IH Cincy - Dr. Vanderhof

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Episode Transcript

Speaker 1 (00:00):
This week on iHeart Sinsei.

Speaker 2 (00:03):
Well, here's one you may not know. There are more
than one hundred and thirty school based health centers in
Ohio alone, open to students and staff and the community
medical providers right where you live, where your family and
your neighbors can access comprehensive care. We're talking from routine
exams and sports physicals to writing prescriptions, routine lab tests, immunizations, vaccinations,

(00:28):
even fast onset illnesses and injuries. Some school based health
systems have vision or dental services. They take insurance, they
accept patients without insurance as well.

Speaker 3 (00:39):
Because they're housed in schools, medical care is now available
in a trusted and familiar community setting, a place where students, families,
and the community already gather.

Speaker 2 (00:51):
These centers in Cincinnati and northern Kentucky are funded by
the States, and Today Ohio's doctor, doctor Bruce Vanderhoff, explains
what school based health centers are, where you can find
one near you, how to access care in your own community,
and he also provides the latest recommendations on flu and
COVID vaccines for all ages.

Speaker 1 (01:11):
Now on iHeart Cincy with Sandy Colleges.

Speaker 2 (01:16):
Today on iHeart Cincy, we are focusing on your health.
We've got cold and flu season upon us, plus COVID
nineteen remains a public health care concern. Our guest today
is doctor Bruce Vanderhoff. He's the director of the Ohio
Department of Health since November of twenty twenty. He leads
a statewide team of public health decision makers and providers
striving to improve healthcare access and health outcomes here in Ohio.

(01:40):
Doctor Vanderhoff has some very important information today about places
to access care in your community.

Speaker 1 (01:46):
You may not know about.

Speaker 2 (01:48):
They are school based health centers where you can receive
comprehensive care and get this year's vaccinations that he and
the CDC recommend.

Speaker 3 (01:57):
I like to turn to our main topic today, which
is school based health centers. These are just what they
sound like, a medical office housed on the grounds of
a school. They're open to serving students in their families,
school staff, and many also see members of the community.
School based health centers are not a brand new concept,

(02:21):
according to the Ohio School Based Health Alliance, the first
one opened in the state in nineteen ninety five, but
in recent years, under the leadership of Governor Mike DeWine,
the state has jumped into this space with both feet
and supported the addition and expansion of many more centers.

(02:41):
The Ohio School Based Health Alliance now lists one hundred
and thirty eight centers operating in Ohio. The Ohio Department
of Health is just one state entity that has supported
these centers. The Department of Behavioral Health, the Department of
Education and Work for the Department of Medicaid, and the

(03:02):
Department of Development through the Governor's Appolation Children's Health Initiative,
have also played key roles in this effort. The hot
Department of Health began supporting school based health centers in
twenty twenty two, initially using federal COVID nineteen relief funding.
With this generous support and then further generous support from

(03:28):
our own General Assembly, we've continued to be able to
support these centers with fifteen million dollars in general revenue
funding in the last budget that was fiscal year twenty
twenty four to twenty twenty five, which has increased to
twenty million dollars in the most recent state budget passed

(03:48):
in July for fiscal years twenty six and twenty seven.
With that funding from our legislature and previous funding So far,
through the twenty two twenty four five school year, ODH
has supported school based health centers in forty nine school
districts in twenty seven counties. This major investment is because

(04:12):
we recognize the importance of improving access to healthcare. Because
they're housed in schools, medical care is now available in
a trusted and familiar community setting, a place where students, families,
and the community already gather. This can help overcome many
of the barriers that we know sometimes prevent people from

(04:34):
seeking care, such as a lack of reliable transportation, the
challenges of a parent or guardian taking time off work
to take a student to an appointment, or simply an
inadequate number of providers in a particular area. Research has
shown that school based health centers not only can improve students' health,

(04:56):
but also support academic success. Data that we've recently begun
gathering from several of our ODH supported centers shows that
kids miss less class time, gaining about three hours of
additional instruction time compared with leaving school for care now. Earlier,

(05:16):
I mentioned the increased funding the General Assembly awarded US
in the most recent budget. In the current fiscal year,
we have awarded nearly eight million dollars to a total
of twenty nine grantees. Now, these grants serve different purposes.
Some are for planning that is needed before launching a
new school based health center, some grants are to help

