Classroom Meets Clinic

Parents lining up at the medical clinic at Columbus Middle School in Canoga Park want to volunteer as classroom aides, but must first pass a tuberculosis skin test.

At Manual Arts High School in South-Central Los Angeles, a student who recently delivered a baby waits to speak to a doctor about contraceptives.

And at San Fernando High School, teenagers stream into a cramped medical clinic for everything from headaches to acne to depression.

Many are indigent and without health insurance. Some have rarely, if ever, seen a doctor. In increasing numbers, they are taking advantage of a growing network of school-based health clinics that specialize in preventive care and operate on the assumption that students must be healthy to learn.

Now, school and health officials are applauding the announcement that the county will pump as much as $50 million a year to expand the Los Angeles Unified School District health clinic network.

“I see this as a very positive thing,” said George Bartleson, an assistant principal at Columbus. “The more you work on the health of a child, the better his learning achievements.”

As district and county officials prepare to approve the partnership this week, school and health officials are drafting their wish lists. Additional school-based clinics are being considered at many schools across the county. Some schools, like Manual Arts and Hollywood high schools, hope to hire new nurse practitioners and expand their schedules, perhaps even providing services to parents and siblings.

“We intend to look at each area and do an assessment of where the most needy kids are,” said Assistant Supt. Sally Coughlin, who is in charge of student health and human services.

A main advantage of school-based clinics is that most students can be treated immediately and returned to class, rather than be referred to a doctor, officials said.

The clinics provide one of the few alternatives to overburdened public clinics, where lines are so long that students might have to miss hours of school and often leave in frustration, officials said.

Roseana Dyas, 18, has insurance but routinely visits the clinic at Manual Arts because it is convenient, she said. To visit her doctor in the Mid-Wilshire area, she normally had to skip class and spend hours in transit. “I come here much more often,” she said.

According to district officials, 70% to 90% of the students who use the clinics come from families without medical insurance. Overall, more than one-third of students in the district are uninsured and cannot afford private care, they said.

The San Fernando High clinic, one of the first three pilot programs launched in the district 12 years ago, is the busiest, with more than 10,000 patient visits last year.

Coughlin said officials are considering ways to extend the hours or add Saturdays to the current weekday program, available from 7:30 a.m. to 4 p.m. daily.

Students, with parental consent, arrive with everything from sniffles to asthma to urinary tract infections. Some come to be tested for pregnancies or sexually transmitted diseases.

More than half the visits to the San Fernando clinic are for psychological counseling or other mental treatment, said Michael Godfrey, district coordinator of school-based health clinics.

At Roosevelt and many other schools, where many of the families are illegal immigrants, officials must assure parents that they are not risking deportation by coming to the clinic. But they say that parents and students generally feel more at ease receiving treatment at school.