New medical clinic at Glencliff High opens its doors to the community

Health services are available to underserved neighborhood By SUZANNE NORMAND BLACKWOOD sblackwood@tennessean.com 259-8268 • October 3, 2008 Glencliff High School is taking an active role in promoting a healthy community. The school recently partnered with United Neighborhood Health Services to open a clinic at the school that serves students, faculty, staff and members of the surrounding community. Many of the clinic's patients are uninsured. The clinic is the fifth that United Neighborhood Health Services has opened in the Metro school system. "We have a 15-year history in the school system," said Walter Stuart, director of school programs for United Neighborhood Health Services. The Glencliff clinic provides screenings, physical examinations, immunizations and sex education, said nurse practitioner Luz Salazar, who sees patients daily. She said the clinic treats a wide range of diseases, including asthma, diabetes, upper respiratory infections and high blood pressure. "We encourage them to be healthy," said Salazar, adding this includes urging good eating habits and staying current on immunizations. The clinic also offers some behavioral health services and will begin providing care by an adolescent behavioral health specialist in January. "If we cannot provide service, we make referrals," Salazar said. Students receive services for free Any student in Metro Schools may receive services for free at the clinic. Although the clinic files insurance claims for students with insurance, the students do not have to pay a deductible or make a co-payment. Uninsured area residents are served on a sliding scale. The clinic also accepts TennCare, Medicare and commercial insurance. "These clinics are important because so many of Nashville students are economically disadvantaged," Stuart said. The clinic will provide consistent health care for those who otherwise might not be getting the services they need because of lack of income, he said. "Our students and this community often go without health care," said Glencliff High School's principal, Tony Majors. "This is an important service we can provide. We care about our students and their families." Also, added Majors, "a healthy student is better able to learn." Majors said the clinic's opening has opened doors for organizations to start providing health and wellness services for Glencliff students and the surrounding community. Parents must consent Salazar, who graduated from Vanderbilt and is fluent in Spanish, is qualified to serve the community's large Spanish-speaking population. There are also many in the community who are Asian or Middle Eastern. Salazar said someone usually comes with the patient to serve as a translator if the patient doesn't speak English or Spanish. "Sometimes it's a family member who helps them or another student," she said. "It's kind of like a team." The clinic sent home consent forms for parents to sign at the beginning of the school year indicating which services they wanted their children to receive or not receive. "We do not see anyone without parental consent, because it is a school clinic," she said. But, she added, "If it's an emergency, we provide service." Pamela Stiles said her niece, Bobbie Jo Puryer, who is a senior at Glencliff, went to the clinic earlier this year for a physical she had to have to be on the bowling team. "They found that her blood was low, so they gave her some iron pills," she said. "It has gone unnoticed a long time." If it weren't for the clinic visit, Stiles said, they don't know when the problem would have been discovered. "I was actually considered anemic before," Bobbie Jo said. Shetold Salazar her history of anemia, and Salazar ordered some lab work. Bobbie Jo said her experience at the clinic was pleasant: "They were very friendly. They make you feel welcome."

Clinic offers sex education, substance abuse services to students

By SUZANNE NORMAND BLACKWOOD sblackwood@tennessean.com 259-8268 • October 3, 2008 Sex education will be a strong focus at the new clinic that opened at Glencliff High School through a partnership with United Neighborhood Health Services. The clinic also discusses with students matters concerning substance abuse. The clinic does not provide contraceptives, but it does offer pregnancy tests and screenings and treatment for sexually transmitted diseases. Although parents are generally entitled to information about their children's health in Tennessee, exceptions include pregnancy tests, concerns related to substance abuse, and screenings and treatment for STDs. "We follow the rules of HIPAA," said Luz Salazar, a nurse practitioner at the clinic, referring to the federal healthcare confidentiality law. Students have the right to confidentiality, she said. The only exceptions are if a student's life is in danger or the student is threatening to harm someone else. If a student reveals that he or she has been experimenting with drugs, Salazar said she first talks to the student about the situation. If the student has a serious problem, she refers him or her to Project SELF, a school-based substance abuse treatment program for youths. A social worker from Vanderbilt University Medical Center and a psychologist from mental health care provider Centerstone also work with Glencliff students. In Tennessee, those age 16 or older may seek counseling without parental consent. Parents also don't have access to information exchanged during sessions with school counselors unless a student is threatening to harm himself or herself or someone else. "We'd rather have them talk to somebody than do something wrong," said Salazar. She said students might not get help if confidentiality were not protected. "We are patient advocates," she said. "We're not here to judge them; we're here to serve them." Private policy has pros, cons Salazar said most parents don't challenge confidentiality policies. "Parents most of the time want the best for their children," and that may mean giving them some privacy, she said. "I agree with that," Pamela Stiles said about the policy. Stiles' niece, Bobbie Jo Puryer, lives with her and is a senior at Glencliff. Stiles, who also has children of her own, said teenagers sometimes need someone personally they can go to with issues. Parents might overreact and not know how to handle the situation. It often helps to have an objective adult who is emotionally detached from the situation and can offer professional advice, she said. Also, said Stiles, teenagers will often listen to other adults before they will listen to their parents. "It's a good thing that students have a place they can go and feel comfortable," said Maria Bernabe, a sophomore at Glencliff. A student with an STD, for example, might delay seeking medical care if he or she fears that his or her parents might find out. Then, by the time the student gets help, it's too late, Maria said. Sophomore Jessica McCarroll said that sometimes parents should be involved. After all, whatever is going on with the teenager may involve changes that need to be made by the parents, she added.