Officials Approve Concept of Health Clinic at Santa Monica High School : Education: Fearing birth control debate might jeopardize plan, school board avoids discussing services.

School district officials and community members who favor setting up a health clinic at Santa Monica High School are proceeding carefully, knowing their cause is a delicate one and vowing not to let it be waylaid in a debate over birth control.

The board of the Santa Monica-Malibu Unified School District this week made the first move toward establishing a health center at the high school. The board approved the concept of a clinic, but did not discuss details. And it put off until later a decision on whether it would offer birth control information or dispense contraceptives.

The board’s unanimous backing will help in talks with the Irvine Foundation, which has expressed interest in funding such a clinic, said Neil Carrey, chairman of the district’s Community Health Advisory Committee.

Carrey told the board at the Monday meeting that Santa Monica students need health services, and that the need is likely to increase as rising medical costs cause many employers to reduce their health-care benefits.

“You’re going to see more and more students with less and less coverage,” he said.

The idea for a clinic is not new in the district. It came up about five years ago but was squelched in a dispute over whether contraceptives would be distributed, Carrey said in an interview.

There was another flurry of controversy in 1988 when the advisory committee, composed of about 50 parents and health professionals, conducted a survey of high school students to determine health needs. A small but vocal group of parents opposed the survey, charging that it would be used to justify a school clinic that would promote birth control.

The survey proceeded nonetheless, and 1,800 students, who had obtained parental permission to take part, responded.

Most of the students said they had visited the doctor in the last two years, but about a fifth said they had no regular source of health care. Students said they wanted information about fitness and hygiene, birth control and sex, drugs, “getting along with adults,” and stress.

About half wanted help in learning how to lose or gain weight. One-fifth of the girls said they had tried to lose weight by throwing up or fasting for several days. One-fifth of the students said they smoked tobacco, and one-fifth said they used marijuana or hashish.

More than a third of the girls and 21% of the boys had contemplated suicide. Eighteen percent of the girls said they had tried to kill themselves.

More than half of all students reported that they had never had sexual intercourse--beginning with almost three-fourths of the freshmen, but diminishing to 31% of the seniors. Forty-two girls said that they had been pregnant, with 32 of them reporting that they had an abortion.

Although Carrey said the survey identified a clear need for a clinic, no immediate action was taken in light of opposition on the school board and in the community.

But with three new members on the seven-member school board this year, “people felt the climate might be right, and the need was definitely there” to develop a clinic, Carrey said.

“It’s high time if not past time that we pursue this,” board member Connie Jenkins said Monday.

It is the “enormous need” for a clinic that must be emphasized, Carrey said, if it is to become a reality.

“If you start getting into discussion into birth control, counseling, dispensing it, you’re going to divert the time and expense of everyone,” he said. The advisory committee, he added, has “no hidden agenda.”

Board member Peggy Lyons agreed. “I don’t want to ruin the chances of this happening by scaring people away,” she said.

“Hopefully, the major opposition has died down,” said Lyons, who sits on the advisory committee. She noted that some committee members fear that a clinic would interfere with parental authority.

She added that some committee members have religious reasons for opposing a clinic that would include birth control. But they have been able to voice their opinions, she said, and the majority of committee members feel the clinic is urgently needed.

In concept, Lyons said, the center is to be “a place where (students) can go privately” for information about problems they cannot or will not discuss with their parents, such as venereal disease, anorexia, abuse and drugs. Lyons said she envisions it as “an expanded nurse’s office”--a room with a few cots, a television and VCR with tapes on nutrition and other topics, a bulletin board with brochures and a schedule of classes.

Such a clinic has been operating since 1987 at the Culver City middle and high school. The Culver City Youth Health Center, as it is known, is open to students in grades 6 through 12 who have parental permission to use it; more than 70% of the 2,500 students do have parental consent, and the active caseload is about 1,500 students, according to Director Adrienne Davis. About 20 students are seen each day, she said.

The clinic runs on an annual budget of about $148,000, mostly from private sources, and $77,000 worth of in-kind services of UCLA doctors, college students and mental-health workers.

One-third of the students seen have no health insurance and depend on the clinic for most of their medical care, Davis said.

The services, all free, include physical exams, treatment for sports injuries, mental-health counseling and prenatal care. Only 8% of the services involve reproductive health care or family planning--such as gynecological exams, diagnosis and treatment of sexually transmitted diseases, pregnancy tests and referrals to family planning clinics. The clinic does not dispense contraceptives.

“The majority (of the work) is just dealing with keeping kids healthy,” Davis said.

An evaluation of the Culver City clinic and six others in California is under way and will be finished in about a year, Davis said. “But we see success every day,” she said, in terms of helping to keep children in school, preventing abuse and boosting self-esteem.

The Los Angeles Unified School District has health clinics at three high schools--Los Angeles in mid-Wilshire, Jordan in Watts, and San Fernando High in the San Fernando Valley. They offer medical and psychological services to all students who have obtained parental consent. Unlike the Culver City clinic, they dispense contraceptives.

If approved, a clinic at Santa Monica High could open as early as next fall, Lyons said.