Danville’s in-school health clinic a victory for localism

Published 6:51 pm Tuesday, June 25, 2019


Contributing columnist

“If you want to consume a great community, you go to Paris. If you want to create one, you go to one of these places.”

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These are the words of James and Deborah Fallows, distinguished journalists with 15 books between them. “These places” are the more than two dozen smaller urban centers spread across America that they visited in their single engine plane between 2012 and 2017. Danville was not included in their 100,000 mile journey, but its recent development of a school-based health clinic would deserve their attention if they surveyed again.

The Fallowses didn’t just drop into the towns and small cities once. They made visits totaling two weeks in each community they chose. They went where exciting things were happening, where small urban centers were not only surviving but thriving, where “a tangible hunger for community” produced real efforts to solve pressing problems.

They had to revise their view of American culture because they found citizens of a polarized country overcoming their differences in local civic involvement for the common good. They found a country bent on becoming a better version of itself, and they called it “localism.” After first coverage in an article in The Atlantic, they produced Our Towns, their recent book on their journey.

The new generation of leadership they found in their towns typically featured people who had made a conscious decision to return to their home town or the place where they went to school or to seek out a community where they could raise a family in a supportive environment and make a difference through civic involvement. Ditto for Danville!

Danville’s new school-based health plan should definitely qualify for localism laurels. What sparked it?  When Dr. Tammy McDonald, Danville’s superintendent of schools, took up her duties last July, she brought more than impressive credentials. She returned to the state where she had grown up in poverty with a passion for “wrap around services.”

Those services include everything surrounding instruction of students other than the instruction itself.  Sick kids and hungry kids and kids lacking family support are not apt to learn and to be successful. That’s why parenting classes, food backpacks for the weekend, dental screening, and on-site nurses are as crucial for student development as the latest information technology.

She came to a district where 68% of the students qualify for free or reduced lunches, and where 10% to 15% of students could be classified as dysfunctionally or extremely poor. She discovered that a surprising number of people in the community did not recognize the magnitude of this problem as reflected in the number of kids in school needing health care. 

She calls herself an advocate for these students because she understands where they come from. The strategic plan that she is implementing is entitled “Success for All.” And to cite another recurring educational slogan, “All Means All.”

McDonald became convinced that the system needs four nurses — one for each building — instead of two spending half-days in each building. Tasked with finding out what other districts are doing about health care, her director of pupil personnel, Ron Ballard, collected information on the 13 districts where Cumberland Family Medical Centers are providing school-based health care services. 

Extensive conversations with Cumberland led to a presentation by Cumberland to the Danville Board of Education that satisfied the eight indicators adopted by the board and did so at a reasonable cost.  Danville Pediatrics and Primary Care saw what was happening and asked to make a presentation. At first, their proposal only satisfied four of the indicators, and they initially preferred not to provide their services on-site.

After more presentations and discussions and bargaining, Danville Pediatrics satisfied all eight indicators and agreed to provide on-site treatment. The practice won board approval to provide the Scott and Goodwin Children’s Clinic — named for Dr. Larry Scott and Dr. Russ Goodwin, the retired partners in the practice who had created a culture of caring for kids regardless of ability to pay. 

According to Dr. Josh Wiglesworth of Danville Pediatrics, who like the other four doctors in the practice chose a small town for the reason cited earlier, it only took three phone calls to flesh out the full range of services the board desired.

One was to Dr. Jeff Johnson, Danville Pediatric Dentistry. A Centre graduate, he decided to return to Danville to practice. While teaching at the dental school at U.K., he led the largest sealant program in the state and had experience with three mobile units and one fixed dental clinic. He even agreed to place a dental clinic in the central office building next to Danville High School. 

A second call was to Dr. Will Webster, a Danville native and a Centre grad. He too made the decision to return to his hometown and join his father’s Webster Orthodontics. He was willing to enable students to have braces that would have had no opportunity on their families’ incomes. 

The third call went to David McKay, CEO of Ephraim McDowell Health. He was the guarantor of mental health services. A four-fold partnership was complete. Every student would have a health card to use for treatment, examinations, etc. in service providers’ offices outside of school hours. For most students, the school district will be able to get reimbursements from Medicaid or private insurance, but all students will have their needs met regardless of ability to pay.

A key factor in this huge step was the public/private partnership (which was a key ingredient in the reinvigorated towns that the Fallowses visited). Sometimes a public health model and a private practice business model can be so at odds that meeting the health needs of children is difficult. Danville’s localism overcame that potential problem.     

The people that made the school-based clinic happen saw the need for every chlld at every age to have a dental home and a health-care home. In the words of Wiglesworth, “If you do what’s best for your patients, it will be what’s best for your practice.” That could be a questionable business decision, but all of the partners in this venture were willing to risk it. 

If the problem of access to health care for sick school kids regardless of ability to pay had been raised in a discussion of the Affordable Care Act or the proposal of Medicare for All, it could well have been dead in the water in the midst of today’s partisan polarization. Instead, the convergence of visions and efforts by local professionals driven by a desire to help children has produced an accomplishment that could earn us a place on the merit map of “localism.”

Eric Mount is the Nelson D. and Mary McDowell Rodes Professor Emeritus of Religion at Centre College.