(05:39):
defray the startup costs of opening a new center, and finally,
some grants are for the expansion or enhancement of services
at existing school based health centers. We are very excited
that we can play an important role in launching and
expanding these school based health centers that help improve the
health of students and entire communities. And now to help

(06:05):
us better understand school based health centers and the work
that happens there, I want to welcome in our guests
doctor Mary kay Irwin, Senior Director of school based Health
Services at Nationwide Children's and doctor Sarah Body, Medical Director
of school Based Health Services at Nationwide Children's. Now Nationwide

(06:25):
Children's has been involved with these centers for years, and
over the past several years, they have been a valuable
partner in the state efforts to open news centers and
expand existing ones. So doctors. As we've mentioned, school based
health centers conserve students, staff and the community could you

(06:48):
perhaps outline a little bit more about how the centers function?
For example, how do people get to see a provider,
do they make appointments, are walking's accepted? And what about
the students who may fall ill during the school day.
And also we all know about school nurses. What role
did they play with a school based health center and

(07:10):
how do these centers assure that parents are involved and
able to give consent. I know that it was a lot,
but if you could just outline some of those issues.

Speaker 4 (07:22):
Of course, so school based house centers generally operate with
flexible scheduling. So certainly appointments are made, and we have
appointments for preventive visits such as for well visits and vaccinations,
but it's important to remain very flexible for children who
may fall ill during the day. So unlike a traditional
outpatient clinic setting, if you say, for example, have a

(07:45):
couple of children on the schedule for a well visit
and all.

Speaker 5 (07:48):
Of a sudden, unexpectedly someone needs us.

Speaker 4 (07:51):
Immediately, we have the ability to move that well visit
to the next day because we're going to be at school,
just like that student will be tomorrow, right, and so
we very much want to be flexible, and most people
in school health you.

Speaker 5 (08:03):
Know, are very flexible.

Speaker 4 (08:06):
That also includes accepting referrals from just about anybody.

Speaker 5 (08:10):
So of course parents.

Speaker 4 (08:11):
We have great relationships with our parents and they can
call in and make appointments for their children.

Speaker 5 (08:16):
Sometimes older high school students refer.

Speaker 4 (08:18):
Themselves and seek care on their own, and also teachers,
school nurses, coaches all refer students into a school based
health center.

Speaker 5 (08:29):
Very important to note though, care.

Speaker 4 (08:30):
Is never delivered without parental involvement, so all care is
consented care, and that.

Speaker 5 (08:36):
Can look a number of ways.

Speaker 4 (08:37):
First and foremost parents are always welcome to attend an
appointment in a school based health center, but it's often
not required. We're trying to reduce barriers. One of those
bearers being that you know, mom or dad has to
take off work to shepherd the child to the appointment.
So in the event that mom or dad is unable
to attend the appointment, that's okay. We make sure we
have the consent for the appointment, and if mom wants

(08:58):
to speak her phone in or FaceTime the appointment, that's encouraged,
or if that's not an option, we may call her
after work to tell her how the appointment went doctor buddy,
want to talk about school nurses.

Speaker 6 (09:09):
Yeah, so just a note on that parental consent. Obviously
we're talking to parents before, during, after, and like Mary
Kay mentioned, the key to that is flexibility because we
know parents often have jobs where they may not be
able to be talking at the time of the appointment,
but they are absolutely involved in every aspect of their
child's care. The school nurse is integral to the success

(09:31):
of school based health centers. School nurses are providing care
for students day and in day out in the school setting,
and they're often the eyes and ears that might know
or identify issues that are coming on. So a child
falls acutely ill during the school day, their first stop
is to the school nurse where they're doing their job triaging.

Speaker 5 (09:49):
That student, understanding what's going on.

Speaker 6 (09:51):
If they're determining that they would benefit from the doctor's
appointment that day, then they're often communicating with the parent
and with the clinic and we're arranging that in real
time for them to work. So this is really a
great relationship back and forth and the school nurses are
invaluable to identifying the success of that. That can also
include chronic diseases. They might be a student that's coming

(10:13):
down to the nurse's office for abdominal pain over and
over again, and we're trying to figure out what might
be going on. So really an open door policy, as
she mentioned, to ensure that we're getting everybody in whatever
their issue may be, in getting their needs met.

Speaker 3 (10:27):
So, you know, I always at an opening of a
school based health center in Belair, Ohio, not all that
long ago. That's a center that nationwide Children's played a
very important role in helping with the startup of and
they were seeing folks from the community as.

