal of the Scholar Clinic is to provide necessary health resources to students who may not have other ways to receive care, and to decrease barriers to access for families.
"Even in a community as resource rich as Columbia, accessing health care is more difficult for individuals that have barriers like poverty," Gass said.
Addressing cost burdens with income-based copays and fees
Clarity said services are offered on a sliding fee schedule, which is adjusted based on a family’s income and ability to pay according to federal poverty guidelines.
Additionally, families of children on free or reduced lunch plans are guaranteed no out-of-pocket costs. Clarity and CPS said this is done to reduce cost burdens for uninsured and underinsured students and their families.
The clinic also accepts Medicaid and other forms of insurance.
“Couldn’t ask for anything better,” Columbia Public Schools Superintendent Brian Yearwood said. “Now 18,000 scholars here in Columbia have access, and that is basically unheard of.”
Working to serve a community with diverse needs
At the Scholar Clinic, Megan Kruse serves as the pediatric nurse practitioner and leads a staff of one medical assistant and one community health worker. The three women outfitted the clinic with toys and books in the waiting room, and handmade decorations in the exam rooms.
Kruse said the decorations serve a dual purpose: making kids feel comfortable, and providing a unique way for her to assess developmental milestones.
“I think doctors offices are a very scary place sometimes, especially for children,” Kruse said. “I just want them to come in and it feel welcoming and fun and put a smile on their face. And it's also things that I can use to do a lot of my day-to-day work – you know, can they recognize numbers and letters? Do they know their colors?”
Kruse and the staff said this is especially helpful if kids are unfamiliar with doctors offices due to previous lack of access to health services, as well as to patients who are new to the country or don’t speak English. According to CPS, 73 different languages are spoken in the district.
Medical Assistant Charmae Loyd and Community Health Worker Samantha Walters said the staff uses a live translation service called Language Access Multicultural People (LAMP), which is run by the Catholic Charities Foundation of St. Louis. They say that Spanish, Swahili, Korean and Kinyarwanda – the official language of Rwanda – are just some they’ve encountered.
“We've seen quite a few students that are immigrants, or refugees from other countries. So, Honduras, Mexico, Rwanda ... those are some places that come to mind. But they haven't seen a doctor for three to five years, and just really getting them in connection with the stuff that they need,” Kruse said.
Breaking health barriers with a new approach
As students walk to the hot air balloon-filled exam room, they pass a cabinet filled with bags of rice, cartons of milk, and cans of ravioli and tuna, among other pantry staples.
Kruse said she aims to tackle student health issues from the root, which starts at home. That means addressing things like poverty and food insecurity.
“Oftentimes, if you can't take care of the things like their food, their clothing, they don't have hygiene products, they don't have cleaning products,” Kruse said. “If you can't address those things, then I can't even get them to think about taking care of their health care needs.”
Kruse said the clinic started carrying disinfecting products, as well as other household supplies like toilet paper and shampoo, to create an option for families who may not have access.
Kruse added that students can take meals and snacks from the cabinet in the hall, or “The School Market,” to help address possible food insecurity.
Keeping the kids at school (and the parents at work)
Like a traditional clinic, families can visit on their own by making an appointment or simply going to the clinic. Staff said that appointments are recommended because walk-ins may have to wait, but the building has a small parking lot and waiting room with toys and activities.
And for families who don’t have transportation, can’t take time off work, or simply need a convenient way to get their child from school to the clinic, options are available.
Clarity Central Region Program Director Jake Rettke said that because the clinic is technically school property, they can arrange transportation between schools and the clinic for students with parental approval — a perk aimed to increase convenience and decrease cost burdens for families.
“We're able to see the kiddo without mom or dad having to take off work … I think about 80% of the time, we've been able to send them back to school,” Rettke said. “Parents know that they're going to have what they need, and we don't have to pull anybody away from work to make that happen.”
Additionally, Superintendent Yearwood said one of the main goals the district had for the Scholar Clinic — aside from improving student health — was to increase attendance rates and keep students in class.
“One of the issues that we found is that our scholars miss [school] because of illness, because of not having access to true medical care - and we wanted to mitigate that,” Yearwood said.
But Clarity and CPS said the clinic’s ability to see students without parents physically present doesn’t mean that parents aren’t involved. Jake Rettke said no treatment is given without the consent of a parent or guardian, and parents can be videoconferenced into appointments or patched in via phone call if they’re unable to be there in person.
“We're not going to see that child until we have a consent from the parent to see them. And then once they're all done, Megan [Kruse] will communicate kind of what that treatment plan looks like back with the parents, make sure that they understand what we're doing,” Rettke said.
Taking a page from Hannibal’s book
The Scholar Clinic isn’t the first venture into school-based clinics for Clarity Healthcare. It runs another school-based clinic in the Hannibal Public School District.
The PATCH Center, or “Pirates Accessing Treatment with Clarity Healthcare” — an ode to the school’s mascot, the Pirates — is located right between Hannibal’s middle school and high school.
Tonya Stamper, the pediatric nurse practitioner at PATCH, said the clinic has made a monumental difference in attendance during the seven years it’s been open.
“A lot of times we’ll get a kid down: sore throat. And any other time, the parent would come pick them up, take them somewhere. Whether or not they had strep, they're done for the day, both of them,” Stamper said. “But that kid comes down, I do the strep, it's negative, they don't have a high fever, I can tell the parent, 'It’s probably just a little viral sore throat, they're fine to be back at school. You can stay at work.'”
PATCH relies heavily on a close relationship with nurses in the school district, whom Stamper calls her “best marketing tool." Hannibal school nurse La Rhonda Behl said she’s seen PATCH boost immunization rates firsthand since it’s opened.
“Immunizations — I can't say enough about that,” Behl said. “We would send hundreds of kids home the first day of school because they weren't compliant with their immunizations. But now they can go up there, they can register, they can come right back down here, get their immunizations, and they're starting into school.”
Stamper said that after seven years, word has finally started to get out about what she once called the “best kept secret in Hannibal”.
In Columbia, however, the Scholar Clinic is still in its early stages. As of right now, not a lot of folks have heard of it yet.
KBIA reached out to numerous parent-teacher organizations throughout the district and to parents and guardians directly, and only a handful were even familiar with the clinic.
The district says the main barrier for the Scholar Clinic is getting the word out to the people that need it most. Megan Kruse said that word is currently spreading mostly through word-of-mouth by school nurses.
As for the future, Kruse and the staff said they’re looking forward to adding vision services as soon as the 2024-2025 school year - a change they hope will help even more CPS students.
The CPS Scholar Clinic is located in the Eugene Field Center at 1010 Rangeline Street. It is open Monday - Friday, 8:00 a.m to 5:00 p.m.
