Personal Health : Worried Sick Over Ill Kids : Special Day-Care Centers Give Parents an Underused Option

With schools opening in Los Angeles and throughout California next week, it’s time for the fall migration--the migration of the common cold from home to classroom and back.

It’s also the time when working parents begin worrying about finding care for their kids who are too sick to go to school.

This dilemma of the virus season results in employee absenteeism and turmoil in the family, yet the idea of day-care centers for children who have minor childhood illnesses is moving slowly in the United States.

Even where sick-child centers do exist, they aren’t always successful. Two in downtown Los Angeles closed last year for lack of usage, apparently because parents preferred to stay home with their sick children, the operators say.

Only about 70 centers have emerged nationwide over the last eight years, with about 700 slots to fill a need that is estimated at 350,000 children daily, according to the National Assn. for Sick Child Day Care.

There are at least 19 million children in the United States younger than 14 whose parents work full time outside the home and who have no one at home during the day, according to a 1986 report by the U.S. Bureau of Labor Statistics.

Families Coping

“Right now, most families are coping by having the parent stay at home with the sick child,” said Carla Rayacich, president of a company that is opening a new center for sick children in the Silicon Valley community of Sunnyvale this week. Rayacich said research by the sick child day-care association estimates the annual cost to U.S. business of these absences at $7 billion to $10 billion, even larger than the cost to employers of illnesses of the workers themselves.

Parents who have to be at work may take their sick children to school or regular day care anyway.

“People load the kid up with Tylenol and drop them off, and then they know they’ll get at least three hours at work before the day-care center calls,” Rayacich said.

Jamar Schoessow, a school nurse at John Muir and Will Rogers elementary schools in Santa Monica, said she sends home about six children a day during the peak of the viral season.

Because a child with a common cold is most contagious just before getting symptoms, there is no requirement to keep him home if he doesn’t have a fever, according to California health guidelines for schools. But the misery index often brings these children to the nurse’s office to lie down and get a little TLC, Schoessow said.

The problem has increased particularly in the last two years, she said, since her district began accepting students who live outside its boundaries but whose parents work in Santa Monica.

“They bring their kids sick because the parents work in Santa Monica and come from so far, and have no one close by,” Schoessow said. “I sometimes keep these kids in school the whole day sick--really sick. Then they come back (to school) too soon because the parents have to go to work.

“I understand that, because these people who have these jobs are people who have worked hard to get where they are. And they need to have a steady job.”

Juggling Responsibilities

This juggling of work and child-rearing places enormous strain on parents and children, Rayacich said, using the poignant story of a 5-year-old to illustrate.

While visiting a center for sick children, Rayacich said, she asked the boy how he liked the center and how it compared to having his mother take time off work to care for him at home.

“I like it (the center) fine,” the boy told her. “It’s more fun. I’m not as lonely and Mommy doesn’t cry.”

Sheri Senter, president of National Pediatric Support Services, an Irvine company that operates Rainbow Retreat sick-child units in Pasadena, Huntington Beach and Newport Beach, said she believes parents are just beginning to consider such facilities as an option.

“It’s a learning curve,” Senter said. “In every needs assessment that we do for corporations, sick-child care is coming back number one. People can’t miss any more days of work. And we’re seeing children enter group care at a younger age, so they’re getting sick more frequently.”

Still, the 15-bed center sponsored by Transamerica Life Cos. at the California Medical Center in downtown Los Angeles closed in June, 1988, after two years because it was never more than one-third occupied, said Sandy Comrie, vice president for human resources for the company.

A two-bed unit at the California Pediatric and Family Medical Center, a downtown clinic, saw almost no usage so it closed in April, 1988, after eight months of operation.

Such problems generally result from not getting the word out to parents, from not answering their questions about the concept and from setting up barriers to usage, Senter and Rayacich said.

Common Questions

The most common parental questions, according to Rayacich:

* How do the centers prevent the spread of disease from child to child? (Toys are kept separate, and each child has his own bed with clean linens. Children with diseases such as chicken pox are isolated, though some centers won’t take chicken pox cases.)

* What are the procedures for bringing the child in? (Usually, a phone call at least an hour ahead of time to reserve space is required.)

* Should registration forms be filled out ahead of time? (It saves time to do this, and also gives a chance for parent and child to tour the center.)

* Does the child need to go to the doctor first? (Some hospital-based centers have pediatricians who examine all the children, either for the same fee as an office visit or sometimes free. They also will do throat cultures or other routine tests. Requiring parents to take the child to the doctor first takes so much time that parents tend not to use the sick-child center, Rayacich said.)

* How much does it cost? (Senter’s facilities charge $5 a hour to the public, $3.50 an hour for corporate-sponsored clients or regular day-care students. Torrance Memorial Hospital and Northridge Hospital Medical Center charge $3 and $3.25 an hour, respectively. Rayacich’s new center in Sunnyvale, called Feeling Better Health Day Care, will charge $39 a day.)

Most of the centers are attached to hospital pediatric units and help the hospitals build good will as well as fill space. Senter said she believes hospitals aren’t the best environment for children who are only moderately ill, but hospitals can keep down the cost of care by piggybacking the sick-child units on existing facilities. Day-care centers can’t do that, so they find sick-child units too costly, she said.

Rayacich’s Feeling Better center is expanding the sick-child center concept outside of hospital and day-care center, into a free-standing facility just for ill children. With 42 beds, it is four times the size of the average unit elsewhere.

Model for Other Centers

Funded by a group of socially conscious investors, she said, Feeling Better is intended as a model for establishment of similar centers around the country.

Given the right promotion, a hospital’s sick-child unit becomes an essential part of the community, said Betty Nosbisch, director of pediatrics at Covenant Medical Center in Waterloo, Iowa.

The five-bed Sick Bay child center at Covenant will be five years old this fall, Nosbisch said, and “a lot of families have come to depend on us.”

One of these parents is Susie Schwieger, assistant director of placement at the University of Northern Iowa. Her daughter Anne, 6, and son Matthew, 4, have been going to Sick Bay for two years.

Her own traditional upbringing made taking the children there for the first time difficult, Schwieger said. “I asked myself, ‘Am I abandoning my children when they’re ill?’ ” she said. “I grew up in a really traditional home where my mom didn’t work outside the home. So when we were sick she was there constantly at our bedside.”

But when the children obviously enjoyed the experience, Schwieger’s fears--and guilt--vanished.