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RN case manager to help chronically sick kids

Registered Nurse Case Manager Barb Yost started working at the Coos Bay School District under a new innovative grant of $30,000. She is to bridge the communication gap between the school, parents and pediatricians so kids don't have to miss so much school.

COOS BAY — The Coos Bay School District is making academic history.

CBSD begins innovative new program

Natalie Youst, third grader at Blossom Gulch Elementary visited the school nurse, Emily Parkhurst on Monday. RN Case Manager Barb Youst made phone calls in the background.

For the first time, the district has brought in a registered nurse case manager to keep track of chronically sick students. Not only will this nurse follow up with kids who miss more than 10 days of school, but will bridge the communication gap between parents, medical providers and the child’s school.

“Case management is not new, they do that in the clinics, but case management directly tied to the school is brand new,” said Lisa DeSalvio, special program director for the district. “This is an innovative practices grant funding a one-year pilot program. The hope is for it to grow in all schools and all districts. It’s not meant to start and stop here.”

DeSalvio called herself the “catalyst” behind the pilot program, which is being done in partnership with Bay Clinic. The $30,000 grant funding the project was awarded to the district in January from Advanced Health, covering kindergarten through 3rd grade.

Of course, DeSalvio envisions the program one day encompassing the entire district.

Though the program didn’t kick off until last month, it has already made an impact.

“On that first day we had the chance to save a kiddo who had lost been lost on follow-up and fallen through the cracks,” said Barb Yost, the district’s new RN case manager hired by Bay Clinic. “This kiddo had labs to be followed up on but instead fallen off from school and the pediatrician who had no address, no number to contact the family.”

It was only when the family tried to re-enroll and couldn’t until they provided a health statement that they popped back on everyone’s radar. On Yost’s first day she visited the family to go over health issues that may or may not get in the way of their child’s academic success.

“Now there is communication between this position and the pediatrician about abnormal labs,” Yost said. “That was just the first day. This is basically boots on the ground to bridge the communication gap. That’s what I’m doing.”

Since starting, she has also encountered a pediatrician who didn’t even realize one of their patients hadn’t been to school in four months.

CBSD pilots new program

Emily Parkhurst, school nurse, examines Natalie Youst, third grader at Blossom Gulch.

When Yost began her first day, it was the district’s attendance advocate Brea Landrum who already identified students who needed her attention.

“The attendance advocate reaches out to families because there are a lot of unexcused absences, but I call parents because their kiddos have a lot of excused absences which means the parent is doing their job,” Yost said. “But the average kid doesn’t miss more than 10 days and I call even if they missed 11.”

Since stepping into this new role as RN case manager, Yost has found that sometimes these students are missing schools for things as simple as chronic ear infections that were resolved with ear tubes and she can cross them off her list.

“But the tag line of this project is not only to improve optimal health to keep kids in school, but to make sure they aren’t lost on that follow-up,” he said. “I’m dealing with what keeps kids out of school not just this year but next year too.”

According to DeSalvio, Yost does not have the duties of a school nurse but can go into schools to do wellness checks and keep staff educated on proper care as needed.

“We can actually help parents with barriers because we have the tribal attendance advocate, nurses, and school psychologists all here,” DeSalvio said. “As we define things, we can help families get other resources. This medical piece is the missing piece and now we have it.”

DeSalvio has been pursuing this idea over the past several years after identifying it as a need during her day-to-day work. She explained that her perspective in the district is unique because she oversees so many programs and is involved with Community Connections, which takes children with complicated health needs and brings their families to the table to form a plan. Parents leave that meeting with a point of contact. After seeing that, DeSalvio wanted to incorporate something similar in the school district.

“Because if they are homeless, (Yost) can call our homeless liaison and so on,” she said. “It is about getting everyone to speak the same language.”

As for Yost, she encountered one parent who wanted to know where she was four years ago.

“She wasn’t angry, but this could have been helpful sooner,” Yost said. “Everything is coming together now.”

Reporter Jillian Ward can be reached at 541-269-1222, ext. 235, or by email at Follow her on Twitter: @JE_Wardwriter.