The Region 5 Public Health Adolescent Services Program

Adolescent Services is a dedicated interdisciplinary, interagency consortium sponsored by the Community Foundation  of Southern New Mexico, Memorial Medical Center (MMC), the Department of Health’s Community Wellness Program in Las Cruces, MMC Family Medicine Residency Program, Ben Archer Health Center, La Clinica de Familia (LCDF)-Dental Services, NMSU Health Science Center, Milagro Community Mental Health, Amanacer Psychological  Services, Sangre De Cristo, Las Cruces Public Schools and Gadsden Independent Schools. Local community health care providers are contracted by Adolescent Services to provide face-to-face on-site mental and healthcare services and direct primary and mental health service via telemedicine at two Las Cruces High Schools and two Gadsden High Schools.

Region 5’s Community Wellness Program has collaborated with Adolescent Services to move forward in the provision of health care to students attending four high schools in Southern New Mexico.  Through the extensive effort of Adolescent Services staff, the school staff and administration and both the health department and the office of school health staff, four high school based health centers were able to successfully pass Medicaid review during this past school year.  The staff from the four high school based health centers joined forces with the health department to share knowledge and skills and to assure the collective success of the Medicaid program.

A review of the impact of the department of health’s contributions to school based health was conducted in June of 2009.  Region 5’s Community Wellness providers and staff joined forces with local private health care providers to address the multifaceted needs of adolescents at four area school based health centers during the 2008/2009 school year. Comprehensive care included health education, reproductive health, primary care of acute and chronic conditions and behavioral health.  During the 2008/2009 school year, DOH staff and providers from theDOH  Community Wellness Program completed 1121 health care visits.  As expected, since the DOH staff included Title X nursing support, reproductive health constituted a large portion of the visits (685). DOH providers also provided 69 Behavioral visits, 362 Medical visits and 5 Health Education visits. DOH providers saw 24.6 % of all the visits at the school based health centers located at Gadsden High School, Chaparral High School, Onate High School and Las Cruces High School. A comparison of the student visits done by DOH providers and non DOH providers, found students were twice as likely to see DOH staff for reproductive health, DOH providers completed 50% of all EPSTAT physicals done at the school based health centers, and treated 25% of the student presenting with asthma symptoms. Despite the comprehensive nature of the services provided by DOH staff, they were less likely to provide some services, treating 0.3% of students seen for weight management, 0.2 % of students seen for musculoskeletal problems and none of the students seen for smoking cessation. Among the goals of the 2009/2010 school based health center clinics will be to continue to provide the confidential services which traditionally DOH providers excel in and to strengthen areas of service not traditionally offered by DOH providers among them musculoskeletal evaluation, smoking cessation and weight management. 

Adolescent Services presently provides primary and behavioral health care services to clients at four school-based health centers in Dona Ana County. 

a.       Provides a minimum of 16 hours of behavioral health care services and 16 hours of primary care services per week (combined) at Onate and Las Cruces High School; this includes services provided via the telemedicine unit.  Both High Schools have a mobile medical cart- “SeeMore”- which are connected to each other and to consultation sites at Chaparral High School SBHC, Gadsden High School SBHC, MMC Family Medicine Residency Program, New Mexico State University, Office of School and Adolescent Health, University of New Mexico’s Pulmonary Project Echo Program and the Department of Health Community Wellness Program.

c.       Provides a minimum of 16 hours of behavioral health care services and 16 hours of primary care services per week at Gadsden High School and Chaparral High School (combined - may include services provided via telemedicine). Both High Schools have mobile medical carts “SeeMore” and “IRIS” which are connected to each other and to consultation sites at Onate High School SBHC, Las Cruces High School SBHC, MMC Family Medicine Residency Program, New Mexico State University, Office of School and Adolescent Health, University of New Mexico’s Pulmonary Project Echo Program and Department of Health Community Wellness.

d.           Provide consultation to youth detained at the Dona Ana County Juvenile Detention Center via the telemedicine unit. The Juvenile Detention Center has a mobile medical cart called ”See-More,” which is presently connected to the Department of Health Community Wellness Program.  The inclusion of the Juvenile Detention Center will allow for smooth transition of students who medical or behavioral needs to the high schools after they have been detained for a period of time.

MMC Family Medicine and Young Adult Clinic: Monday thru Thursday 4pm to 5pm, Family Medicine Residents along with Prescribing Psychologists provide integrated behavioral primary care and mental health services.  Walk-in patients age 12-25 and their babies will be seen regardless of presenting problem.

Las Cruces Public Health Office:  Monday thru Friday 8am to 5pm adolescents can receive reproductive health services on a appointment or walk in basis. Community Wellness also offers comprehensive health services which includes reproductive health, asthma education and treatment and mental health and substance abuse health service to adolescents and young adults ages 12-25 on both a walk in and appointment basis.

ConnecXion : Telemedicine capabilities have increased in Southern New Mexico. The Adolescent Services telemedicine program is an example of an interagency, interdisciplinary telemedicine program that works. The major obstacle with providing cross agencies telemedicine is navigating pass the firewalls. Collaborative teamwork among IT, Public Health and Health Care Staff have successfully addressed these challenges among the multiple agencies.

Energy Pod. The school based health center staff and the school nurses at Gadsden High School are working collaboratively with the physicians at the Southern New Mexico Family Medicine Residency Program and staff at the Department of Health Region 5 in a program that identifies sleep problem in students and develops individualized treatment plans to address sleep, which includes the potential use of the EnergyPod.  The use of the EnergyPod and the evaluation of sleep habits of Gadsden School Students is one attempt to impact this problem. The EnergyPod is basically a jazzed-up recliner with a blast shield that provides a "semi-private acoustical and visual environment." When it is time to wake up after 15 minutes, the chair starts vibrating, the music turns off and lights turn on.  Research is limited on the best treatment to address sleep deficits in adolescents.  The present plan is to evaluate the effectiveness of adolescent napping with the use of the EnergyPod. An interdisciplinary team will refer students for this short intervention on an as needed basis during their free periods.

Talk About It- Together

Students who have attended any of Adolescent Services' school based health centers are now able to reach health educators and providers from the school based health center and Region 5 health department staff during off hours, weekends and school holidays and vacations through a program entitled "TAI (TalkAboutIt-Together)" developed by AnComm. Talk About It®’ is an online and text based reporting and emergency notification service for schools. Easy-to-use and implement, ‘Talk About It®’ is a preventive solution focused on bridging the communication gap between students and school based and health department faculty to foster a safer, more comfortable learning environment. For students, ‘Talk About It®’ serves as an ‘icebreaker’ giving teens a familiar form – the Internet  –  to reach out to staff and communicate their own problems or the troubles of other schoolmates and peers.  For school based health center staff, ‘Talk About It®’ empowers faculty with an ‘early warning system’ so that they may proactively communicate, intervene and resolve student health questions or concerns, improving health access through communication. Although thousands of students in more than 300 elementary, middle and high schools across the United States rely on AnComm’s ‘Talk About It®’ to report problems and incidents, this is the first time Talk About has been used to expand school based health centers off hour services and to assure continuity of care between the school based health centers and the DOH Community Wellness program.

For more information, you may contact the Community Wellness Program at 575-528-5053.