Community Health Center presents school-based clinic model; board signals interest

The Community Health Center of the New River Valley outlined a model for a school-based health center it operates in Pulaski and Giles counties and told the Montgomery County Public Schools Board it could provide medical, dental and behavioral health services inside a county school if the district provided appropriate space and consent processes.

The presentation was made by Michelle Bronze, chief executive officer of the Community Health Center of the New River Valley, and Rebecca King Mallory, the center's chief medical officer. Bronze said the center converted from a free clinic to a Federally Qualified Health Center model and now bills Medicaid, Medicare and private insurers while maintaining a sliding fee scale for patients at or below 200% of the federal poverty level.

Bronze described services already in Pulaski County High School: primary care, dental operatories, behavioral health and telehealth. 'We turn no one away due to inability to pay,' she said, noting the center accepts all insurance and offers sliding-fee discounts. King Mallory explained parental consent and enrollment procedures used to see students at school without a parent present.

Why it matters: board members asked how a clinic could reduce barriers to care and absenteeism by allowing students to receive well-child visits, immunizations and sick visits during the school day. Bronze said the model reduces transportation barriers, keeps parents at work and can eliminate trips out of school for appointments.

Key details presented - The center currently provides both medical and dental care in Pulaski County High School and mobile dental care across schools using a converted van. - Pulaski/Giles use: 237 individual medical patients and 281 dental patients served (figures given for the center's Pulaski/Giles work). - Facility expansion: Bronze said the center is undertaking a capital campaign and moving to a new facility purchased in 2020'21; planned expansion would increase dental operatories from six to 16 and exam rooms from eight to about 18 (details presented by Bronze). - Billing and cost: the center bills insurers and uses a sliding-fee schedule; patients who cannot pay are not turned away. King Mallory said patient charges are billed but the clinic works with families on plans. - Consent and logistics: the center obtains written consent in advance or via online forms, coordinates with school nurses, and uses school buses in Pulaski to transport students to the high-school clinic when needed.

Board reaction and next steps Board chair Mister Hudson and several board members asked logistical and budget questions. Miss Bond, Dr. Rountree and Miss Fussell asked about transportation models and space. Miss Fussell recommended the division also consider qualifying a site as a community school under Virginia Code 22.1-199.7 to access additional state support; she cited Roanoke's Fallon Park as an example. Dr. Bragan and board members discussed renovation costs; Bronze said the Giles space cost roughly $30,000 to convert but that each arrangement depends on available school facilities.

The board asked staff to pursue further information. When Chair Hudson asked for a show of hands on whether the board wanted to pursue next steps and more information, multiple members gave a thumbs-up; administrators and presenters planned follow-up meetings to flesh out site options, renovation costs and timelines.

Implementation notes and caveats Bronze said the center's model and scope are flexible and determined in partnership with each school system; in Pulaski the school system provided a renovated space and the center supplied staff and equipment. Bronze said Pulaski funded renovation costs and the center covers operation costs and staffing. The presenters emphasized that services and which populations are served (students only or broader community) are set by the local district.

No formal board action was taken; board members asked administration to return with specific proposals and cost estimates if a school-based clinic move forward.

Speakers quoted or cited Michelle Bronze, chief executive officer, Community Health Center of the New River Valley (nonprofit): 'We turn no one away due to inability to pay.' Dr. Rebecca King Mallory, chief medical officer, Community Health Center of the New River Valley (nonprofit) Mister Hudson, Board Chair (government) Dr. Bragan, Superintendent, Montgomery County Public Schools (government) Miss Bond, Board Member (government) Dr. Rountree, Board Member (government) Miss Fussell, Board Member (government)

Authorities referenced - policy: Federally Qualified Health Center model (referenced by presenter) - code: Virginia Code 22.1-199.7 (referenced by Miss Fussell as a pathway for community-school designation)

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Discussion vs. decision - Discussion: Presentation of the Center's services, billing model and logistics; board questions about space, transportation, and costs. - Direction: Board asked administration to pursue follow-up (site identification, renovation cost estimates, partnership options) and return with specifics; multiple board members gave informal approval to continue exploring the model. - Formal action: None taken at this meeting.

