SAN GABRIEL VALLEY / COVER STORY : A Medical Breakthrough : A groundbreaking program in Pasadena schools provides free health and dental care for poor children. The idea is catching on elsewhere.

Six-year-old Amber Mays took a breath of “happy gas,” closed her dark brown eyes and boldly opened her little mouth for the dentist’s drill.

“Open up real wide like a lion,” coaxed dentist Lynette Jackson through a pink face mask as she drilled deeper into a baby molar.

This was Amber’s fourth visit to the dentist. When she came in for her first visit, Jackson said, Amber’s teeth were so badly decayed that four baby teeth needed fillings and two could not be saved.

A revolutionary 4-year-old health project in Pasadena schools brought Amber her first dental care, just as it has brought medical care, dental and psychological care to thousands of other young students without medical coverage. Startlingly simple and inexpensive, the groundbreaking project, known as Young and Healthy, is being imitated in 12 other school districts and studied by at least two more jurisdictions.

“We heard about what Pasadena was doing and said, ‘Why can’t we have a Young and Healthy?’ ” said Kathy Hacker, volunteer coordinator with the Claremont Unified School District, which just started a similar program.

Based in the Pasadena school district’s health offices, Young and Healthy uses a staff of four administrators and school nurses to put children who need care in touch with more than 200 health providers throughout the city.

The program does not rely on tax money or an annual fund-raising campaign, nor is it the result of a sweeping health-care reform package. Young and Healthy in Pasadena has proven to be a practical way to spread the availability of health care to the poor without straining doctors, hospitals or charity dollars.

The doctors, dentists and other providers work in their regular offices, fitting the children into spaces in their schedule and offering their services for free. The youngsters are spread among many of them, so no one ends up with a practice of the impoverished.

Children who need medical care are examined by school nurses, who contact Young and Healthy. The program in turn refers each child to a health provider, arranges transportation, translation if needed and free prescriptions.

Of the 22,500 students in the Pasadena Unified School District, which includes Altadena and Sierra Madre, 11,700 are from low-income families and 7,000 are from families lacking health insurance and Medi-Cal, according to district statistics.

“Many people don’t realize how poor some families are in Pasadena,” said Mary Donnelly-Crocker, program director of Young and Healthy. “They work, but after rent and food, have no money left over for medical emergencies, and there are no free clinics in Pasadena.”

Amber’s mother, Valerie Mays, is a case in point.

“Amber’s teeth were so bad because I didn’t have the money to take care of them in the beginning,” said Mays, a single mother of four who works full time in the food service department at Huntington Memorial Hospital in Pasadena and has no dental coverage.

usan MacLaughlin, a school nurse at Wilson Middle School and Willard Elementary School, said she sees students with everything from lice to strep throat.

“I’ve seen a child whose mother tried to pull out his tooth with a pair of pliers and recently a little boy who had a pencil stuck all the way through his hand,” MacLaughlin said. “But most just have toothaches or ear infections.”

Young and Healthy is funded primarily by foundations, local organizations and individuals. The annual budget of $300,000 pays for a staff of four, one part-time assistant and materials such as X-rays, casts and fillings. Eleven area pharmacies supply free prescriptions, and a local laboratory performs free tests. Huntington Memorial and St. Luke hospitals allow participating physicians to use their emergency rooms.

Now in its fifth year, Young and Healthy has brought treatment to more than 6,101 youngsters, and the approach is catching on in communities throughout California.

In West Covina, a group of doctors at Queen of the Valley Hospital began treating students last September through a program called ECHO (Every Child’s Healthy Option), which serves eight surrounding school districts.

“I heard about Young and Healthy and was intrigued,” said Tom McGuiness, a hospital vice president in West Covina. “So I got some school nurses and doctors together for breakfast and they agreed to get involved.”

Children who qualify for the ECHO program must be enrolled in a participating school district and have no health insurance or Medi-Cal. Like Young and Healthy, school nurses make referrals to a coordinator, who sets up an appointment with a volunteer health provider.

The only doctors signed up are on staff at Queen of the Valley Hospital, but ECHO is enlisting volunteers in private practice, said Tish Woodington, assistant director of nursing at Queen of the Valley.

Although only a handful of children have been treated so far because of the newness of the program, McGuiness said, there is a big need in West Covina, especially for dental care.

“You don’t have to go to a Third World country to see Third World conditions,” McGuiness said. “There are a lot of poor families in West Covina, and they belong to all of us. We really want to make sure these kids get the care they need.”

