Claiborne County Rural Health Care Services Outreach project

Health education must be a priority for Delta residents. Individuals must know how to prevent illnesses and injuries through healthier life-styles and behaviors. The optimal place for health education is the schools. The Claiborne County Rural Health Care Outreach Project was established to provide early health education sessions with children to prevent many of the critical chronic health problems seen in the county. The project provides affordable, accessible, quality primary health care to K-12 school children as well as adults in the surrounding area.

The school clinics provide increased access to health care providers regardless of working hours, location, or insurance. Having health care access in the schools is eliminating many of the barriers to health care for a major portion of the population in the county. Health care access in the schools is also providing early detection and monitoring of at-risk behaviors leading to chronic diseases like cancer, diabetes and cardiovascular disease. In addition to regular health checks, children are provided health education through the school nurses and teachers who work with the clinics to provide information throughout the school year.

The key premises utilized in the program include; health is a valuable asset; each individual has primary responsibility for attaining a healthy body and mind; each individual can, in part, ensure a higher quality of life through a healthy lifestyle. Age specific programs will be implemented geared toward educating the students on becoming responsible for their own health and to practice preventive health.

These programs will include personal hygiene for the body (all ages), your health as part of your total hygiene makeup (all ages (obesity/weight management classes for identified students, reproductive health/abstinence education, building positive self-esteem and assessment for at risk behavior or at risk psychosocial environment factors.

Hurricane Katrina hit about three months soon after the project was notified of its funding. The School District did not begin to remodel the first clinic site at the elementary school until the end of June and not much work had been completed when Katrina struck. Because Claiborne County is in south Mississippi and also near Louisiana, many of the evacuees from both the Gulf Coast and Louisiana came to the county. The CCFHC was inundated with new patients for over a month and many of the workers who were doing the renovation on the school went to help with the Gulf Coast recovery. The Outreach project came to a standstill as the county and our state recovered from the devastation of the hurricane.

Katrina delayed the opening of the project by three months due to repairs that had to be made to the building and clean up efforts around the community. There wasn’t much the project could do but wait until people could begin working again and things returned to some form of normality. However, personnel were hired before the hurricane hit and they expected to go to work.

Unfortunately, no project income or revenue was realized during the hurricane delay making it very difficult to maintain personnel salaries and other expenses during this three-month period. Some personnel left and others had to be hired. Medicaid was extremely slow in getting the project assigned with a Medicaid number and this has also caused problems and adjustments in project revenue. In addition to these problems, the project had to make adjustments in personnel expenses due to the increase in medical personnel salaries necessary to attract quality providers to the area after Katrina.

There was really no way to overcome the difficulties caused by Katrina simply because of the magnitude of the damage and after affects of the storm. However, the project continued even though it was at a much slower pace. Every member of the Consortium was affected by the storm. The school sustained damage that had to be repaired and this slowed down the remodeling efforts for the clinic. The CCFHC buildings sustained some damage that had to be repaired immediately for business to continue. The patient management system used by the clinic was shared with another clinic in Tylertown.

Katrina destroyed the telecommunications connections between the two clinics and the PMS was down for over a month. All patient information had to be entered by hand, which slowed down the workflow process immensely, just when there was an influx of new patients from the evacuees. The new influx of patients demanded the clinic’s full attention due to the concerns caused by uncompensated care, no information on medical records or pharmacy records, and liabilities for the medical personnel who were treating the patients. However, after about six weeks, the stream of new patients began to slow and clinic workflow slowed to pre-Katrina conditions.

The County Health Department was also faced with the influx of evacuees and experienced many of the same problems as CCFHC. In addition, many of the state health department personnel were called to serve in the medical units that went to the heavily damaged areas of the Mississippi Gulf Coast.

In rural settings such as Claiborne County, many in the community do not have health insurance and often do not get health care for their children or themselves. Having clinics in the schools increases their access to quality health care and helps get the children enrolled into insurance and other healthcare programs that can help these parents support healthy lifestyles for their children.

This project identified realistic and practical indicators that will provide useful information in improving school health promotion and education in rural communities. While simple and uncomplicated, projects such as this one can provide best practices for building school based clinic networks that make significant impacts on the quality of life and healthcare for rural communities.