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Gaithersburg, Watkins Mill and Wheaton high schools are moving forward in earnest to plan in-school "wellness centers" for students without health insurance or who face other barriers to medical treatment.

Recently released budget recommendations from Montgomery County Public Schools Superintendent Jerry D. Weast say that the schools are ready to take on the project.

The Gaithersburg and Wheaton centers would be built during the school renovations tentatively scheduled for 2013 and 2016, respectively. Fiscal 2009 funds were approved for a feasibility study at Watkins Mill but a construction timeline will not be set until money is designated in a future budget.

Centers are planned to open at New Hampshire Estates Elementary School next August, Rolling Terrace Elementary School in August 2011 and Highland Elementary School in August 2012.

At the five existing centers in the county — three in Silver Spring and two in Gaithersburg—the school system partners with county's Department of Health and Human Services to create a hybrid of health care and social services support. At the high school level – Northwood's is run out of office space at the school – they are called "wellness centers" and at the elementary level "school-based health centers."

The centers are funded out of Health and Human Services and built as additions to the school, costing an average of $1.3 million to construct. In the health care half, they offer a range of services including prescriptions, on-going treatment and immunizations. That aspect of the center is staffed by health technicians and the school nurse. A nurse practitioner is on hand four days a week; a pediatrician is there once a week.

On the social service side, Linkages to Learning provides youth and leadership development, counseling and referrals through two case managers/social workers and a therapist.

All told, the county's five centers treat 3,200 students per year, said Judy Covich, HHS's director of school health services and chairwoman of the interagency group that determines which schools need a center. Criteria include the number of students who lack insurance, how many receive free or reduced meals, and areas with the highest incidence of communicable disease such as asthma, tuberculosis or lead poisoning.

Pointing to a 96-percent rate of visits that are for preventative care, Covich said that the program's real success comes in keeping students from having to leave school.

"The whole concept of school-based health care has a very broad range of support," she said. "... It has demonstrated certainly in this county the ability to provide access to health-care in a culturally sensitive, familiar environment."

At the center in Summit Hall Elementary School in Gaithersburg, which opened in August, the nurse practitioner or pediatrician is seeing six to eight students a day, mostly treating sore throats, ear pain, headaches and skin conditions. But they have done a few immunizations and a round of FluMist.

Summit Hall was a Title 1 school when Keith Jones became principal six years ago. In the six years since, the number of students receiving free and reduced meals has climbed from 60 or so percent to 77.7 percent, he said. Summit Hall draws from an abundance of rental and high-density housing and the school is 61 percent Hispanic, which is reflected in use of the center, though not exclusively.

So far, 300 of the 453-student school are registered with the center. The goal is to register every student while encouraging those with insurance or their own doctors to keep doing so, Jones said. And he knows that the center is not a cure-all.

"This is at least one level lower where you can at least identify an issue, and if it can't be done here, then we know exactly what to tell people," he said. "Having the expertise here and the physical site here is really a blessing."

Even more encouraging is the possibility of expanding the center's reach, Jones said. School administrators are considering a plan to allow students at Rosemont Elementary School to access the Summit Hall center and students at Washington Grove Elementary School to use the center that opened at Gaithersburg Elementary School in 2005.

As families in the Gaithersburg school cluster have become more familiar with the broad range of services, the centers have been able to keep more students from missing school, which translates into better academic performance, said Steve Augustino, cluster coordinator.

"This is an opportunity to keep the kids in an environment where they can learn," he said. "We want everyone to do their best. If they're sick and they're not in school, they can't. It just kind of snowballs and they lose interest and that's not healthy for anybody."