When Bissell Santos needed a physical last fall in order to play soccer at Omaha Northwest High School, he called a doctor's office to schedule an appointment.
There would be a month's wait, he was told.
School nurses at five OPS schools will conduct screenings using the “telehealth” model, taking pictures or videos of children's teeth and sending them to a dentist for diagnosis.
A fluoride varnishing program will also expand, with the goal of treating 2,700 students. Next school year, a roving dentist with portable equipment will visit schools three days a week.
Dentists from local universities will participate.
Discouraged, he called Northwest's school-based health center to see if it could squeeze him in.
“They said, 'Come in tomorrow,' ” said Santos, 16.
That kind of easy accessibility to basic health care — the ability to pop in for a throat culture or vision test between lunch and sixth period — is one of the driving factors behind the school-based health centers in the Omaha Public Schools.
This fall, Bryan High's center became the eighth such center to open, further expanding a program that began in 2010 — a program organizers call a success.
Students praise the convenience; principals tout the ability to keep kids focused and in school; and medical professionals are able to provide medical and mental health services in a location familiar to most families.
“With high school kids, sometimes they try and tough it out,” Bryan High Principal Robert Aranda said. “Here, they can get little checkups, say, 'I'm sick, let's get it taken care of right away.' ”
The centers provide routine care that many low-income, uninsured patients might otherwise do without or seek at costly ERs.
All OPS students, their under-18 siblings and qualified preschool students are eligible for a wide range of care: immunizations, tests for mono, treatment for bumps, cuts and sprains — all provided in a setting nearly identical to a doctor's office.
Before students can be treated, parents must sign consent forms. Most students are either uninsured or covered by Medicaid, and payment is offered on a sliding scale. No students are turned away because of inability to pay.
“Those acute illness things are something we can take care of,” said Debra Gartin, the nurse practitioner who staffs Northwest's center. “The parents don't have to leave work, pick their kid up and take them to the doctor. It keeps them in school longer.”
In the first three years of operation, the centers logged 12,304 visits and served 9,394 kids. Some sites have been busier than others. Several clinics saw their hours cut in half this year due to lower usage rates that officials say point to a need for more marketing.
There are about 2,000 school health centers across the country, including one in Grand Island, Neb., that opened in 1997.
“We've just started our fourth year, and we definitely have the capacity to grow,” said Jeanee Weiss, CEO of Building Healthy Futures, which oversees the Omaha centers.
Building Healthy Futures is a spinoff of Building Bright Futures, a nonprofit dedicated to improving education.
Principals and health care providers say that providing students basic health care is paying off.
At Indian Hill Elementary, 97 percent of students qualify for free or reduced lunches. The school has one of the highest refugee and English language learner populations in OPS, according to Principal Sharon Royers.
“These are people who don't necessarily know how to access the health care system in our country,” she said. “When our children are sick, they miss school, and it affects not just their health but their test scores.”
In the last four years, attendance at Indians Hills is up from about 89 percent to 97 percent.
“Considering our poverty rate and the population we serve, that's an incredible change,” Royers said. “We credit a lot of that to having a health clinic here.”
Bryan High senior Jocelyn Sorto stopped by the clinic at her school after it opened in September. She thought she had strep; a quick test proved otherwise. She left with a clean bill of a health and a flu shot.
“Before, I probably would have gone home and stayed home for another day or two,” she said. “My parents probably would have taken me to an urgent care clinic or an ER.”
At Indian Hill, a child psychologist visits twice a month, a service Royers said is desperately needed by her students, some of whom suffer from ADHD or bipolar disorder.
Statistics from Building Healthy Futures and a recent Douglas County teen health survey point to mental health as a growing health crisis for local kids and teens.
Bimonthly child psychologist visits were added in 2011-12, and within one year, visits increased by 156 percent. More than half of mental health patients were 5 to 9 years old, and boys overwhelmingly outnumbered girls, by 78 to 22 percent.
The school health centers are overseen by Building Healthy Futures and run by OneWorld Community Health Center in South Omaha and Charles Drew Health Center in the north. They are funded by a mix of medical payments and reimbursements, federal grants and Building Healthy Futures funds that cover any gaps.
This year, each center costs about $100,000 to operate.
The University of Nebraska Medical Center's College of Public Health is expected to study some of the local data over the next year to assess the centers' impact on ER usage and absenteeism.
One study found that Cincinnati students who used school health centers were hospitalized less and had fewer ER admissions — resulting in a savings of nearly $1,000 per student.
In Oregon, 68 percent of school health center users surveyed claimed they did not miss a class while using clinic services.