Summit School District counseling preserved through gifts to Care Clinic
September 18, 2016
The financial challenges continue for the Summit Community Care Clinic in Frisco, and concerns recently mounted that those issues may bleed over to the school district's health centers, particularly its behavioral-health services.
The region's safety-net clinic, routinely used by un- and underinsured patients, started alerting community partners this summer of upwards of a $400,000 budget shortfall. In July, the district's Board of Education hosted two Care Clinic employees for a presentation warning of potential cuts that could be made to the center's myriad services, including school counseling hours, if solutions weren't found, and quickly.
Therapy hours at the four school-based clinics were maintained at previous levels to start the academic year while options were explored, but the beginning of October loomed and both organizations were facing the difficult decision of reductions by almost half. Fortunately through their combined efforts, the Care Clinic has now received additional contributions in the last couple months totaling $200,000 for this year from the county and local municipalities, as well as private donors. The district's school board will also vote this Thursday on whether to provide a one-time $20,000 pledge from reserve funds, in addition to a new confirmed revenue stream through Medicaid that will help offset some of those behavioral-health costs to avert this potential crisis, at least for now.
"We had a short-term shortfall," said Jordan Schultz, the Care Clinic's development director, "but I think we have collectively, as a community and as the management team, worked to mitigate that. But there's a longer-term conversation and issue ahead of the Care Clinic, which is how do we handle this increasing need combined with the lack of health insurance and the rising cost of living? I think that's a combination of things we have not figured out yet, that has not been resolved."
According to the district, some 350 students — about 10 percent of the total population of Summit's schools — visited the school-based health centers last year for behavioral-health needs. They totaled approximately 2,000 therapy sessions ranging from a 20-minute check in to hour-long appointments, and preserving that level of availability was crucial to ensuring the health and well being of the community's children.
"We have lost two students to suicide, and we never want that to happen again," said Julie McCluskie, district spokeswoman. "It is very important to everyone in the school district that we do all we can to support kids with behavioral-/mental-health services because we want to keep our kids safe. The school-based health center partnership is a key part of those services, and we are so pleased that community is stepping up to support the Care Clinic during this time so that we can maintain those services."
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The Care Clinic has been providing these services at the four schools — the high school, middle school (which includes Snowy Peaks High School) and both Dillon Valley and Silverthorne elementaries, with appointments also available at Upper Blue, Summit Cove, Frisco and Breckenridge elementaries — for the past five years. It receives an annual $75,000 grant from The Summit Foundation for this specific purpose, but the majority of those hours were otherwise covered out of the clinic's general $7.4 million budget. With a payer mix of more than 60-percent uninsured, and growing, and behavioral-health visits increasing by 42 percent in only the last year, including the largest growth within the school system, the Care Clinic had reached a breaking point.
"We were trying to be out in front of the issue with the school district," said Schultz, "and wanted them to know that, 'Hey, this potentially may occur.' We've always been need-driven and if there's a need, we want to meet it. We're committed and … with that new Medicaid reimbursement potential, that really shores up our ability to continue providing those services at the schools."
The Care Clinic, a Federally Qualified Health Center (FQHC) offering integrated general medical, behavioral-health and dental care, had applied for that Medicaid compensation dating back to February 2014, but it was only as of this past week that negotiations netted an agreement for those payments moving forward. The clinic is also working on back pay for at least the past three months and perhaps even further back that could net at least $100,000.
"I never believe it until I have a check in my hand," said Care Clinic interim CEO Helen Royal. "But it's been many, many years to try and get this to happen, so this is a huge success for us."
Those requests for private community donations are still being firmed up. Most of the governmental commitments, for Care Clinic needs to manage its general budgetary woes, are for two years, however. That breaks down to $100,000 from Breckenridge, $20,000 from Silverthorne exclusively for the school-based health centers, $10,000 from Dillon and $20,000 from Frisco, though that is still being finalized. The county's $50,000 gift this year is for just the one year, but conversations are ongoing for how it can further support the clinic into the future.
The clinic is also having internal discussions to re-evaluate processes to control costs where possible, as well as proceeding with prior plans to increase its dental unit from three labs to seven, set for completion in mid January. The expansion will be located on the third floor of the Medical Office Building after an in-kind donation from the county, and provides a greater opportunity to continue using dental care as a revenue generator. It also allows those current three offices on the MOB's first floor to be used for general care.
It's with all of these other developments that Care Clinic personnel are confident it can carry on operating just as it had previously with behavioral-health hours at the schools. And that's welcome news just as the notable predicament of major cutbacks were a real possibility.
"School-based health centers work," said McCluskie. "For many of those students, who are either uninsured or underinsured, this is a tremendous service and treatment option for them. The behavioral- and mental-health services that we are providing for kids is filling a need we can't fill elsewhere, and it's very important we be able to continue that and support those social, emotional needs. We too will continue to look at the future and the system as it currently works and how we might refine it, make it more efficient and more effective for kids and families."
The Care Clinic plans to continue closely examining ways to become more sustainable. As organizational leadership recognizes, though, especially with the ever-evolving health-care system as well as persistent increases in the cost of living in the mountain region, the next obstacle is invariably only around the corner.
"The monster in the shadows is always there with having to cut services," said Royal. "There's the potential for that. We would do everything creative, just like we did this time, to make sure that doesn't happen, but that is our reality. In the future if we need to come together and brainstorm ways to keep it going, we will do the same thing."