ST. LOUIS • There's no excuse to miss class for a doctor's appointment when the medical clinic is in the school.

The first full-time school clinic in the area opened this year at Roosevelt High School, operated by the Mercy health care system with help from a $500,000 grant from Boeing.

School-based clinics gained favor in the 1970s as a way to bring health care to inner-city children and teenagers who might not otherwise get it. Now there are more than 2,000 medical clinics in schools across the country, although St. Louis has been slow to adopt the trend.

A steady stream of student athletes has been coming to Roosevelt's clinic for physical exams required to play sports. Students and staff members also can receive immunizations and get treatment for various infections and chronic conditions such as asthma.

Junior Ayana Greene, 16, who needed clearance to play in Wednesday's volleyball game, said she hadn't expected that kind of perk at school. "If I had to go to a doctor, I would have to wait days and days."

By visiting clinics inside their schools, students can be treated earlier for health and behavioral issues and avoid trips to an emergency room. School administrators say healthy children are more successful in the classroom.

The Roosevelt clinic includes a waiting room and six exam rooms for physical, behavioral and dental care. The space was carved out of former classrooms in the south city school with $300,000 from St. Louis Public Schools.

A nurse practitioner is available from 8 a.m. to 4 p.m. weekdays to see patients, including babies and toddlers from the school's nursery for teenage parents.

No money or insurance cards are needed to be seen at the clinic, although a majority of students are on Medicaid government insurance for low-income families. Aigner Channel, the clinic manager, said some of the students don't regularly see a doctor.

"There are still a group of children and adolescents in our country who just don't have access to health care," said John Schlitt, a vice president at the National Assembly on School-Based Health Care.

More than half of school clinics nationwide are in urban areas. The clinics are typically funded by state or local governments. More recently, federal grant money became available through health care reform.

Illinois has more than 60 clinics in schools across the state.

While a few of the earliest school clinics opened in Kansas City, the movement did not catch on in St. Louis.

"The model has had some detractors from folks who don't think adolescents need access to health care in other locations," Schlitt said. "I've never understood the reason Missouri has not embraced the model. Quite honestly, I'm going to chalk it up to politics or lack of information."

When Dr. David Campbell opened a part-time community clinic about 10 years ago in the Hancock Place School District offices, there were questions about the role of doctors in schools.

"What I was hearing was that the reason that things in this community kind of got shut down was a concern that it was going to be all about reproductive health," he recalled. People feared he was "just going to be handing out condoms."

Missouri law requires abstinence-based sex education, so school clinics are not allowed to dispense birth control. The Roosevelt clinic also will not offer contraceptives because it would violate Mercy's and the school district's policies, although students can be treated for sexually transmitted diseases.

Planning for the clinic started more than a year ago when Mercy executives started working with school districts on ways to improve community health.

"Our goal is really to minimize any time lost from school for health reasons," said Dr. Robert Bergamini of Mercy Children's Hospital in Creve Coeur. "Optimizing the health of students is a way to keep them at their best."

Because 20 percent of the students at Roosevelt speak a primary language other than English, the clinic has a video-conference interpreting system for the more than 20 languages spoken at the school. Behavioral health services also will be handled mostly by telemedicine on computers in each exam room.

Mercy budgeted $200,000 a year for the clinic after an initial $130,000 investment in medical equipment. While Mercy has no plans for more school clinics, People's Health Centers of St. Louis intends to open a similar but smaller clinic at Vashon High School.

One of the biggest fans of the Roosevelt clinic is the school's head football coach, DeAndre Campbell, who has referred 35 players for physicals there. In previous years, players had to sit out for weeks to save up money or wait for an appointment.

"It's definitely a benefit, and more of a blessing," Campbell said. "This has allowed us to get the kids on the football field. I rave about it every day."