Speaker 2 (10:46):
Well as Doctor Bruce vander Hoffe is the medical director
for the Ohio Department of Health. Sharing information about school
based health centers you may or may not know exist
in communities all across Ohio and north in Kentucky. There
are many here in the Cincinnati area and of course
in northern Kentucky.

Speaker 1 (11:04):
He'll have more information for you here in just a moment.

Speaker 2 (11:07):
But school based health centers provide comprehensive care in the community,
not only for the students and the staff, but also
community members at large. And it doesn't matter whether you
have insurance or not. Let's get back to doctor Vanderhoff
on iHeart Sinse, could you.

Speaker 3 (11:23):
Speak a little bit too security set up in terms
of some of these centers being open to the public
but also protecting the school environment.

Speaker 4 (11:33):
Sure, so, some school based health centers are embedded deep
inside of the middle of a school. Maybe it's a
classroom that has been converted into a doctor's office. Other times,
school based health centers.

Speaker 5 (11:45):
Are a little clinic in the parking lot or.

Speaker 4 (11:47):
Even in addition onto the school itself. In an ideal circumstance,
school based health centers have both an internal and an
external entrance. What I mean by that is internal to
the school, students who want to be seen can access
the clinic without leaving the building. And then the external
entrance for community members children from the community, moms, dads, grandmas,

(12:10):
and grandpas that would.

Speaker 5 (12:10):
Like to seek care for themselves. But that's not always possible.
And so when a school based health center is.

Speaker 4 (12:16):
Embedded in inside of a school, it's great for engagement,
you know, with a student body, and then what basically
that center has to commit to then is a little
bit extra effort to ensure when people from the community
are coming in. So that looks slightly different with every operation,
but generally speaking, when we see patients from the community,

(12:37):
they are buzzed in through the front office, they are
stopped at the front office and sign in, and the
provider usually sends you know, an assistant down to the
office to escort the patient back to the school based
health center and then we see them out of the building.
So there's a number of different things that can be done,
and you know, cameras can be leveraged of course, all

(12:57):
the different.

Speaker 5 (12:57):
Things that can be done from a.

Speaker 4 (12:59):
Safety perspective, and we take that very seriously in partner
with our school districts to ensure that we are following
their safety procedures as well.

Speaker 3 (13:08):
So can you just walk us through what one might
encounter if they were to actually go to a school
based health center? What does an office look like?

Speaker 5 (13:18):
Very different.

Speaker 6 (13:19):
Some of our offices can look like as you would
imagine a medical home setting. They might have multiple exam rooms,
it might look very a similar setting to you. Others,
as Mary Kay mentioned, have to be pretty flexible.

Speaker 5 (13:31):
We're partnering with schools.

Speaker 6 (13:32):
So we're working on sometimes existing space and limited space
inside buildings in order to serve the students. So we
have all kinds of creative spaces. One of ours, as
an example, was a chemistry classroom that wasn't being utilized
at the time, So great for a clinic space because
it has multiple sinks all along it that we can

(13:52):
utilize for those purposes. So you can get fairly flexible
with that. But what you do encounter when you come
is typically school based health center staff that is very
open door, welcoming, understands how to welcome students and community
members into the space, not as formal as you might
encounter in a typical medical home setting, and the purpose

(14:14):
of that is to really ensure that those kids are
feeling comfortable and confident to access those services, So we
don't want that to be intimidating. This is very adolescent friendly,
child friendly centers, where again all are going to be welcome.

Speaker 3 (14:27):
Well. You know, in addition to essential primary care services,
I know that a number of school based health centers
are beginning to add services to their portfolio. It increased
behavioral health support, dental services, and some vision services. Could
you talk a little bit more about these services and

(14:48):
that evolution.

Speaker 4 (14:49):
Certainly so, school based health centers generally start with comprehensive
primary care, so the primary care sort of being the
anchor of the service, and then OFTENTI are looking toward
how to address mental health and that can look at
a number of different ways relative to therapists that are
there in the school, telepsychiatry services, primary care providers.

Speaker 5 (15:11):
Who are trained in primary care mental health.

