The Point
Charleston County, South Carolina
The Point, on Johns and Wadmalaw Islands in Charleston County South Carolina, is a relatively new comprehensive adolescent health clinic serving a population ages 15 to 24. Staffed by a multidisciplinary team that includes an advanced practice registered nurse, a health educator from the South Carolina health department, and a licensed professional counselor, The Point provides teens sexual health, mental health, and primary care services. However, the clinic was originally established to focus solely on preventing teen pregnancy, a problem identified by a dropout prevention program (CIS) as a cause of Charleston County’s very high dropout rate of 66%. CIS’s initial response had been to focus on health education and provide high-risk students weekly individual and group education sessions regarding healthy sexual choices, but it soon recognized that education was only one piece of prevention. CIS then partnered with the state health department in an effort to increase access to reproductive clinical services by establishing the clinic, and, over time, it saw the need for mental health and physical health services as well. Last year 360 adolescents were seen at the clinic, both students and dropouts, with over 60% returning for follow up visits.
The Point, which currently operates only three days a week, makes every effort to address teens’ concerns. Before the clinic officially opened its doors, focus groups were held with groups of students from the local high schools. Several of the problems the adolescents raised were related to the need for confidential, teen-friendly services. Students also chose the clinics’ name, identified video materials for the waiting room, and helped with the clinic’s design. In response to patient feedback, providers began making themselves available via text message and welcome drop-ins without appointments. They also are coordinating referrals for health problems they are unable to address at the clinic, making sure that patients have access to free or low cost providers.
The Point is supported largely through Medicaid reimbursements with virtually all patients Medicaid-eligible. Additionally, the state’s family planning waiver allows females as young as ten, who may not have their Medicaid card or who may not even know if they are Medicaid enrolled, to receive coverage for family planning services. The Point also has funding from the federal Office of Population Affairs, a local foundation, and the National Association of City and County Health Officials, which helps to facilitate the partnership between the state health department and CIS and is used to host a variety of outreach activities such as a back-to-school celebration and both a Mother-Daughter and Father/Son dinner and lecture. In the future, the clinic will be adding a healthy weight and exercise program, expanding the types of vaccinations offered, and implementing both a mentoring program and a peer education and outreach program. It will also be working with local high school sports coaches to bring team members in for quick visits that will include a STD screening test and anticipatory guidance on family planning and sexually transmitted diseases.
