SPS Future Ready: Student Health and Wellness

What does it take to keep students healthy, supported, and ready to learn? In this episode of the Future Ready podcast, Superintendent Dr. Adam Swinyard and Stephanie Slater sit down with Becky Doughty, Executive Director of School Support Services, to explore the growing network of health and wellness resources inside Spokane Public Schools.

From the school-based health clinics operating at four high schools in partnership with CHAS, to the brand new clinic opening at Logan Elementary through a partnership with WSU's College of Medicine and Nursing, Spokane Public Schools is redefining what access to care looks like for students and families. Becky also shares how the district has worked to staff nearly every school with a nurse and a mental health therapist, and why that level of care is far from the norm across the region.

We also hear from Addisyn Samuelson, licensed athletic trainer at Shadle Park High School, who is part of the district's partnership with Shriners Children's Hospital. Addisyn shares what it means to be a full-time presence for student athletes, from rehabbing injuries and reducing costs for families, to sitting with kids through the emotional toll of a season-ending injury. Her goal is as straightforward as it is meaningful: keep kids playing the sport they love, safely.

Together, these stories paint a picture of a school district committed to supporting the whole child, because when students are healthy, they are ready to learn.

Transcript

Hosts: Stephanie Slater and Superintendent Dr. Adam Swinyard and Becky Doughty, Executive Director of School Support Services

Stephanie: Welcome to Spokane School's Future Ready podcast. Today's episode focuses on something foundational to student success: health and wellness. We're excited to dive into this important conversation, highlight the work happening across Spokane schools, and discuss how supporting the whole child helps us build a stronger, more future ready system for every student. Today we welcome Becky Doughty, Executive Director of School Support Services. All things student health is what we're talking about today, and we obviously are very committed to the well-rounded approach.

Dr. Swinyard: Something that I think our school district should be really proud of. We've been a leader in this area. Becky's been instrumental in that over the last decade, leading up to the pandemic, through it, and as we've emerged, really building in resources and supports where we're thinking holistically about kids' needs. We know that kids need to have their basic needs met and their health care met in a way that allows them to focus on school. So lots to be proud of.

Stephanie: Absolutely. We all enter this conversation from similar but different perspectives. I've been a PE teacher for 20-plus years, committed to active classrooms and kids developing habits. Becky, how did you get involved in student wellness and health?

Becky: I came to the district a little over ten years ago. I had previously been working with homeless men and women in downtown Spokane, and had the opportunity to come here and work with kids and work on keeping them healthy so that they can be at school.

Stephanie: Something exciting that has been evolving over the last few years is our student health clinics. Tell us about where they are, who they serve, and how students can access them.

Becky: That was a dream that was born before I even got to the district. As soon as I started working here, we were having meetings about the possibility of opening a school-based health center. They'd been very successful in other places in the country, and there was interest in replicating that here in Spokane. We managed to partner with CHAS, and we opened our first school-based health center at Rogers in 2019. Right off the bat, it was very heavily utilized, and so we knew that was going to be a great thing to have at all of our high schools. Right now we have one at four of our five comprehensive high schools, Rogers, North Central, Ferris, and Shadle. Hopefully at some point we'll be able to have one at LC too.

Really, the beauty of it is that it answers our most basic issue. Kids across all ages face barriers around access to care, not just because of timing (your kid is in school all day long, so it's hard to schedule doctor's appointments), but also because not all families have resources to access our health care system. This really addresses that need. Kids can be seen for any health need they might have during the school day. In the high schools, the clinics are embedded in the school, so kids are able to just walk in and be seen.

Dr. Swinyard: What are some of the most common reasons for visits?

Becky: Your run-of-the-mill illnesses and ailments, sick to their stomach, a headache. But honestly, especially with our adolescents, they're able to seek mental health care and physical wellness. Because they can make their own medical decisions at that age. Really just your run-of-the-mill stuff you'd see for high school kids. Kids who might otherwise want to stay home from school can now go be seen at the clinic and then go back to class.

