Sheridan Health Services (SHS) in Denver
Launched as a nurse managed school based clinic back in 1995, Sheridan Health Services has grown and expanded to serve 2300 unique patients in 10,000 encounters per year and serves all ages from two sites in Sheridan, a lower income suburb of Denver, Colorado. It wasn’t an easy journey and the road ahead is still fraught with challenges but Children’s Hospital Colorado that initially opened the school health center with a grant from the Bureau of Primary Care, and the University of Colorado College of Nursing, that acquired the school clinic from Children’s in 2005 with HRSA Division of Nursing grant funding and now owns and operates the entire Sheridan system, were always committed to improving the health outcomes for the population.
There are two clinics, just blocks apart (one for children and youth, housed in a school district building, and a larger adult site leased from the federal government at the closed Fort Logan campus), that comprise a Federally Qualified Health Center after a successful public entity application in 2012. Initially, Associate Dean Amy Barton, PhD, RN funded growth of this vital work through a Nurse Managed Clinic grant from the Affordable Care Act. As that money was scheduled to end after three years, she began successful navigation of the FQHC application by the university. Today, in addition to adult and pediatric primary care services, SHS offers prenatal care and delivery using certified nurse midwives, low cost pharmacy services through a collaboration with the College of Pharmacy, integrated behavioral health at both sites, substance abuse services, care coordination, and dental services. There are plans to add optometry shortly.
Colorado is a Medicaid expansion state which means that health insurance is available to virtually every citizen in the state through employer plans, health exchange plans or Medicaid–both traditional and expanded plans. In theory, clinics like Sheridan should see their uninsured burden decrease and thus make it easier for the clinic to be financially stable. One challenge in Colorado, however, is the lack of insurance access among the undocumented population. Sheridan continues to care for many who are not eligible for insurance programs which places a financial burden on the clinic where patients pay cash for services using a sliding scale based on income. Legally, clinics like Sheridan must care for the uninsured regardless of documentation status. Most would argue that morally and ethically, services should also be available.
Sheridan is meeting the health needs of anyone who seeks care and patients are grateful. “My mother had just died.” Sandra told me, “and I needed to place my young son in day care so that I could go to work. When I applied at the pre-school program they told me he had to have a physical and to go to the school health clinic to get one. They took care of him and they took care of me, too. The nurse practitioner saw right away that I was depressed and having a lot of trouble just getting through the day. She connected me with counseling services. We needed help and we found it here.”