Getting children and especially adolescents in for medical care isn't simple, for them or their parents, and hasn't gotten easier during the COVID-19 pandemic. A new clinic at Valley Center High School, organized by KU Wichita Pediatrics and the school district, is designed to take medical care right to students needing it.

The reasons for not receiving care are many. Sometimes a family cannot afford it; sometimes they haven't found a doctor. Often it's a challenge of transportation and time, with parents having to miss work and kids having to miss class. Valley Center doesn't have many medical offices, so children often travel to nearby Wichita. Time spent traveling, waiting for doctors and visiting pharmacies adds up.

"By the time parents get off work, come to school, get their child and go through the process, they've missed half a day. Now, it can be as little as 20 minutes," said Cory Gibson, district superintendent.

There's more than just time at stake. Not seeing the doctor or nurse practitioner can be a matter of illness and death. Vaccinations and other preventive care are delayed or put off. Recommended screenings for blood pressure, eating disorders, anxiety, suicidal thoughts and other issues don't occur, meaning providers miss vital opportunities to assess and care for young people.

The clinic aims to ensure those opportunities aren't missed. Although in the high school, it's open to students in all six of the district's schools, ranging from age 3 to 18 and beyond. With over 3,000 students from Valley Center, Kechi, Park City and Wichita, there's plenty of potential patients. District staff can use it, too, starting April 1.

Kari Harris, M.D., associate professor at KU School of Medicine-Wichita, is medical director of the clinic, while Kerry Nantsis, APRN, staffs the clinic on Tuesday and Thursday mornings. Both are true stakeholders, as they live in the district and have or will have children in the schools.

Studies have found, Harris said, that school clinics can reduce absenteeism and inappropriate emergency room visits and increase the likelihood students receive care. The need exists for both medical and mental health care, especially with "depression and anxiety increasing exponentially" during the pandemic, she said.

"Big picture, schools have become more and more a wraparound service, not just instructing kids," said Gibson, noting how food service was once considered an extra. "Now, we're much more focused on understanding that kids need to be well taken care of in order to learn. We connected with a mental health clinic a couple years ago, so we have social workers in direct contact with mental health support services. The clinic is just one more avenue where we're trying to take care of our kids."

Harris said she's been interested in a school-based clinic for years, as was Gibson, whom she serves with on the Kansas Maternal & Child Health Council. He'd become familiar with such clinics while working in southeast Kansas and said the concept was "novel to us but not novel across the nation."

Nantsis willingly came aboard, having previously set up and staffed a juvenile detention center's clinic run by KU Wichita Pediatrics. "She took the reins and got everything started, and she's here on the ground doing the work," Harris said of Nantsis, who works at KU Wichita Pediatrics' Carriage Parkway clinic as well.

Other key participants are KU School of Medicine-Wichita Medical Practice Association, which provides administrative services and handles billing, and two foundations that provided grants. New clinics typically take 12 to 18 months to achieve financial sustainability, Harris said, so the $15,000 from the Kansas Children's Foundation and $2,250 from Menocause: Ignite Valley Center are critical to carrying the clinic through its first year. The district is also using federal stimulus funds. The clinic accepts multiple insurance plans, but currently no one is turned away because of inability to pay.

The KU team also includes Brent Duran, D.O., a KUSM-Wichita associate professor of internal medicine and pediatrics who acts as Nantsis' collaborating physician for adult staff care; Stephanie Kuhlmann, D.O., associate professor; and Aaron Ryan, executive director of the Medical Practice Association, which handles the business side of practice for faculty physicians.

The clinic's development is a natural interplay with the work of the Kansas Covid Workgroup for Kids, a group both Kuhlmann and Harris are involved in that has advised school districts during the pandemic. The clinic also dovetails with the medical school's KSKidsMAP initiative, which seeks to give primary care doctors the tools to more effectively provide mental health care for children they see.

The clinic opened in early February and is across from the nurse's office at Valley Center High School. Parents can make appointments for their children by contacting the school nurse. Parents, especially of younger children, are encouraged to come for appointments. The clinic also has the ability to let parents participate in the visit virtually if they cannot come in person.

"If a student comes to school and they're not feeling well, they will go to the nurse, who determines whether they need to go home or if they should follow up with their doctor or other provider. Then the nurse can offer the option of following up with me," Nantsis said.

Medical equipment and furniture for the clinic came from the Medical Practice Association and school district. It has an examination table and vital sign equipment and can perform lab tests. Using mobile providers, X-rays, sonograms and electrocardiograms can be done there. For starters, the clinic is providing acute care for colds, allergies, sports physicals, headaches and other aches and pains. The hope is to expand to other primary and preventive care, including vaccinations.

Steadily, the number of patients has grown. "Word is getting out, and parents are starting to realize how convenient it is," Nantsis said. Organizers are meeting with athletics officials to tout the clinic's capabilities and convenience.

"If it's successful, we hope to be able to expand in Valley Center beyond an urgent care clinic. That's something we think we can pull off," said Ryan, noting that it's a "replicable model" and that other districts have expressed interest in opening clinics.

"It's a great example of collaboration, vision and partnership between the Medical Practice Association and our Department of Pediatrics and our neighboring communities," Ryan said. "It's a way to positively impact our area and find ways to take care of patients."