Clarifying details [{"category":"patients_served","detail":"Pulaski and Giles clinics data","value":"237 medical patients, 281 dental patients","approximate":true,"source_speaker":"Dr. Rebecca King Mallory"},{"category":"capital_expansion","detail":"planned dental/medical expansion; operatories and exam rooms","value":"6 to 16 dental operatories; 8 to ~18 exam rooms","approximate":true,"source_speaker":"Michelle Bronze"},{"category":"sliding_fee","detail":"sliding fee eligibility","value":"200% of federal poverty level","source_speaker":"Michelle Bronze"},{"category":"facility_renovation","detail":"example cost in Giles County","value":30000,"units":"USD","approximate":true,"source_speaker":"Michelle Bronze"}]

proper_names:[{"name":"Community Health Center of the New River Valley","type":"organization"},{"name":"Pulaski County High School","type":"school"},{"name":"Montgomery County Public Schools","type":"agency"},{"name":"Virginia Department of Education","type":"agency"},{"name":"Federally Qualified Health Center","type":"other"}],

searchable_tags:["school-based-health","community-health","dental","behavioral-health","MCPS","PulaskiCounty","FQHC"],

provenance:{"transcript_segments":[{"block_id":"4565.8647","local_start":0,"local_end":240,"evidence_excerpt":"We are here today to just share some information and hopefully education around the work that we do at the Community Health Center of the New River Valley. So I am Michelle Bronze. I'm the CEO of that organization. I've been with it for 20 years..." ,"reason_code":"topicintro"},{"block_id":"5334.985","local_start":0,"local_end":140,"evidence_excerpt":"Near to date, in Pulaski and Giles County Public Schools, we've served 237 individual patients from medical services and 281 patients for dental services.","reason_code":"topicfinish"}]},

salience:{"overall":0.75,"overall_justification":"Direct service model with potential to affect access, attendance, and health outcomes for students; board signaled interest.","impact_scope":"local","impact_scope_justification":"Will affect Montgomery County students and staff if adopted","attention_level":"medium","attention_level_justification":"Board discussion and follow-up requested; operational implications and budget/space decisions required","novelty":0.4,"novelty_justification":"School-based clinics exist elsewhere locally but would be a new arrangement for MCPS","timeliness_urgency":0.6,"timeliness_urgency_justification":"Board asked to pursue feasibility before next school year","legal_significance":0.2,"legal_significance_justification":"Requires local facility agreements and parental consent processes; no legal change reported","budgetary_significance":0.45,"budgetary_significance_justification":"Renovation and ongoing operating costs depend on local arrangements; center covers many operating costs","public_safety_risk":0.05,"public_safety_risk_justification":"Standard clinical risk management applies","affected_population_estimate":1500,"affected_population_estimate_justification":"Estimate based on county enrollment and pilot scope; exact numbers not specified","affected_population_confidence":0.2,"affected_population_confidence_justification":"Not specified in transcript; rough estimate","budget_total_usd":30000,"budget_total_usd_justification":"Example renovation cost given for Giles County (~$30,000); full budget not provided","policy_stage":"proposal","policy_stage_justification":"Presentation and board direction to pursue; no formal agreement yet","follow_up_priority":8,"follow_up_priority_justification":"Board asked administration to return with site and cost details for consideration next steps","fact_check_risk":0.2,"fact_check_risk_justification":"Most details came from presenters who run the clinics; external verification (contracts/costs) advisable","uncertainty":0.4,"uncertainty_justification":"Multiple variables (site, renovation costs, transportation) remain unresolved","source_diversity":0.2,"source_diversity_justification":"Primary sources were two presenters from the clinic and board members"},

engagement_forecast:{"newsworthiness":{"national":0.05,"regional":0.15,"local":0.85,"justification":"High local relevance to families, moderate regional interest if expanded; limited national interest"},"notify_recommendation":{"audience":"city","reason":"High local impact for students and families and a possible near-term decision point; useful to notify local health and school stakeholders","audience_regions":[],"justification":"Board directed staff to pursue feasibility; community members should be informed of next steps"},"notify_thresholds":{"local_min":0.5,"regional_min":0.7,"national_min":0.9},"predicted_interest":{"national":0.05,"regional":0.2,"local":0.9,"justification":"Parents, school staff and local media likely to be interested"},"predicted_click_through":0.45,"predicted_click_through_justification":"Local parents and staff will click for practical details"},

graph_signals:{"jurisdictions":["US-VA-MON"],"jurisdictions_justification":"Montgomery County, VA","ontology_topics":["school_health","access_to_care","school_partnerships"],"ontology_topics_justification":"Directly about health services in schools","entities":[{"id":"chcnrv","name":"Community Health Center of the New River Valley","type":"organization"}],"entities_justification":"Primary presenter"}}