Caught in Bureaucracy – a School Loses both Building and Health Center

Last year, Richwood Middle and High School were damaged beyond repair in historic flooding and the schools moved into temporary spaces for the 2016-’17 school year.

But when the schools moved, the kids didn’t just lose their buildings, they also lost their school-based health center. Now  a bureaucratic quagmire may prevent the middle school families from having a center next year.

Richwood Middle has been sharing a building with Cherry River Elementary, a couple miles across town. It worked, mostly, but was crowded. But when the middle school moved in with Cherry River, there wasn’t enough room for their health center to follow.

“Richwood Middle and Richwood High School actually shared a school-based clinic,” middle school principal Gene Collins said. “We were actually one of the first school-based clinics in the state of West Virginia back in the early to mid-90s. For many of my staff, for many of my students, that was their primary care provider.”

School-based health centers are a big deal in places like Richwood because parents don’t always have transportation, time or money to drive their children out of town for care. So if the kids don’t get care at school, they may not get it at all.

According to New River Health, the federally funded health center that ran the clinic, 99 percent of Richwood’s middle and high school students were enrolled in the clinic.

“We have always anticipated that when we get into our temporary modulars that we would have a school-based clinic moving in,” Collins said.

The modular, semi-temporary classrooms that will become Richwood Middle are being built with federal emergency management assistance money at the back of the Cherry River Elementary property.  

“And in fact, FEMA has paid for a separate modular for them,” Collins said. “There is a separate clinic building, which was going to be very nice. But now with the federal regulations HRSA will not approve the clinic because they’re saying our address is now Cherry River Elementary, which the scope has been assigned to another provider already.”

The Health Resources and Services Administration, or HRSA, is the federal oversight agency that manages the federally funded health centers.

According to HRSA, New River Health applied for a temporary permit to serve the middle school families. When that permit expired, New River submitted a request to make it permanent, but the paperwork they submitted to HRSA was incomplete.

Then there’s another issue. Cherry River Elementary hadn’t had a school-based health center before the flood, but Camden on Gauley, another FQHC, had been planning on opening one there. When Richwood Middle School moved into Cherry River after the flood, though, the middle school took the space the health center would have used. So, for 2016, neither the elementary nor the middle school had services on site.

But Camden is planning on starting one in the elementary school for next year and has permission from HRSA for those kids. Now that the middle school is right next door, who has the jurisdiction to care for those kids?

“And that’s a complicated process, but basically we have to prove a need in the community for those students in order for HRSA to approve us to go into that location,” John Schultz, Chief Executive Officer of New River Health, said.

“And because there’s another FQHC up in that area, HRSA has to look at what services are they providing and are they maxed out basically or can they continue provide services to additional students.” 

Alicia Hamrick is the mother of a seventh-grader at Richwood Middle School. She said for her, the center is much more convenient than driving her daughter 40 minutes to the doctor. For others, it’s a lifeline.

“Lot of the families around here they don’t have vehicles, they don’t have transportation to do that and it needs to come back,” she said.

But unless the health center is able to cut through the red tape, many of those middle school families may not have the care they need.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation, Charleston Area Medical Center and WVU Medicine.