Exploring the Health
Care Needs of Students
in Rural West Virginia

By Julianne Yacovone, Coordinator of Child Health, West Virginians for Affordable Health Care

I’m not a native of West Virginia. I have an outsider’s perspective on the struggles the state faces—such as poverty and poor health. I’ve come to find West Virginians to be considerably generous and receiving people. Regardless of the challenges they may be facing, they will go out of their way to help you. The state has faced no shortage of hardships: battling a statewide drug crisis, food shortages, and a lack of mental health care resources have taken a significant toll on its population. In areas where we lead other states, it tends to be in the worst ways. We are first in obesity, type 2 diabetes, Cancer, and drug-induced deaths according to Trust for America’s Health data. West Virginia is also the top state for child removals, according to the West Virginia Department of Health and Human Resources WVDHHR, with a shocking 85% of those removals being drug related. Nearly 6800 of West Virginia’s kids were placed in foster care in the month of August, 2019 alone.

I wasn’t an employee with West Virginians for Affordable Health Care (WVAHC) when they launched the Children’s Health Collaborative Project— a project to better connect health care and schools, so all children have better access to quality, comprehensive health care—but if you are familiar with any of the issues our state is currently facing, there are many reasons why this relevant, and so needed.

Work began in 2018, when a survey was disseminated to all of the West Virginia’s 55 counties. Nearly 800 responses were received by school personnel, health care professionals and community stakeholders. While 20 survey tools were tailored specifically to each professional demographic, two questions were asked on all: 1). Are their children in your community in need of health care but not receiving it? and 2). Do you believe that schools are an appropriate place to receive that healthcare? The answers to both were definitive and detailed in our survey results.

When I started as the Coordinator of Child Health for WVAHC in April of this year, I traveled to many rural communities to hold community meetings and see what access their respective schools had to health care, as well as what policies were already in place to assure that children were receiving the health care that they needed. Those invited to these meetings included school staff, health care providers, parents, and community leaders. At every community meeting, we asked this same set of questions based on the survey findings. And I learned so much about community dynamics at each event.

One of the most consistent reports was that there is a general lack of pediatric mental health services, not only in the schools, but across the state. Mental health services that focus

specifically on the needs of adolescents are few and far between. Another challenge is the lack of transportation and how it prevents community members from accessing the services that are available. Having school-based health services addresses this need.

Also, I learned that there is a genuine disconnect of services, meaning there are certain services available, but the communication between those providing the services and needing services is lacking. It was encouraging to see our community meetings serve as a means to facilitate connections between these different systems and sectors. The majority of participants also felt it would be helpful if teachers across the board received trauma training. I heard this many times: “our teachers are trained to teach kids that don’t exist;” “colleges and universities haven’t adapted their curricula to the needs of our state’s children;”and/or“our students need social and emotional supports.”

In the greater context, and what I found most surprising, was that our schools have adopted very few policies linking health care to their schools. We found that while individuals, schools, and school-based health center staff often have systems in place to address children’s needs, there are very few policies in place. The work is being done, but nothing is down on paper.

Having statewide policies, created with the input of those who are in these systems, would help. For example, take a child that has been removed and placed into foster care. If they then attend a new school the next day, the school staff does not have access to any medical information on the child or what type of care they may need. Having policies in place to collect health insurance information on a new student could help everyone in that situation and could only benefit the child. Many of our schools continue to collect health insurance enrollment status only at the beginning of the year, in case of emergencies.

Following each community meeting, we ask participants if they are interested in being part of a team focused on creating and improving school health policies that could be implemented on the state level. These teams consists of the most passionate individuals I’ve met in these communities, including: teachers, principals, members of community organizations, and health care providers. The Children’s Health Collaborative hopes that the creation and implementation of some of the policies these teams craft will help meet the needs of our schools’ students, especially in areas such as mental health.

It’s an unfortunate reality that we have generations of children, and schools full of students, who have been exposed to a variety of hardships due to the drug epidemic. It is important that those caring for them on a daily basis are equipped and properly trained to help them learn.

Having access to the appropriate health care services while at school can prevent absences and provide a healthier learning environment for all involved. It would also help with transportation issue that many in the rural community’s face.