A bell attached to the front door of Ashland High School's Health Center jingles every time someone walks in, looking for help. At lunchtime on Sept. 10, students trickled in needing a Band-Aid, ointment and saltines for a stomach ache.
All small medical services for sure. But the bell also could jingle for a student needing a vaccination, sports physical or a pregnancy test.
Since the school's health center opened in 1990, the nurse practitioner has called for an ambulance a half-dozen times for serious conditions such as an anaphylactic reaction, acute appendicitis and threats of suicide.
It almost happened that the door to the health center would have been closed this school year, leaving students and faculty without physical, mental and preventive health care services.
But when Jackson County told administrators that it could no longer fund the center, the nonprofit Community Health Center stepped in to cover the gap, as it does for almost 10,000 people across the Rogue Valley who do not have adequate health coverage.
Community Health Center operates clinics in Ashland, Medford, White City and Butte Falls, and school-based health centers starting with Eagle Point High School last year, Butte Falls Charter School and Ashland High School this year.
Across Oregon, county health departments have been partnering with hospitals and federally qualified health centers to cut costs. La Clinica, a nonprofit health center group based in Medford, also operates school-based health centers and has a mobile health center.
Community Health Center's first clinic opened in Ashland in 1972, making it the first health center in Jackson County to provide affordable access to medical care. Last year, 53 percent of its clients were uninsured.
About 48 percent of Community Health Center's income is received from patients who pay on a sliding fee scale based on income or who have health insurance coverage. The majority of the funds come from the state, cities, grants and fundraising efforts. Last Saturday, a house concert in Ashland raised nearly $5,000.
Community Health Center staffs the AHS center every school day and refers patients to other health providers when more medical care is necessary.
"Our goal here is to keep students healthy and in school, and offer convenient medical care that helps parents stay at work, which helps employers," says Melissa Klegseth, director of School Health and Outreach Services for Community Health Center. "Students can also get accurate health information here."
According to the Oregon Health Authority, adolescents often have the lowest access to health care service and are the least likely to seek care through traditional office-based settings.
Judy Blickenstaff, who has been a nurse practitioner at AHS's health center for 21 years, has first-hand experience with students needing medical and other attention.
"The most important service we offer is preventive care," she says. "Certainly taking care of headaches and stomach aches and sore throats is important. But we have a unique opportunity to ask students in a private, nonjudgmental setting about some of the decisions they are making about themselves and their lives."
She says students don't tell the medical staff everything that is going on in their lives, but enough "to be able to give adult input into some really important decisions."
Inside the school health center, there are racks holding brochures with information from nutrition to body piercings and driving under the influence. There are baskets of condoms and handouts on sexually transmitted diseases. A sign reads: "This is a safe place to talk about family problems, homelessness ... anything."
At one end of the waiting room is a counseling center, where students can speak confidentially, but with the knowledge that conversations about suicide, harm to others and being the victim of a serious crime will be reported to authorities.
Even though clients are teenagers, a teddy bear sits ready to be hugged in one of two examining rooms. Nearby is a computer, where office visit reports are added to individual electronic medical records. Parents receive an after-visit summary and instructions for any follow-up treatment.
Primary care physicians can receive a copy of the report, too, says Klegseth. "For some of the students, we are their primary care provider."
When school is not in session, students who are patients of Community Health Center can visit the clinic at 99 Central Ave. in Ashland.
If students do not have health coverage but qualify for the Oregon Healthy Kids Program, a publicly sponsored health insurance, the staff is trained to assist the family in applying.
"I feel we are helping students who would not be able to get medical care," says Klegseth. "That is a good feeling."
Reach reporter Janet Eastman at 541-776-4465 or firstname.lastname@example.org