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The History, Vision and Leadership of The Montefiore School Health Program

"I don't want to go to school today, my tummy hurts," whined Kiara at 7 am.  She doesn't want to get up and Crystal, her mom, has to get to work. Is she sick? Is she having a bad experience at school? At some point every parent has faced this dilemma. Crystal has an ally at her daughter's school-based health center.

Montefiore School Health Program's 21st health center opens today. We serve more than 30,000 children and parents in 65 schools in the Bronx. It all started thirty years ago, in 1983, when Montefiore joined a group to open a part-time school health program at PS 85. The center had a nurse practitioner (NP) and a medical assistant who split their time between Montefiore and the school. Healthcare institutions, including Jacobi, Morrisania, Martin Luther King Jr. Health Center and Bronx Lebanon were among the early sponsors and providers of school health services. The centers provided well-child care, acute care and monitoring of chronic illness. 

Supplies were carried from the sponsoring site to the school. School health NPs had prescribing privileges, well before their hospital and health center counterparts, thanks to a special provision by the state. The services were well utilized and well received in these early years, but inadequate.

Our director, Dr. David Appel, was a social pediatric resident during these years. He saw the great need in this community and designed a comprehensive school health center as his social medicine project. It was a great plan, but seen as almost impossible by the folks that oversaw the budget.

Ten years later, a door opened and new regulations allowed school visits to be reimbursed at the same rate as their sponsoring organizations. This change allowed the chairman of the Department of Family Medicine to track Dr. Appel down and offer him the challenge of his lifetime - to create a sustainable school health program at Montefiore.

And he accepted that challenge!

In 1993 the program had three part-time sites. Then he was able to add in dentistry and mental health services. By 1996 we had seven full-time health centers. Through great vision and leadership, along with creative partnerships, institutional support, statewide advocacy and the hard work of everyone involved in the program, we have made a great impact to the children and families in the Bronx. But our work isn't even close to done.
Our community still has great needs for complete and integrated medical and mental healthcare services. We also are committed to impacting the obesity epidemic - providing nutrition and fitness programming.

The vital services offered through the Montefiore School Health Program help families like Crystal and Kiara all the time. When Crystal stopped by the school health center on her way to work, Kiara was examined by the medical provider who found that her stomach aches were related to being bullied at school. They were able to meet with the school health mental health provider the same day and Kiara now feels safer at school – and no more tummy aches!

We are making a difference and history is happening now!

Margaret E. Rogers DNP, RN, FNP-BC, is Director of Primary Health Care at The Montefiore School Health Program

Posted by blogmoderator on 10/21/2013 at 8:40 AM Add Comment