Rural areas are not the only places for which health care access is a challenge.
In urban areas like Wilmington, North Carolina, access is also an issue, especially for teens and young adults in underserved populations who face barriers like transportation, location, and insurance coverage. Jill Boesel, the Development and Outcomes Director at WHAT, or Wilmington Health Access for Teens, has been a part of closing the gap and bringing health care closer to where teens and young adults are.
WHAT is a community-based nonprofit health care organization that focuses on improving health care access and integrated care for adolescents and young adults between the ages of 11 and 24 in the Wilmington area.
WHAT opened its first school-based health center in 1999 and currently runs centers in three of the four local public high schools in Wilmington. The centers are located on the high school campus, open to students as walk-ins or by appointment. The centers are staffed with multidisciplinary teams that include a primary provider, mental health counselor, and registered dietician at each site.
School-based health centers have several advantages from their location. In addition to overcoming the barriers mentioned above (transportation, geography and insurance coverage), WHAT minimize lost class time for students, as students are able to simply walk down the hall to their appointment. WHAT also minimizes lost work time for parents. Parental participation in appointments is strongly encouraged, but rather than a parent having to pick their child up, take them to the doctor and back to school, parents can simply come to the school for the appointment and then return to work.
In addition to offering health care services to students in the form of one-on-one appointments, WHAT also provides the entire school with ongoing education about the health care needs of students, and WHAT providers work closely with school counselors, social workers, faculty and administration to improve the overall health of students.
Along with the school-based clinics, WHAT also runs a centrally located facility that offers adolescents and young adults, ages 11-24, access to primary care, mental health, nutrition and prevention services. Three-quarters of the population served by WHAT clinics are either publicly insured or uninsured, which provides a fair share of challenges for the clinics, especially in the rapidly shifting health care environment in the country and in this state.
Jill Boesel came to the Wilmington area and to WHAT in 2007, and her primary role focuses on seeking and securing public and private grants and managing current grants. She is also a member of the organization’s leadership team, and believes that the key to her work is communicating very effectively the advantages of having a school-based health center situated conveniently on campus for students and parents.
“The most cherished aspect of my job is having the ongoing opportunity to develop relationships with so many incredibly talented, energetic and committed people—both within and outside of Wilmington—who are working relentlessly to pave the way for a better tomorrow here in North Carolina, despite the often seemingly insurmountable challenges we face in health care today,” Boesel says.
She points out that WHAT is focused on “whole person care”, where the traditionally separated areas of primary care, mental health care, nutrition, and other areas occur within a connected network. This enables the provider in each area to be aware of what is going on in other areas and proactive in connecting the dots when appropriate to give the patient the best overall care possible. By having different types of providers serving patients in a team-based approach in the same location, integrated care works naturally and improves the patient experience and outcome.
Boesel is a current Bernstein Fellow, and her project is very fitting with the true integrity of the Bernstein Fellowship program and the mission of Jim Bernstein: ensuring access to health care for the populations that are most vulnerable in our state. She is exploring how WHAT as an organization can improve the use of data for population health and patient engagement, within the context of an integrated school-based healthcare setting.
Boesel says: “My fellowship has afforded me the unique opportunity to connect with others doing similar work throughout other regions of the state, including my “fellow Fellows” and many others.”