Budget cuts and a change in organizational direction have resulted in the Buncombe County Department of Health deciding to close three health centers in local schools.
The department operated school-based health centers at Asheville High School, Asheville Middle School and Erwin Middle School. The centers served 2,000 of the roughly 30,000 students in Buncombe County public schools and functioned much like doctor’s offices. Students received medical care and mental health treatment, including physicals, immunizations, lab tests and nutrition counseling at the school-based centers.
“We didn’t feel like it was the best use of public healthcare money,” said Nelle Gregory, Buncombe County Department of Health coordinator of community health services.
The health department reduced staffing levels at the centers through the past couple of years as funding from the state and other sources declined. The department evaluated funding and department priorities and the decision was made to close the three centers at the end of the school year.
“It’s a changing climate, and we have to constantly look at our priorities,” Gregory said.
The budget for the school based-health centers was $320,000 for the current budget year, which ends June 30. The health department will hire three school nurses with the funds.
Gregory said the closings are part of a larger trend within the department. The health department has decided to move away from clinical services and focus on education and outreach for three major public health problems – obesity, infant mortality and communicable diseases.
“We had some hard choices to make,” Gregory said.
School nurses only can evaluate a student and recommend that a student visit a family physician. They cannot provide treatment with a doctor’s order.
Connie Parker, executive director of the North Carolina School Community Health Alliance, said she was disheartened about the student-based health centers closing in Buncombe County.
Parker said the county’s school-based health centers were some of the first to open in the state in the early 1990s.
“It was a model,” Parker said. “All the centers became a model. They handled things beautifully and were so well run.”
The student-based health centers mostly serve lower-income students in a community, Parker said. The mission of her nonprofit, the North Carolina School Community Health Alliance, is to support accessible, affordable, quality health care in school-based and school-linked health centers.
Catawba County is the only other county in North Carolina to close a school-based health center recently. Parker said both programs were run by health departments and suffered from a decline in public health funding.
In other communities, hospitals or separate non-profits run the school-based health centers and receive funding from the school system.
Gregory said the health department looked for partners in the community to take over the school-based health centers but no deal was ever reached.
“It wasn’t the right time,” Gregory said.