Dr. Swinyard: How does it work with insurance? Does that get cumbersome?

Becky: CHAS has it so dialed in. Each one of these clinics is just like one of the CHAS clinics out in the community, so they are able to work with all of the insurance companies.

Dr. Swinyard: So really, any kid, regardless of whether they have their own coverage through their family or maybe state coverage, can get access?

Becky: They do not deny any of the kids care.

Dr. Swinyard: We're really fortunate to have had a long-term school board member, Mike Wiser, who was heavily invested in the health care sector. He was really the catalyst for starting that conversation of what it could look like. Spokane has a great health care sector, and it's a really natural fit for the school district to be building those types of partnerships. And a new one is starting this week, Logan.

Becky: Yesterday, we opened yesterday.

Stephanie: Logan Elementary! That's so great. Long time coming and so needed in that neighborhood. Tell us about that partnership.

Dr. Swinyard: A little different than the high schools.

Becky: Yes. This one is a partnership with WSU's College of Medicine and College of Nursing. I envisioned it being more of a teaching clinic. As a clinical instructor at the College of Nursing myself, I know it was very difficult to find clinical placements for students. You want your medical and nursing students to have good experience, and it's really great if you can work in a community that is struggling with access to resources. It's a really great learning opportunity for those students.

Previously, the Logan neighborhood had some presence from Providence Family Medicine Residency, where doctor students were able to come in and provide some care to families. We really just built on that. I already had a connection with WSU, and they've done us a great service by partnering with us. They're able to provide care to those kids and families in that community while also providing a learning opportunity for their students.

Stephanie: That's awesome. I know we were dreaming big about student health clinics during the middle school planning, pre-COVID. I remember visiting a school from Oregon that had a great model of the health care center right next to the school. It made a lot of sense for access and convenience for families. And the sports physicals available at our high school clinics have been huge, that's been a real barrier for families. The Logan neighborhood absolutely needs more resources, and this puts it right there at the school.

Dr. Swinyard: Outside of the health clinics, we have a lot to be proud of in terms of the level of care provided across all of our schools, the number of nurses we have, and that almost every school has a mental health therapist embedded. Can you talk about how that model works cohesively inside our neighborhood schools?

Becky: I want to give credit to Dr. Swinyard and to the board for the focus on increasing our school nurse staffing, because we feel so blessed to have as many nurses as we do. That is not typical across the region.

Dr. Swinyard: Almost every school has a nurse?

Becky: We're about 5 or 6 nurses short of having a full-time nurse in every building. We are better staffed than we ever have been. And even then, just like with mental health therapists, you're still not meeting the need. There's always so much need.

What it has allowed us to do is, when students are seen in the high school health room, we don't have to refer them out and never know what the follow-through is. Now we're able to just send that student down the hallway to the clinic, and some of those needs that maybe weren't being addressed are being addressed right there in real time. Our partnership with those clinics is fantastic at the elementary and middle school level too. For example, we just had a local clinic that provides most of our care for a particular chronic health issue close unexpectedly. We were able to refer all of those kids who were left without a provider to our CHAS clinics right away.

Dr. Swinyard: Nurses aren't funded by the state. There's only a very small allocation. Those nurses are funded out of our local levy, so those are decisions our local community has made in how to resource our schools. Can you talk about the mental health therapist model? That's really unique across the state.

Becky: It's a program that was really built by Dr. Crump, Dave Crump. All of the positions are grant funded. He has worked with MCOs and grant funding mechanisms to fund those positions, and it's extremely unique in that he's been able to assemble such broad financial coverage that we do have a mental health therapist available at most of our schools. Again, the need always outstrips our resources, but he really did build a very unique program based on grant funding and partnership with entities.

Dr. Swinyard: That's a really good point. There's so much need. Is there enough money and enough people to hire a therapist for every kid? No. And I think it highlights the importance of our Engage in Real Life initiatives and those other types of strategies. For kids to be physically and mentally healthy, they need to be active outside of the school day. They need to be off screens. They need to be moving. They need to be building relationships with positive adult role models. That really goes into our holistic approach to trying to have as healthy a school community as possible.

