MetroHealth’s School Health Program Celebrates 10 Years

School Health Program - JY

The MetroHealth School Health Program (SHP) launched 10 years ago as a single clinic at Cleveland Metropolitan School District Mound STEM Elementary School. Since then, it has become a national model for school-based health, providing clinical services for more than 4,800 students enrolled at more than 25 schools throughout Cuyahoga County.

But none of these numbers illustrate the program's success more than a single moment that played out in the parking lot of John Adams High School a few years ago.

Tamara Foster, a John Adams High School graduate, was visiting the school when she spotted the MetroHealth SHP mobile clinic and the familiar faces working there. She went straight to SHP Family Nurse Practitioner John Yousef, APRN-CNP, and opened her arms wide for a hug.

"He helped me with a very difficult time of my life," said Tamara, noting that without the MetroHealth mobile clinic at her school, she would not have been seen by a health care provider during that time of her life. "It was a hard, hard time, and he was the main person who was there for me and was that shoulder to lean on if I needed someone to talk to. (The School Health team) provided emotional support and always told me 'You're a smart girl. You can do this.' It helped a lot having people in your corner who believe in you."

Connections like this one are the foundation of the SHP, which now provides clinical services with two mobile units and multiple in-school clinics through partnerships with Cleveland Metropolitan School District, Cleveland Heights – University Heights School District, Saint Martin de Porres High School, Urban Community School and Positive Education Program (PEP).

"I'll never forget the first time I walked into the school and the kids recognized our team and said they wanted to come to the clinic to see us," said Associate Director of Pediatric Psychology Lisa Ramirez, PhD, who collaborated with Christine Alexander-Rager, MD, and others in the System to initiate the program. “Some would come just for a hello or a hug, and some because they weren't feeling well, but either way they knew we were there for them.”

A Matter of Trust

Katie Davis Bellamy, RN, Executive Director of Community and Corporate Health, said members of the SHP team work hard to earn their place in the school communities they serve.

"You have to build the relationships," she said. “It doesn't mean you just build a clinic, and then everyone is going to show up. They need to trust you.”

Over the course of its 10-year history, the SHP team of providers, nurses, program assistants, drivers and community health workers have earned that trust, and the results have been extraordinary. Students who participate in the program:

• Have fewer Emergency Department visits.
• Are 97% more likely to have completed a well-child exam.
• Are more likely to be up to date on required school immunizations.
• Show improvement in academic performance.

The SHP, part of the MetroHealth Institute for H.O.P.E.™, continues to grow as it enters its next decade. With the addition of community health workers, the program has improved its engagement with schools and increased student enrollment. The community health workers also help students whose families are affected by Social Drivers of Health (SDOH) – those factors beyond traditional medical care that affect our health and well-being. They include access to safe housing, healthy food, reliable transportation, job opportunities and so much more. An SDOH assessment aimed at pediatric patients is in development to help identify students who are in need.

This academic year, the SHP is establishing a telehealth program and will begin to offer dental services. All the program's services also are available to students' families and school employees.

"The School Health Program, part of the Institute for H.O.P.E.™, is making a real difference in the lives of our community's young people and their families," said MetroHealth President & CEO Airica Steed, Ed.D, RN, MBA, FACHE. "This program not only is important for the students' current health, but it also helps establish a focus on wellness that they will carry with them into adulthood."

Breaking New Ground

The MetroHealth SHP has earned a national reputation as an innovator for initiatives that push beyond the traditional model of school-based care to address the youth mental health crisis.

In addition to providing integrated primary care through its in-school and mobile clinics, the SHP has expanded its services to include preventive behavioral health care, including the high-profile, first-of-its-kind SAFE (Students Are Free to Express) Project.

Dr. Ramirez, Davis Bellamy and Linda Jackson, Director of the Center for Arts in Health, developed the SAFE Project five years ago as a collaboration of the SHP, Center for Arts in Health and community partners. The nationally recognized project brings professional teaching artists into the classroom using an arts-based, psychologically informed, primary prevention curriculum aimed at urban youth who are exposed to trauma and toxic stress.

In 2022, the SHP received the prestigious Gage Award from America's Essential Hospitals. The national honor was validation for all that the program does to improve the health and lives of Greater Cleveland's children. But, for the SHP team, the most gratifying reward comes with the work itself.

"Caring for students and their families is beyond satisfying," said Julie Cobb, RN, Manager of the SHP. "Their acceptance of us, willingness to entrust their children to us and gratefulness for our services is an honor and a privilege that we do not take lightly. The work we do is pertinent, meaningful and intentional. Through our collaboration with school districts and partners, we provide bridges to care that otherwise would not be available to our students and their families. That is inspiring."