by: Rick Swart, Pam Avilla, a pediatric nurse practitioner, gives Tanner Schwirse, 11, a physical during a routine checkup at Sacagawea Health Center. The St. Helens youngster has been getting his free checkups at the school-based health center for the past two years.

Kids learn better when they're not sick.

Working from that basic premise, school health nurse Robin Loper embarked eight years ago upon a journey that has since changed the face of health care in St. Helens.

It's called school-based health care.

With the backing of Northwest Health Foundation and Legacy Health System, St. Helens in 2000 became one of the first school districts in the state to open a health care clinic for small children on one of its campuses.

Sacagawea Health Center is named after the Shoshone Indian woman who accompanied explorers Meriwether Lewis and William Clark on their legendary journey to the Pacific Ocean in 1806. Located at Lewis and Clark Intermediate School, the center and its nurse practitioner, Pam Avilla, a Yale graduate, currently provides medical treatment for nearly 400 students a year.

The St. Helens health center, and others like it, increasingly is being recognized as a highly effective way of delivering medical services to some of the neediest members of society - kids with little or no access to health care. The 47th such facility opened last week in Tigard, with a pledge from Gov. Ted Kulongoski to develop more school-based clinics in the future. In fact, three such facilities are already on the drawing boards at St. Helens High School, Rainier and Vernonia, thanks to funding for planning efforts approved last year by the Oregon Legislature.

'School-based health centers have been proven to be very effective ways of getting health care to kids who otherwise wouldn't have access,' said Betse Thielman, director of Sacagawea Health Center.

School-based health clinics are extremely cost-effective, according to Thielman, because of their focus on early intervention and preventative medicine.

Sacagawea's annual operating budget is $146,000, plus in-kind donations of a 1,000 square-foot building from the school district as well as medical oversight and pro bono medical treatment for more serious cases provided by Legacy Health System in Portland.

Partnerships are key to the success and continued operation of Sacagawea, according to Thielman.

A big chunk of the facility's operating budget comes from the upcoming 'Touch the Heart of a Child' art auction and benefit, which will take place May 17 at the Olde School in St. Helens' historic 'old town' district. It will feature works of art donated by local artisans as well as pieces contributed from private collections.

In past years the event has generated as much as $17,000 for the health center, or 10 percent of its annual budget. Just as important, according to Thielman, the event 'is our way of maintaining our connections to people who make a difference.' The center also receives $45,000 from the Oregon Department of Human Services, $34,000 from the Northwest Health Foundation, $18,000 from the Kellogg Foundation and $36,000 from private donations and fundraising events.

Loper said the results of having a clinic on campus have been dramatic.

'We have kids who have had serious asthma problems who have missed less school because we have a nurse practitioner here who can help manage asthma plans,' she said, adding, 'We have had kids with infectious disease or injuries who have been treated before their condition reaches crisis mode.'

Parents can preregister their kids so they can go to the center unaccompanied, which is a huge benefit even for parents with health insurance but who have trouble leaving their job or finding transportation to a doctor in Portland. Loper said the number of families who took advantage of preregistration jumped 40 percent in the past year alone. While officially the center is open to students in grades kindergarten through eighth, it also admits high schools who have an infectious disease and provides physicals to student athletes.

'The place is busy all the time,' she said, noting the center is open three days a week - Monday, Tuesday and Thursday - and the schedule is always booked solid.

Heather Schwirse, a St. Helens mother whose son, Tanner, has been using Sacagawea for the past two years, said the health center has been a godsend. Although her family has insurance, prior to using the center she had to take off from her job in Portland several hours early go drive back to St. Helens, pick Tanner up, and take him back to his nurse practitioner's office in Beaverton.

'It was awful,' she said. 'We love coming here; it's so much more convenient.' It has the added benefit of communication between Avilla and Tanner's teachers, which offers a more holistic approach to his attention deficit disorder.

St. Helens has been identified as one of the most medically underserved communities in the state, which gives the health center a crucial role to play.

'It is truly a community effort that keeps this clinic going,' said Thielman.

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