Telehealth at Deer River High School is 1st step toward health center

DEER RIVER — For some Deer River students, seeing the doctor means a full day out of school.

“Most of it is transportation and getting up to Cass Lake for an appointment, if they have one,” explained district employee Susan Nelson. “And that can be an all-day affair. You’re 60 miles up and 60 miles down.”

The Deer River Public Schools district overlaps with the Leech Lake Band of Ojibwe Reservation, including the communities of Ball Club and Inger, and Nelson said almost of half of Deer River students are Native American. Many are covered by the Indian Health Service, meaning getting care can present a significant travel burden.

There’s an Essentia Health clinic and hospital just a mile from Deer River High School, which can make appointments easy for some families. But even then, parents and guardians still have to take time away from work to get their kids to appointments — another barrier to health care.

A new program is trying to address those challenges with just an iPad and a quiet room.

Deer River launched its telehealth program with help from Essentia in October. Nelson is the project manager.

The process itself is pretty straightforward. On the iPad, Nelson has set up video conferencing apps like Microsoft Teams and Zoom and health care programs like MyChart.

If a student has an appointment, they log in on the iPad, which they can connect to a TV if they’d like. Then Nelson steps out of the room — which is also her office — until they’re done.

“I actually sit out in the hall, and I wait, just in case there’s some error or something happens, and it cuts down, then I’m accessible to them,” Nelson said. “So that is probably one of the steps, of trying to fix that: where I’m landing.”

Initially, appointments were only available with Essentia. But in the first week of December, Nelson finalized a partnership with North Homes Children and Family Services. She’s also working on setting up the system for other providers, including Indian Health Service.

Contributed

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Dana Scherf

"We’ve had all those conversations, and they’re [IHS] looking forward to that next step,” she said.

In the first month and a half, there’s been 15 visits between about five students, mostly for speech and behavioral therapy.

“It’s still 60 hours worth of time that wasn’t taken from our staff or parents,” Nelson said.

Dana Scherf, operations service manager for Essentia’s Deer River and Grand Rapids clinics, said the project is in its growing phase as students, staff and parents learn about it.

Essentia’s goals with the initiative, she said, are to reduce absenteeism, improve access to health care and minimize disruptions for parents and guardians who might otherwise have to take time away from work.

“We just really want to make sure we provide the same-day access for our community, for those students,” Scherf said. “ ... It’s a rural community, and you really have to be innovative for rural communities.”

'Health and education belong together’

Deer River has been coordinating student appointments as a full-service community school for years.

The district was one of the inaugural grantees for Minnesota's full-service community school program in 2015. A combination of state and private grants have funded the work since, allowing the district to schedule appointments, help with transportation and connect students to other resources for housing, food, clothes, insurance — anything that may be a barrier to academic success.

Those efforts are an example of how education models have been shifting for over a decade: What support do students need to succeed, in the classroom and beyond, and how can we offer that support?

Megan Buffington

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KAXE

“Health and education belong together,” Nelson said. “If we don’t have healthy kids, we don’t have good education.”

Nelson is especially passionate about ensuring disadvantaged communities have equal access to these kinds of programs and resources.

Building beyond telehealth

The telehealth program is just the first phase of the project Nelson is managing: A school-based health center.

The center will bring health care access — whether vision, dental, behavioral, physicals or immunizations — to one spot at the school.

"When a kiddo gets sick or injured here at the school, with a school-based health center, we’ll be able to see them while they’re here, and then do an assessment to see what else they need or coordinate a follow-up for them to have an appointment at the clinic, or even if it’s a telehealth,” Nelson said. “We want to be the heart of all the kids for coordinating all the stuff they need.”

Before the COVID-19 pandemic, there were plans for a community wellness center to be added to Deer River High School.

“Of course, with COVID, we know what happened. Most of those big thoughts ended up being little thoughts and/or go[ing] away,” Nelson said.

The health center is a scaled-back version of that idea, funded by a three-year grant from the Minnesota Department of Health. It is set to soft launch at the beginning of the next school year.

The first step is infrastructure changes like a separate, secure entrance to be able to bring in physicians.

While a school-based health center is student-focused, it will be a resource for the entire community when it officially opens by the end of next year.

“By December of ‘26 ... doors are open to everybody,” Nelson said. “Staff, students, community. To this resource center slash health center.”

She pointed to White Bear Lake’s school-based health center as the “big picture” of what Deer River’s could be. That’s where her passion for equal opportunities comes back in.

“There’s money out there, but you have to be a certain type to get it. You have to be doing a certain thing to get it,” she said. “And it really shouldn’t be that hard, when I can give you the data, and it shows, yes, they need it.”

Nelson is a self-described big dreamer. She gets emotional thinking about all the work that is already being done behind the scenes to make Deer River a stronger community, without much, if any, recognition.

“This is a community that has been surviving,” she said. “And I think having this initiative is a chance for us to thrive.”