County May Extend Student Medical Care

The Board of Supervisors today will seek federal authorities’ approval to include students across the county in an innovative plan designed to provide basic medical services for students in Los Angeles schools.

The program could funnel as much as $90 million into treating basic maladies before they turn into more severe ailments.

In October, the supervisors approved an effort to secure federal Medicaid dollars to fund medical care in the Los Angeles Unified School District and to seek out other school districts interested in joining such efforts.

On Thursday, Supervisor Zev Yaroslavsky announced that the county can qualify for twice the funds initially expected by expanding the program to other school districts in the county. Seven have already lined up to participate, he said.

Those districts are Pasadena, Alhambra, Monterey Park, El Monte, Pomona, Long Beach and Culver City. Officials hope to expand that list even further, saying any school district with a basic medical program and more than 75% of its students receiving free school lunches is eligible.

“This is a very important thing for us to do,” Yaroslavsky said. “It massively expands primary health care to the segment of our population that is most vulnerable.”

Nancy Krause, director of educational support services for the Los Angeles County Office of Education, added that “you’ll have kids in a better position to learn. They’ll come to school ready to learn because they won’t be sick.”

Over the past few decades, schools have gradually assumed the role as the first line of preventive health care for an increasing number of students without insurance. Schools have expanded their medical facilities, turning nurse’s offices once stocked with bandages and aspirin into miniature health clinics providing basic medical screenings and vaccinations.

“School districts have jumped into the business for the most part out of need,” Krause said.

But those programs, largely funded with money earmarked for education, reach only a fraction of the 500,000 uninsured students in the county. In the Los Angeles schools, for example, half the children reporting earaches do not get treatment until the condition worsens into an infection that requires hospital treatment.

In the Pasadena Unified School District, one of those seeking the federal aid, two nurses working out of a clinic in the district’s headquarters are overwhelmed treating a plethora of ailments and helping families get state aid. More federal money could expand that operation, said Patricia Lachelt, director of health programs.

“That would be a tremendous boon for the parents,” she said. The money could also help expand nursing programs at schools where nurses are only present part time to administer as many as 39 types of medicine.

Paradoxically, the recent near-collapse of the county’s hospital-based health system provided the opportunity to improve school-based treatment.

When the federal government bailed the county out of possible bankruptcy in 1995, it tried to prod the bureaucracy into changing its wasteful ways by promising to match each dollar spent on care in community clinics rather than on costly inpatient hospital care.

Yaroslavsky and school officials are banking on that promise and arguing that the school-based clinics are essentially extensions of the county’s health system and, therefore, eligible for matching funds.

Noting that education dollars rather than health money are generally spent on school treatment, federal officials have expressed support for such a program, and have approved similar arrangements in more than a dozen states.

Supervisors and school officials said they hope the new money will begin coming in by the start of the federal fiscal year, July 1. L.A. Unified will be first in line for the funding and has begun coordinating with the county health department to beef up its services.

“The more primary care we can provide to kids,” Yaroslavsky said, “the less expensive it is for the county to deal with those individuals and the more humane it is for those individuals.”