Stephanie: We've had quite a few kids on this podcast in previous episodes, and they all talk about the benefits of activity on their mental health. I remember some Ferris athletes, multi-sport, really involved kids, who said, "I do these activities so that I feel better. I am busy, I do have to plan and organize, but I do this to feel better because if I didn't, I would be home on screens." And another student voice piece we've heard lately is that students want to be outside and active, not just inside all the time. Kids recognize the value of having these services at their school, plus the programming and wraparound support. We've got to use those partnerships to everyone's benefit so that we can all be a part of this together.

Becky: Health care wise, if you can engage with patients early and start working with them at a very young age, it does impact the health outcomes that you see. Being able to do that within our schools is a great place to start.

Stephanie: One of those partnerships is with Shriners Children's Hospital, who partner with us on our athletic trainers. We have five, one at each high school, and we're bringing on two more to support our middle school football program this fall. 

Athletic Trainer feature by Jim Hazelton

NATS: Good evening sports fans! Welcome to Shadle Park High School.

Jim Hazelton: At a high school basketball game, all eyes are on the action. But on the sideline, there's someone more interested in the athletes themselves rather than the scoreboard.

Addisyn Samuelson: Yeah, last year was really fun.

Jim Hazelton: Addisyn Samuelson is a licensed athletic trainer at Shadle Park High School, acting as a consistent health care professional for student athletes.

Addisyn Samuelson: I try at the beginning of each season to talk to all my coaches.

Jim Hazelton: Even though she isn't employed by Spokane Public Schools.

Addisyn Samuelson: Shriners employs all of the athletic trainers for Spokane Public Schools, and so we're employed through them. It's called like the medical model. So we have that hospital backing and then they contract with Spokane Public Schools and basically put us here. I'm here 40 hours a week. I'm here full time.

Jim Hazelton: That access means an open training room every afternoon, and someone in the student's corner through every phase of their recovery. Samuelson says that continuity is what sets her role apart.

Addisyn Samuelson: But here I see them most times every single day. And then I get to see them come back and I get to see them do their sport. I think it's so special to get to see their, their journey and their evolution as, you know, human beings and as students and then as athletes on the field. It's really awesome.

Just kids to know what's going on with their bodies and what's going on with their injuries. And how things like sleep and nutrition and hydration and appropriate equipment all come into play, too. And just being a resource that's knowledgeable in that, I think is really important for kids.

Jim Hazelton: And not just focusing on injuries, but how those injuries might affect the kid's mental well-being.

Addisyn Samuelson: You know, you have kids concussions, season ending injuries, even just fractures and broken bones and things like that. Like that takes a big toll on on athletes. Being able to, you know, sit with them and be like, no, this is normal.

Jim Hazelton: For athletes across the district, having that resource on campus means more than just convenience.

Addisyn Samuelson: Some kids just might not have access to go to physical therapy once a week, for their injury. So me being here and rehabbing an injury, saves costs for families, keeps kids here at the school, keeps them in their community, keeps them competing in their sport.

Jim Hazelton: It took five years of graduate school to get here, but for Samuelson, the job is simple.

Addisyn Samuelson: Be there for every athlete, every day. My biggest goal is to keep kids playing their sport that they love safely.

Music and Back to Main Group 

Stephanie: Tell us a little bit about the Shriners partnership.

Becky: We had a need, and I was already connected with Dr. Ryan Baker, so it seemed like a really good place to start that conversation. Dr. Baker was already at Shadle and was really a resource for school nurses on sports medicine questions. We already had a relationship with him, and figuring out that Shriners as an institution was interested in modeling something like this. They've just made a really great partner.

Stephanie: They're absolutely committed to injury prevention, student care, wellness, and injury response. We meet with them monthly and they are all in to support our kids. Having that partnership across all five high schools, and now folding into our middle school football program, has been really key to our success.