L.A. Schools Move to Remedy Health Services

The Los Angeles Unified School District took the first step Monday toward revamping its school health-care program after hearing a report that criticized the district’s 50 doctors and 500 nurses for being busier with paper work than medical services.

School board members adopted the report’s harsh findings and its recommendation that the district join forces with the Los Angeles County Department of Health Services to eliminate overlapping services and inefficient use of staff and resources.

County officials attending Monday’s meeting indicated they would be willing to share health-care services with the district, which is expected at its Jan. 14 meeting to adopt a resolution seeking the county’s help.

The report said district programs are out of date and fail to meet the needs of students, especially those of recent immigrants who have never seen a doctor. Adequate services do not reach the one in five city schoolchildren who live in poverty and the one in three who lack medical insurance, the report also concluded.

Compiled for the district by an educator, a health-care specialist and a pediatrician, the report presented a number of proposed changes that could be implemented starting immediately.

If only “relatively few dollars (were) spent in school-based preventive and primary care, (it) would save the county enormous sums in inappropriate emergency care,” the report said.

The report also found that money to improve the district’s student health-care program is available but the program would have to be reorganized before additional funding could bring improvements.

One suggestion was for the district and the county to explore possible linkups with colleges, universities or medical schools to provide better health care for children. The Department of Nursing at Cal State Los Angeles, for instance, has expressed interest in jointly developing a training program to upgrade the skills of new school nurse practitioners.

Board member Julie Korenstein said she was not aware that school nurses could be put to better use. “Frankly I was very amazed to find . . . what nurses can do on our campuses,” she said.

Among the report’s recommendations:

* Turn over responsibility for some medical services such as screening for tuberculosis to the county Health Department, which already performs such tests.

* Install nurse practitioners in school clinics to care for children with minor medical problems, instead of sending such children home and having them enter county hospitals, which proves costly to the county.

* Reevaluate the assignments of 320 district psychiatrists, who spend a significant part of their time performing tasks that do not require their professional expertise.

* Restructure the jobs of the district’s 50 doctors and 500 nurses so that doctors are able to treat more ailing students and nurses are able to prescribe medication.

The report, which took one year and cost $40,000 to compile, was based on interviews with more than 100 medical experts, educators and administrators.

In other business, the board said it plans early next year to review its expulsion policy, toughened last June to allow automatic expulsion of students who bring firearms to class or seriously assault others.

Board members said they want to offer an alternative to students as young as 12 who are currently being expelled and left to the streets because there is no place for them at county-run programs.

Concerned about the fate of such delinquents, the board on Monday voted to suspend the expulsion of nine teen-agers whose cases had come up for review.