Fall 2010
Coming together to improve children's health

synapse: University of Nevada, Reno School of Medicine

Caroline Barangan

Caroline Barangan, M.D., enlists the services of pediatric residents and medical students to help her run the three school-based health centers in Las Vegas. Photo by Edgar Antonio Nunez

Advocacy for children in high-risk areas of Las Vegas.

By Anne McMillin, APR

That was the common goal of the University of Nevada School of Medicine’s pediatrics department, the Clark County School District and the Nevada Youth Alliance when they came together over the past 18 months to form community-based health centers for children in at-risk areas of the city.

This collaboration’s main purpose was to make health care accessible to Las Vegas youth who are affected by gang violence and other unhealthy circumstances that create obstacles to their success.

Nevada Youth Alliance and the City of Las Vegas Neighborhood Services Department worked with the Las Vegas Police Department to compile information to identify challenges and needs for the target area in West Las Vegas. Through input from the community, youth violence prevention and intervention programs and improving health care needs were identified as priorities.

“We had identified disparities within the community that were issues to our kids’ health and access to health care was one of the top five,” said David Osman, president and founder of Nevada Youth Alliance.

Osman and the Nevada Youth Alliance had fostered a good working relationship with the Clark County School District and knew the best way to reach parents and children was through the school system.

He approached Caroline Barangan, M.D., an assistant professor in the pediatrics department whom he had met at University Medical Center while a case manager, and she jumped at the opportunity to join forces.

Through the hard work and coordination between the partners over several months in 2009, free health care is now being offered on a weekly basis to students in need at Matt Kelly Elementary, Kermit R. Booker, Sr. Empowerment Elementary School and West Preparatory School in Las Vegas.

“Working with the school, we initially set up space on campus at Matt Kelly Elementary in a converted storage room and got our equipment and supplies through donations from the Clark County School District,” Barangan said.

Health care is offered one morning a week during the academic year at each school. Parents fill out health questionnaires and consent forms for their children to participate.

Students can be referred to the health centers through the school nurse by parents and teachers because of health concerns, such as acute illnesses.

The medical team will also have students come in based on the health questionnaires if the answers reflect concerns or symptoms that may indicate a chronic illness that has or has not been diagnosed for preventive care.

Eight children are seen on average per school session.

“We don’t do blood draws, lab tests or dispense narcotics or contraceptives, but we do have low-cost medications available off-campus and can check oxygen levels and give nebulizer treatments,” said Barangan, who volunteers her time and runs the health centers with help from pediatric residents and medical students.

The medical team also provides health education and disease prevention instruction on physical, dental and mental health issues, hygiene, asthma, obesity, Attention Deficit Hyperactivity Disorder and smoking cessation.

“We’ve seen all the kids at Matt Kelly with chronic illnesses and are working through the charts at Booker,” Barangan said. Obesity, asthma, and the common cold are some of the most prevalent conditions seen by Barangan and her team.

For her part, Barangan is a natural choice to lead the centers.

Board certified in adolescent medicine, she has a passion for community-based health care based on her early training in New York and Florida. She said it is one of the primary ways to train pediatric health care providers and offers excellent clinical opportunities for residents and medical students alike.

David Gremse, M.D., Barangan’s chair, is proud of her accomplishment to reach out to children who lack access to health care providers.

He is looking to apply for grants to expand his primary care residencies and is hopeful that access to community-based health centers in schools can provide an additional clinical setting for instruction and improve the overall training experience for residents.

The benefits of the community-based health centers at these three schools are tremendous, according to Lynn Row, health services coordinator for the Clark County School District.

“Students can be seen during school hours for sore throats, asthma or toothaches and parents don’t have to leave work to take them to the doctor,” she said. “There is no charge for visits and a minimal charge for medications.”

Funding for additional equipment and supplies for the community-based health centers comes from a variety of private sources and federal agencies including the Nevada Bankers’ Collaborative, Walmart, the Nevada Department of Public Safety and his own grant writing efforts, said Osman, who believes the collaboration between these partners is “key and necessary.”

“Everyone is helping everyone and brings their own special skills sets to the table. We all have a similar vision for the health of our community,” he said.