Of the 85,000 students in districts covered by ECHO, 25% have no health insurance or Medi-Cal, according to school district statistics.

Taking part in ECHO are the Rowland, Baldwin Park, Azusa, Bassett, Charter Oak, Covina, West Covina and Hacienda La Puente unified school districts.

Funding for ECHO comes from Citrus Valley Health Partners, the parent company for Queen of the Valley Hospital, Hospice of East San Gabriel Valley and InterCommunity Medical Center.

Project KIND, (Kids in Need of Doctors) in Riverside is another spinoff of Young and Healthy. It began serving elementary school children in April, 1994.

“My wife, who’s a school nurse, told me about Young and Healthy a year and a half ago,” said Gerald Saks, a Riverside pediatrician who was instrumental in creating Project KIND.

“I called Donnelly-Crocker; she came down here and spoke to a group of doctors, who were very receptive,” Saks said. “And now we have 72 volunteers, including doctors, dentists, psychologists and pharmacists.”

Project KIND works with the Riverside County Medical Assn., which provides a staff person who acts as a liaison between the three participating school districts. School nurses make the assessments and call the medical association, which refers each student to the appropriate health professional.

“This program is designed for families who have no money for health care and don’t know what to do. And there are a lot of them in Riverside,” said Dolores Green, associate executive director of Project KIND and the Riverside County Medical Assn.

“The first patient I saw had an ear infection which had been draining for three weeks,” said Alan Kwasman, medical director of Project KIND. “He could have had permanent hearing damage if his ear wasn’t treated.”

Of the 28,000 students in the Riverside, Jurupa and Alvord unified school districts targeted by Project KIND, 40% have no health insurance, according to the study.

“Most of these parents are working, but their employers don’t provide insurance. They are faced with putting food on the table or taking their kid to a doctor,” Green said.

All expenses are currently being covered by health providers who donate their time, staff and beds. Transportation is a problem for many families. Often, school nurses take time out of their schedules to drive children to appointments.

Officials with the Riverside project are seeking grants in hopes of persuading local taxi companies to volunteer their services.

Glendale also has taken a cue from Young and Healthy, providing free health care as of last August to needy school children through its Healthy Kids program.

Alarmed by health problems she was seeing in schools, Frida Martinez, coordinator of health services for the Glendale Unified School District, did a needs assessment for the district in early 1993.

Of the 30,000 students enrolled in the district, about 15% have no access to any health care whatsoever, said Carrie Reynolds, executive director of Healthy Kids.

“With Healthy Kids, there won’t be a single child in the district that will go without medical care,” said Reynolds, who used Pasadena’s Young and Healthy as a model. Glendale Memorial Hospital, Glendale Adventist Medical Center and Verdugo Hills Hospital donated seed money to start Healthy Kids, which has about 70 volunteer health professionals.

The three hospitals pay for Healthy Kids’ administrative staff, and a combination of grants and private donations cover expenses such as laboratory tests and X-rays. Four area pharmacies donate prescriptions.

Healthy Kids has seen 40 children to date, mostly for such ailments as sore throats, earaches and eye problems that had gone untreated and advanced to more severe illnesses.

“There is an immediate reward for everyone involved in relieving children’s pain and seeing them return to school,” Reynolds said. “A big medical bill can ruin a family, and there are no free medical clinics in Glendale.”

A big obstacle for families is transportation, said Reynolds, who is working with the PTA to recruit volunteer drivers.

The concept behind Young and Healthy--a community seeking an antidote to a problem within its own volunteer public--continues to capture the imagination of people elsewhere. Claremont, which is in initial stages of a similar effort, also points to Pasadena as its inspiration.

Claremont’s Healthy Kids program plans to operate in the same manner as Young and Healthy. It has three dentists and six physicians signed up, and students started participating in the program in January.

“Everybody looks at Claremont as a rich community, but we have a lot of people who fall through the cracks,” said Kathy Ables, chairman of the Claremont chapter of the American Red Cross. “We have many one-parent families who can’t afford health insurance, and those children are hurting.”

Of the 6,000 students enrolled in the Claremont Unified School District, 8% have no health insurance or Medi-Cal, according to a study done by the League of Women Voters in early 1994.

The Red Cross is supplying an administrative staff and is asking for donations to help with prescriptions and outside costs.

Kern County in central California is taking steps to found its own version of Young and Healthy.

“We were amazed at what we saw in Pasadena,” said Claudia Jonah, assistant health officer for Kern County. “We went there and looked at the possibility of starting something here and now we are in the process of getting a dental program going.”