It was when Maria Hauersperger heard her health coach use “the D word” that she began to make some serious changes in her diet and exercise routine. Diabetes, she said in an interview, does not run in her family, but the nurse practitioner found high glucose levels and seemed concerned.
“That was the impetus for me to get back on track,” said the 6th-grade teacher with the Seymour Community Schools (SCS) in Indiana. Now she occasionally fasts, maintains a low-carb diet, and walks every evening with a group of colleagues during the school year.
Hauersperger had access to the coaching because the 4,700-student district, south of Indianapolis, offers an onsite Activate Healthcare clinic for employees and offers three different health plans — benefits that are not only convenient for the teachers, but also save the district money on healthcare costs.
Being self-insured has saved the district $1.3 million in medical claims, prescription drugs and health care premiums, according to Steve Nauman, chief financial officer for SCS.
“Now, the majority of them look at it as a primary care facility and not an urgent care facility,” Nauman said in an interview. “That was the biggest hurdle that I felt that we had to accomplish.”
Whether they participate in one of the insurance plans or not, all employees have access to health screenings. ”It just helps people to be more aware of where they are physically,” Nauman said. Those biometric screenings showed that 21% of the district’s employees had hypertension, 9% were asthmatic and 6% were diabetic.
'One promising action'
While school-based health clinics typically target students and their families, researchers are finding that improving educators’ access to health and mental services has benefits for both teachers and students.
A RAND Corp. study released last month confirms what SCS has experienced. Led by Harry H. Liu, a health policy researcher, the study focuses on the much larger Metro Nashville Public Schools (MNPS), which opened five school-based clinics in 2009. The clinics were placed throughout the district so that teachers would not have to travel more than 15 minutes to reach one.
Compared to teachers who used a community-based provider, those who used the district clinics had fewer inpatient admissions and fewer primary care visits. Using the onsite clinics also resulted in lower costs for inpatient care, outpatient care and prescriptions. The researchers also found lower teacher absenteeism rates for those using the clinics, but the difference was not statistically significant.
“Our findings suggest opening onsite health clinics may be one promising action that school organizations can take to help lower their health care costs,” Liu said in a press release.
A May article from researchers at Child Trends also notes that in addressing stress and mental health issues among students, it’s important for schools to give the same attention to their teachers.
“Teacher wellness has been linked not only to teachers’ physical health, but also to stability in schools and to teaching effectiveness and student achievement,” they write. “Promoting teacher wellness requires attention to physical and mental health, professional development and support, and resources needed to be effective in the classroom, among other things.”
Developing ‘a relationship’
Getting younger teachers in SCS to use the clinic has been less of a challenge than attracting those who already had a primary care provider, Nauman said.
Hauersperger, for example, had been attending the same family practice since she was a child. The doctor there delivered two of her children. But the office was a half hour away so an appointment would require time off work. “I put great thought into making the change,” she said.
It was the pain from a torn meniscus that caused her to eventually visit the district clinic, and the service she received — a same-day appointment for X-rays — that won her over.
“They were with me every step of the way,” she said. “I feel like there’s a relationship there.”
Now, at the Activate clinic, she can pick up a prescription on her lunch hour and not have to miss any work. “I can’t tell you the last time I had to take off for a clinic appointment,” she said.
The clinic is located in the district, but not within a school, which Nauman said he actually prefers. Placing it within a specific school, he said, might mean that staff members from other schools would be less likely to use it.
“It’s more like one of our buildings,” he said. The healthcare program has also become a tool for recruiting teachers to the district.
Nauman added that he focuses on making sure employees choose the plan that is best for their needs, which lowers claim costs, and the clinic stocks generic drugs whenever possible.
Impact on students
The RAND study found no significant difference in reported health status between MNPS teachers who use the onsite clinics and those who don’t. They also didn’t see any impact of reduced teacher absenteeism on student performance.
But Greg Prange, principal of Seymour High School, sees a direct line between convenient clinic hours that keep teachers from missing school and students being more successful. The district has seen increases in average SAT and ACT scores and the rate of graduates receiving honors diplomas has increased from 31% to 34%.
"When a teacher misses school due to illness or doctor appointments, the learning process in their classroom is negatively affected," he said in an email. "The likelihood of this negative impact manifesting itself in standardized test scores is understandable."
Hauersperger says she feels she has more mental clarity in the classroom, and now her husband is also taking advantage of the health coaching services. “It’s impacted my family,” she said. “Being healthy, feeling energized, I wake up wanting to go to work.”