Clinic program brings healthcare to schools

A student suffering from a mild asthma attack stops by North Miami High’s medical clinic. After receiving a breathing treatment, he heads back to class in 30 minutes.

At John F. Kennedy Middle, a student stops by the dental trailer and gets a sealant painted onto her teeth to prevent cavities.

The services are the results of the Dr. John T. Macdonald School Health Initiative, a network of school-based health clinics that operate out of nine Miami-Dade public schools, mostly in North Miami and North Miami Beach.

As more and more students depend on school-based health clinics for their primary medical care, the initiative’s offerings have expanded to keep up. While they began as basic medical clinics, they have morphed into centers for eye care, dental health and psychological services.

“The idea is a simple one. The best place to get healthcare to kids is where they are most of the time, which is school,” said Dr. Arthur Fournier, who helped start the school-based clinics more than a decade ago.

At the beginning of the school year, students turn in a parental consent form that allows them to be seen by the clinic staff. That means parents don’t have to leave work for their child to get medical attention unless the child is seriously ill.

Experts and health providers point to a direct correlation between access to healthcare and academic success.

Many of the 12,000 students the clinics see are either foreign born or children of foreign-born parents, mostly Haitian or Hispanic.

“Most of the issues that we have looked at indicate that they did not have primary or preventative care, ” said Fournier, who co-founded UM’s Project Medishare in Haiti with his colleague Dr. Barth Green.

Through the school health initiative, which works with the University of Miami’s Miller School of Medicine and Miami-Dade schools, there is an aggressive push to change that.

Dr. Joycelyn Lawrence, medical director of the health initiative, oversees the clinics at the North Dade schools and at Booker T. Washington High in Overtown.

“The most rewarding part for me is when we see that kid who would not traditionally show up to your traditional office setting that needed attention,” she said.

Last year, the clinics received a $4 million Health Care Innovation Award grant by the Centers for Medicaid and Medicare Services. The grant allowed the program to expand into dental and mental health services and to employ community health workers.


The community health workers, who speak English, Spanish and Creole, help uninsured parents navigate affordable insurance options, and helps them understand medication instructions and follow-up care.

And it doesn’t cost a fortune — the estimated tally to provide services to a student for one school year is less than $250.

“I think the choice between crappy care for kids and no care for kids or expensive care for kids is a false choice. You can give high quality care at low costs,” said Fournier.

Recently retired as the associate dean of community health at UM’s Miller School of Medicine, Fournier, the son of an assembly-line man who died of a heart attack at age 40, said that he chooses to remain involved in the school-based clinics because of a personal connection.

“I’m not what I look like. I grew up poor,” he said. “My career has been dedicated to how to give healthcare to the poor.”

Fournier said he hopes more schools and communities, both nationwide and locally, will see the program as a model.


Nicholas Boothe, 18, a senior at North Miami Beach High School, said that he is grateful for the easy access to medical care. When he needed a physical to join the school’s swim team, he went to the clinic there.

Then there was the time he had difficulty catching his breath in the middle of class. Nicholas had asthma when he was in elementary school, but as he got older it seemed his asthma disappeared.

When he went to the school clinic, the nurse told him he was having a “really bad” asthma attack. He was stabilized in the school’s clinic and then transported to an area hospital.

“There are students coming to the clinic every day,” Nicholas said. “A lot of schools don’t have clinics, we are very blessed to have one.”