PAWS CAHC and E3 Program

The School Linked PAWS CAHC  

In 2010 Three Rivers Health worked collaboratively with Three Rivers Community Schools, the Community Health Agency of Branch-Hillsdale-St. Joseph County, and Community Mental Health to submit a grant application to the Child and Adolescent Health Center Program, a division of the Michigan Department of Health and Human Services, for the purpose of opening a school linked health center. 

School Linked Health Center models are nationally recognized as one of the best ways to provide effective, efficient, and appropriate health care services to adolescents. These health centers are primary care clinics providing medical and mental/behavioral health screening and treatment for young people near school grounds.  Statistics reveal that middle and high school aged children have the lowest utilization of health care services of any age group, and are the least likely of any age group to seek care at a provider’s office.  School Linked Health Centers help eliminate transportation barriers to appointments, reduce time that students miss school, and increase access to healthcare services.

Three Rivers Health was awarded the grant, and in October 2011 the Prevention and Wellness Services (PAWS) School Linked Community Adolescent Health Center (CAHC) opened its doors.  And since opening its doors, the health center has provided over 17,000 medical visits, administered over 9000 immunizations, and has provided over 5000 Mental/Behavioral Health visits.  

PAWS Community Adolescent Health Center Brochure

The School Based Enhancing, Expanding Emotional Health (E3) Program

The mental health status of today’s youth has become a growing concern with 37% of teens reporting feeling sad and hopeless, and 1 in 5 admitting they have seriously considered attempting suicide.  Teens report being bullied, and more than half report they have experienced at least one traumatic even in their lifetime.  Additionally many students in Michigan lack adequate access to mental health services.  Increasingly, families cannot afford time away from school and work to seek services. Many families live in areas with limited mental health providers and lack health insurance, money, transportation and knowledge of how to navigate the mental health care system. 

As a result, the Child and Adolescent Health Center Program, established the Enhancing, Expanding Emotional Health (E3) Program to provide access to comprehensive mental health services for children and adolescents in a school-based location by a licensed mental health professional. The school setting is an ideal place to provide mental/behavioral health support to students by eliminating transportation barriers and reducing time that students miss school. A major emphasis of this program is to provide students within the target school building access to a range of prevention, early intervention, support, referral, and coordination services that help to improve their social and emotional well-being.

In 2019, Three Rivers Health and the PAWS Community Adolescent Health Center in collaboration with Three Rivers Community School submitted an application for a grant and was awarded funding to start an E3 Program within Three Rivers Middle School. The program is an extension of the PAWS Community Adolescent Health Center with a private office located within the Middle School. 

The School Based Enhancing, Expanding Emotional Health (E3) Program Brochure

PAWS CAHC offers both Primary Health Care Services and Mental/Behavioral Health Care Services:

Primary Health Care Services

The School Linked PAWS CAHC provides comprehensive primary care services. However, if a student has their own primary care provider (PCP), we collaborate and communicate with their PCP to ensure the best possible health care is received.

Services are provided to anyone ages 10-21 regardless of their ability to pay.  All insurance plans are accepted, including Medicaid and Medicaid Health Plans. Insurances are billed directly.  A sliding fee schedule is available for those without insurance.   

The PAWS CAHC offers a full range of medical services that promote student health!  These services include:

• Comprehensive Health Assessments such as:     
  • Well Child Exams
  • Sport Physicals
  • Camp Physicals
• Treatment of acute illness/injury
• Chronic disease management (asthma, diabetes, obesity, etc.)
• Immunizations
• Basic lab services and tests
• Health Education
• Risk Assessment and counseling
• Referral for specialty services
• On-site Medicaid enrollment assistance

Mental/Behavioral Health Care Services

Behavioral and emotional health is important to a person’s overall health.  Both the PAWS CAHC and the E3 Program have a Licensed Master Social Worker (LMSW) providing comprehensive mental health services to students with mild to moderate severity of need.  These services are aimed at providing students with skills and strategies to better manage mental health related concerns. 

The PAWS CAHC’s Social Worker provides services to all students ages 10-21 and is located in the PAWS CAHC office, while the E3 Program’s Social Worker provides services only to Middle School students and is located within Three Rivers Middle School.

Services offered include:

• Individual Therapy for treatment/management of:     
  • Depression
  • Anxiety
  • Anger Management
  • Family / Peer Conflict
  • Loss / Grief
  • Substance Abuse    
• Group Therapy
• Referrals for specialty services

PAWS CAHC

The PAWS CAHC is like any other medical office.  Parents/Guardians call and schedule appointments as needed. 

The parent/guardian may choose to utilize school linked services which allows the student to attend their appointment without their parent/guardian at time of service.  High School students are able to walk over, while transportation is provided, if needed, for Middle and Elementary school students at the request of the parent/guardian.   A PAWS Community Adolescent Health Center and E3 Program consent form must be on file for students to attend an appointment.  If a student does not have consent on file, the student is allowed their first visit with verbal permission from a parent/guardian, but will not be allowed another appointment until a consent form is completed and returned to the PAWS CAHC office.

How do school linked services work?

• High School students:  PAWS CAHC staff calls the attendance office to make them aware of the appointment time and the student is given a dismissal to attend the appointment.   After the appointment, the student is given a return to school slip from PAWS CAHC with the date and time the appointment ended.  The appointment is logged in PowerSchool.  Students are provided with a detailed summary of the visit to provide their parent/guardian.  Parents may request the summary to be mailed. 
• Middle and Elementary School students: The School Linked Nurse Liaison contacts the school and makes them aware of the appointment time and provides transportation to and from the appointment.  The appointment is logged in PowerSchool.   Students are provided with a detailed summary of the visit to provide their parent/guardian.  Parents may request the summary to be mailed.

Please Note:  The Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act (HIPPA) privacy rules related to the use and disclosure of information are followed.

E3 Program

To utilize services through the E3 Program, a parent/guardian can call the PAWS CAHC to schedule an appointment.   Appointments are scheduled, however appointment times may change due to a variety of reasons such as school testing, absences, and or urgent situations.   Students are provided a visit notification/plan of care form to bring home after each visit. 

A parent/guardian who wishes to speak to the E3 Program therapist can call the PAWS CAHC office and staff will notify the therapist of the request.  The therapist will return the call within 24 hours from receiving the message.

• A parent/guardian may withdrawal their consent at any time. A withdrawal of consent form is available on the school website. Parents/Guardians may also request one through the school office or at the PAWS CAHC office.