Ailing Finances May Hurt Sick Pupils : Schools: To cut $2 million, the district laid off four nurses, leaving three to treat 11,000 students, many from poor families.

The boy barked in class and threatened to bite other students. When teachers in the El Monte City School District tried to calm him, he growled at them too.

Maladjusted and perhaps even dangerous, the boy didn’t belong in the classroom. In desperation, administrators sent him to the school nurse.

The nurse was struck by similarities between the boy’s behavior and a rare disease she had studied in nursing school. On a hunch, she referred him to a specialist. The diagnosis: The boy had Tourette’s syndrome, a rare, neuropsychiatric disease characterized by muscle tics and involuntary noises.

If not for the nurse, the boy might have ended up in a school for delinquents or mentally disturbed children. Instead, he got needed medical care and special education.

School nurses treat a variety of ailments, including hernias, internal parasites, ear infections and open sores. Some students are referred to clinics.

But El Monte administrators fear that many sick students will be out of luck in September because budget constraints have forced the district to gut its nursing program. Four of seven school nurses have been laid off, a move expected to save $208,433. That is just a part of the $2 million that the district must cut from its $42-million budget by Tuesday.

Throughout Southern California, strapped cities and school districts face further cuts in health care this year because of dwindling state resources. And in this city of 79,494, where more than half the residents have incomes below $15,000 a year, the cuts hit particularly hard.

“In this community, we are the doctor for many children,” said Jeff Seymour, superintendent of the El Monte City School District.

Administrators and nursing staff say the cuts will eliminate the last safety net for poor families, many of whom are recent immigrants or don’t have any medical insurance.

Starting this fall, El Monte will have three nurses to care for the district’s 11,000 students--roughly one nurse per 3,500 students. There also is a nurse practitioner who works out of a small clinic at district headquarters, but most of the students she sees are referred by school nurses.

“Those nurses are our first line of defense, because unless someone sends us those kids, we don’t know about them,” said Mary Borja, the nurse practitioner.

In the three-room clinic, Borja is booked solid from morning to night as children and, sometimes parents, line up to see her. Borja does all her own lab work, blood and urine tests, and physical examinations. Each physical takes an hour.

One recent afternoon, she stopped for a moment, stethoscope around her neck, to greet a 14-year-old boy who sat patiently waiting for her. “Como esta, mijo? Bien?” she asked as he smiled a shy welcome.

In the next room, the boy’s mother, Griselda Andrade, waited for the exam to be finished. She spoke frankly about what this clinic means for her two sick children.

“We don’t have resources to go to a private doctor,” Andrade said in Spanish.

El Monte nursing administrators say that, in many cases, they serve as the bridge between families and the social services available in the community. Some parents are too afraid or suspicious of government agencies to apply for help, and others don’t know what services are available or how to fill out forms.

Valerie Wood, a school nurse who heads the district’s health services program, said that community resources are already overtaxed.

The district recently received word that a UCLA-sponsored eye clinic is being scaled back and will no longer treat students from El Monte. The county’s El Monte Comprehensive Health Center is overwhelmed by an increasing number of patients, many of whom have lost their jobs due to the recession.

When Wood refers families of sick children to County-USC Medical Center, she warns them to take enough food for two meals and a blanket because of daylong waits at that overcrowded facility.

Sometimes, nurses are sent to family homes to teach hygiene and take simple medication.

Seymour recalled two siblings who were out sick for 15 days in one month. It turned out that the children’s mother kept them at home out of embarrassment because they had chronic lice. When the nurse visited the home, she found that the children kept getting reinfected after treatment because the house was contaminated.

The nurse returned with medication and soap to treat the carpets and furniture, as well as the hair of all family members, Seymour said. Soon the children were back in school.

Students’ needs can be as simple as clothes or a grocery bag of food. El Monte school officials say they are seeing more hunger; in some of their schools, virtually all of the students are poor enough to be eligible for free lunches.

“I’ve taken kids home, and there’s one loaf of bread and one can of soup in the cupboard,” Seymour said.

Seymour said it is difficult for students to concentrate on learning when they are hungry, sick or abused. “You can’t have a good learner unless they’re in good health,” he said.