Hardy County School-Based Health Project

The majority of people living in Hardy County are low-income families. Many of these families are uninsured or underinsured and must rely on public-sector programs, such as Medicaid and Medicare, for health care coverage. Farming, including poultry production and processing, is the major industry in the area. There is no reliable public transportation, and although there are several highways, most are two-lane roads. The majority of children ride a bus to school, with travel time taking up to 1½ hours each morning and afternoon.

School-age children in Hardy County experience high rates of poverty, and because of the rural, mountainous terrain, they have poor access to health care services. As a federally designated health professional shortage area and medically underserved area, the county has only a limited number of health care providers.

Specifically, the project was designed to:

• Decrease disruptive behavioral episodes, suspensions, and expulsions
• Help provide a nurturing and safe environment for children
• Increase understanding and cooperation among the education, health, and mental health systems
• Improve each student’s ability to reach his or her full academic potential without interference from physical or mental health issues
• Support families in their efforts to nurture their children and raise competent adults

At first, recruiting qualified, competent staff members for the health centers was a difficult challenge, but eventually the project was able to hire capable primary care staff members. Another challenge was recruiting staff members who met the necessary qualifications for billing. Many well-qualified professionals cannot bill for services because billing is restricted to LCSWs and clinical psychologists. As a result, some staff positions were covered by grant funds.

The project yielded several additional accomplishments. For example, staff members organized a prevention program that was offered at East Hardy High School and at special events at two middle schools. The program promoted tobacco and substance abuse prevention and provided health-positive alternatives for children and adolescents. Ultimately, the project was selected to develop statewide public service announcements on substance abuse prevention. In addition, articles about children’s mental health appeared regularly in the Hawse Health Center newsletter, increasing awareness of children’s mental health issues among the target audience.

It is important to note that school-based health care services require increasing community awareness of the project’s goals and services and generating broad-based community support. The project also requires securing the firm support of the local BOE during the planning phase—before the project is implemented.

The Hardy County School-Based Health Project plans to continue providing school-based primary care and mental health services at the East Hardy site. Only primary care services will be offered at the Moorefield sites until additional funding is secured to support mental health services at that location. Due to budget constraints, PHG decided to stop participating in the school-based project and terminated the mental health team’s services in June 2003. As a result, EAHHC submitted an application to the West Virginia Health Care Authority to become a mental health care provider site. The request was granted, and the project hired an LCSW and a social worker to strengthen the project’s mental health services. The project continues to seek additional funding from local, State, and private foundation sources to help sustain project activities.