Officials Call for School-Based Health Clinics : Medicine: Group wants to establish the basic care facilities countywide for low-income students and their families.

Thousands of children in Ventura County are in need of basic health care services, but are unable to get the help they need.

That’s something Dr. Chris Landon, director of the Pediatric Diagnostic Center in Ventura, and a group of county health officials want to change.

One way to do that, Landon said, is to establish school-based health clinics in every district throughout the county where low-income students and their families can be diagnosed and treated for basic illnesses.

“Across the United States, the whole concept of school-linked health services is a growing movement,” Landon said.

According to the 1990 census, about 60,000 children in Ventura County are from low-income families that are eligible for MediCal, a state and federally funded program that provides health insurance for the poor. But many families are unaware that they can get the free health services.

“We’re looking at going to where the patients are,” Landon said. “We have to be integrated into the community, to give people access to health care. The schools can be an entry point.”

Landon said the newly formed Children’s Medical Services Committee, made up of 15 county health officials, is exploring ways to organize and finance the school clinics, which would be run by school nurses.

He said the clinics may be funded with a combination of grants and money that the county receives through MediCal, California Children’s Services and various other state and federal programs. Money that school districts receive to provide certain health services also could be used.

Landon said the Medical Services Committee is applying for a grant from the California Wellness Foundation to create a training program that would enable nurses to become authorized nurse practitioners.

School nurses are now required to have a registered nurse’s license, a bachelor’s degree and a state credential authorizing practice on a school campus. But despite the extensive background and training, the nurses are limited in the number of services they can provide.

Once they complete the training program, Landon said, school nurses would be able to give physical exams to students and screen them for diabetes, epilepsy, asthma and other illnesses. Under the supervision of a pediatrician, the nurses would also be able to treat minor illnesses as well as prescribe and dispense medications. Many of the services would be free.

“But it would not be just for the children themselves,” Landon said. “We need health care for the whole family.”

Many school nurses throughout Ventura County said they support the program because it would enable them to broaden their skills. They said, however, they already carry a heavy workload and wonder how they would be able to provide extra services.

“This brings up a dilemma for us because we’re already stretched to the limit,” said Diane Garcia, a nurse with the Hueneme Elementary School District and president of the Ventura County Nurses Assn. “Trying to find time for a new project would really be difficult.”

In the past two years, the number of school nurses in the county has dropped from about 45 to 26, mostly due to school budget cuts, Garcia said. The nurses serve more than 110,000 students in 20 school districts.

Two districts, Ojai unified and Santa Paula elementary, have no nurses, but instead contract with the county or others to perform required services, which include testing vision and hearing and checking for scoliosis, a condition involving a spinal curvature.

But Garcia said nurses also serve as counselors, hold parent conferences, keep health records and ensure that all students are immunized.

Several nurses, including Garcia, said nearly half of their time now is spent doing paperwork.

Landon said if the nurse practitioner program is efficiently managed, additional nurses could be hired to work at some school sites.

But Landon acknowledged that a number of details still need to be worked out, including how long it would take for nurses to complete the training program, how much it would cost and how it would be paid for. He said nurses might have to pick up some of the costs.

Even if all goes well, Landon said, it could be two to three years before the program is fully implemented.

The Oxnard and Santa Paula elementary school districts, however, will not have to wait that long to see how such a system would work.

The two districts last month each received $400,000 grants as part of Gov. Pete Wilson’s innovative Healthy Start Program, aimed at providing health and social services at or near schools attended by needy children.

In the Oxnard elementary district, families whose children attend Juanita, Fremont and Rose Avenue schools will be eligible for a wide range of medical and social services under the three-year program. Families who live within the boundaries of Barbara Webster, Thille and McKevett elementary schools in the Santa Paula district will have the same opportunity.

Services will include mental health, substance abuse and family counseling. Also, nurse practitioners from the Ventura County Public Health Department will operate a health clinic for students and their families at a designated district site each Tuesday.

“These nurses are kind of the icebreakers,” Landon said. “Their job is to break ground.”

Jim Medina, principal of Webster School, where one family service center will be located, said he is excited about the center, which will officially open this week.

“This is a tremendous program,” Medina said. “It’s going to help families who didn’t know how or where to go for help. It’s going to be a one-stop family service center.”

Linda Butcher, the school nurse at the Oxnard Elementary School District, said the center in her district opened earlier this month and has already held two weekly clinics. Butcher, who is helping to coordinate the Healthy Start program, said the center is at the now-defunct Ramona Elementary School.

“I’m excited about it because we’re really impacting a lot of areas with low-income families,” she said. “And it’s a way of forcing different social service agencies to begin to collaborate and work as a team. We feel we’re really helping to blaze a trail.”

Butcher and Medina said the main reason that both school districts qualified for the Healthy Start grants was because a large number of students come from low-income families with limited English-speaking skills.

“We’ve been living with the need for a long time,” Butcher said. “But living with the frustration of not being able to help children that need help has been much more difficult.”

Butcher said she believes the program will continue even after its three-year run.

“Once the need is documented and people see how valuable it is, I think there will be pressure to keep it going,” she said.

Butcher said she would like to be trained as a nurse practitioner under the program now being studied by county officials.

“It would be wonderful,” she said. “It would really enrich our practice. Anything I can learn that makes my service more valuable is important to me.”

Landon said the Children’s Medical Services Committee plans to meet Dec. 10 to discuss further plans for establishing the nurse’s training program.

He said that for the next several months, the medical community will be busy educating parents, teachers and students about the plan.

He said he expects to meet with some resistance. He recently attended a conference in Santa Barbara to talk with school officials about developing such a system.

“Several principals said, ‘My goodness, we have to feed them breakfast, take care of them after school, and now you want us to provide health care for them in the schools? When are we ever going to get a chance to teach them?’ ”

Landon’s response:

“If they’re hungry and not in good health, they are not going to learn,” he said. “I’m sorry, but it’s a modern era.”