Speaker 4 (15:13):
And you're right, we're seeing an expansion of dental care
and not just seilants. We're seeing, you know, people being
able to do both a preventive and restorative care, even
X rays in school settings. Vision care we're seeing as
not just a vision screen, but rather connection to glasses
and even glasses repair. Also collaborations with specialty care, so

(15:35):
for children who are having a hard time, you know,
following up on say, frequent lab draws, you know, how
can the school based health center collaborate with specialists to
take do some of those in between appointments. So lots
of exciting things coming relative to the expansion of scope
of care that's delivered in a school based setting. But
what I would say is really important in school health is,

(15:55):
regardless of the type of care that we are offering
in a school based health center, it's really important that
it's comprehensive. So Generally speaking, these school based health centers
are located in places where individuals are disconnected from care.

Speaker 5 (16:08):
Or have a hard time with follow up.

Speaker 4 (16:10):
So, for example, you don't want to be doing well
visits at the school, but then say, gosh, I wish
I could give you your vaccines due today, but I can't.
You're going to have to go somewhere else. So it's
important you know that it is comprehensive. So again, regardless
of the type of care, you tend to see successful
school based health centering centers being comprehensive. So for example,

(16:31):
again not just a vision screen, but a way to
get glasses right, so they're comprehensive. And then they're also
linked to twenty four to seven care. So you want
to make sure that the patients who are seen in
a school based health center, if they have a problem
on a Saturday, a Sunday or over summer break, that
they that those patients know exactly where to go, so
that the care that they have access to is comprehensive

(16:53):
and safe and year round.

Speaker 6 (16:56):
The other thing I'll add is that for many of
our kids that might be suffering from chronic health conditions
such as asthma or other situations. The incredible thing about
the school based health centers is that those providers are
embedded in the school. They're there every day. They can
ensure follow up for these conditions, so it's very easy
for them to diagnose tree and follow They often have

(17:19):
great communication with teachers. So when I'm caring for kids
in our school based health centers that have mental health
care conditions, it's a real collaboration. So the students, the parents,
the community, we're all sort of wrapping our hands around
together for that student and to ensure that they're getting
everything they need and their needs met. So, as Mary
Kay said, you don't want to be referring out because

(17:39):
you already know there are barriers and you're right there
and you can have that comprehensive access for them over time,
and that's really important.

Speaker 3 (17:48):
Well, thank you both very much. I really appreciate your perspective.
I'd like to add that we just posted a podcast
on this topic, the latest episode in our Healthy Perspectives
with doctor Hoff. It features a conversation with doctor Vanessa Meyer,
medical director from Metro Health's School Health program located up

(18:09):
in the Cleveland area. You can find that podcast through
our YouTube page on Spotify and also on Amazon Music.
We'll put those links in the chat.

Speaker 1 (18:19):
Now, come on up.

Speaker 2 (18:20):
Have you got questions about when to get a flu
shot or should you get a COVID nineteen vaccine this year?
The answers are coming up next from doctor Bruce Vanderhoff.
That's next on iHeart Cincy. This is fifty five KARC
an iHeartRadio station. iHeart Cincy is iHeartRadio's local public affairs

(18:44):
program focused on the tri state community's challenges and offering
solutions from qualified professionals and dedicated public servants.

Speaker 1 (18:52):
I'm Sandy Collins.

Speaker 2 (18:53):
Now let's get back to doctor Bruce Vanderhoff, the medical
director of the State of Ohio's Department of Health, with
his COVID night and flu shot recommendations.

Speaker 3 (19:03):
Now turning to the flu, the CDC says that an
annual flu shot is recommended for anyone six months of
age or older. For COVID nineteen, the CDC has emphasized
shared decision making while preserving the availability of the vaccine
for all ages, including children who are eligible for the

(19:25):
Vaccines for Children program. The recommendations from the FDA and
CDC underline the fact that those age sixty five and
over are at particular risk, as well as those with
a wide range of medical conditions that can increase your
risk of contracting severe COVID nineteen. The CDC encourages you

(19:49):
to have a conversation with your provider, who can discuss
your personal medical history and help with informed decisions. We
know that many people go to farm to receive vaccines,
and it's important to note that under Ohio law, pharmacists,
pharmacy interns, and pharmacy technicians are permitted to administer COVID

(20:11):
nineteen vaccines to any person five and up without a prescription.
We do recommend that you call ahead to a pharmacy
to ask about availability and any vaccine policies they may have.
Of course, vaccines protect us from a wide range of

(20:32):
serious illnesses, including measles. Sadly, we continue to see outbreaks
of measles across the nation this year, and even here
in Ohio we had a cluster of cases not long
ago in the Greater Columbus area. The fact is that
we continue to see too many people contracting illnesses. They

(20:53):
can have very serious health effects, whether it be measles
or more commonly pertussis, which also known as whooping cough,
which can be particularly harmful to very young children and infants.
For decades now, we have had very safe and very
effective vaccines for serious diseases that include polio, tetanus, rotavirus, flu,

(21:19):
new macoccal disease, hepatitis, and many others. So I joined
countless health care providers in encouraging everyone to stay up
to date on their vaccines.

Speaker 2 (21:32):
Doctor Bruce Vanderhoff is the medical director for the Ohio
Department of Health. We're wrapping things up here on iHeart
since he's got a little bit more coming your way
about the holidays and how to keep your family healthy.

Speaker 3 (21:45):
As we wrap up today, obviously the holidays are almost
upon us, I'd like to take a few moments to
talk about how we can stay healthy during this wonderful season.
The first thing to consider with holiday gatherings is who
is coming to visit. Do we need to be thoughtful
about protecting people who are perhaps more vulnerable due to

(22:07):
age or medical conditions. This in turn goes back to
thinking about whether you've been vaccinated against respiratory illnesses. It
also prompts us to think about into our air, which
can facilitate the transmission of some airborne diseases. Fresh air
can make such a difference in preventing respiratory illnesses, so

(22:29):
depending on the weather, consider cracking the window here or there.
Another consideration is food safety. Every year people get sick
because they aren't following the basics, which we call the
four seas of food safety. Those are clean, cross contamination, cook,

(22:50):
and chill. Clean involves washing your hands and surfaces. Often
it's simple, but very important. Second, avoid cross contamination by
making sure you use separate cutting boards for produce and
raw meat, poultry, or seafood, as well as separate utensils

(23:11):
and plates for cooked and raw foods. The third sea
is also simple. Cook food to the right temperature. Use
a food thermometer to ensure that food has been heated
enough to kill harmful bacteria. Turkey, for example, should be
cooked to an internal temperature of one hundred and sixty
five degrees And the fourth sea, chill, deals with both

(23:34):
safely thawing food and also making sure it doesn't sit
out too long. Thaw frozen food safely in the refrigerator,
completely submerged in cold water, or in the microwave. Never
thaw food on the counter, as bacteria multiply very quickly
on food that reaches room temperature. That's also why you

(23:57):
should never leave parishap of food out for more than
two hours. Enjoying leftovers, of course, can be a great
way to extend the holiday meal. Just remember to put
those leftovers in the fridge within two hours and to
use them up within four days. I'd also like to
put in a plug to try to build in some

(24:19):
physical activity during the holidays. For example, there are many
turkey trots on Thanksgiving, and in my experience, you don't
even have to trot. Many times I've participated in these
by walking with my family. Similarly, if it's a nice day,
taking a walk together before or after eating is a

(24:41):
nice way to get some exercise. Just be sure your
healthcare provider has given you the green light for the
exercise you plan before you start. It's my sincere hope
that we all enjoy a happy, healthy holiday season with
family and friends.

Speaker 2 (24:59):
Thank you, Doc Actor Bruce Vanderhoff, Director of the Ohio
Department of Health, advancing the health and wellbeing.

Speaker 1 (25:05):
Of all Ohioans.

Speaker 2 (25:06):
You can check out the Ohio website ODH dot Ohio
dot gov. It's an action packed and fun field site
full of information resources, legal information, local health district information.
Also in Kentucky. The info is on the Team Kentucky website.
Just search for Kentucky school based health centers. In Indiana,

(25:28):
they do have them, but they're in Indianapolis. We don't
see any here in southeast Indiana. I would love to
hear your comments on this show or any show. Any
questions or suggestions. Our email is Iheartsincy with an I
at iHeartMedia dot com. Have you got an idea for
a guest who can shed some light on an important issue,
a nonprofit.

Speaker 1 (25:48):
With a challenging mission. Just jut it down and let
me know.

Speaker 2 (25:52):
You can find the iHeart Cincy archive on the iHeartRadio app.
Just look under the podcast section and you can search
for my name, Sandy Collins. That'll take your right to
this show. iHeart Cincy.

Speaker 1 (26:03):
The app is.

Speaker 2 (26:03):
Free and you can listen to your favorite radio stations, podcasts,
personalities all right here in southwest Ohio and northern Kentucky
and explore stations across the country. I'm Sandy Collins. Thanks
for listening. We'll see you here next week.

Speaker 1 (26:17):
iHeart Cincy is a production of iHeartMedia Cincinnati,