Mobile Clinic Is a Shot in the Arm for Needy

Sitting in the shade of a 38-foot-long camper van parked on the playground of 9th Street School last week, Maria Martinez unfolded a yellow card. She pointed to the immunizations -- for polio; diphtheria, tetanus and pertussis; and measles, mumps and rubella -- that her son Ricardo had just received from the COACH for Kids and Their Families mobile clinic. “He needed them for school,” the 26-year-old downtown Los Angeles resident said through a Spanish translator.

Like many parents at the beginning of a new school year, Martinez discovered that Ricardo lacked the state-required vaccinations when she tried to register him for elementary school.

School officials directed her to COACH for Kids, which regularly parks at seven schools in Los Angeles and Inglewood to offer free primary and preventive medical care, mental health services and counseling to low-income families. (COACH stands for Community Outreach Assistance for Children’s Health.)

The staff -- nurses, social workers and aides from Cedars-Sinai Medical Center in two brightly painted vans -- sees about 30 families a day.

The Martinezes were grateful to be among them. Although the family’s emergency Medi-Cal insurance has assigned Martinez to a clinic in East Los Angeles, she said she has no transportation to get there.

“I don’t have anywhere else to go for shots,” Martinez said.

As recorded on a card that follows students through their schooling, those immunizations are a passport to education. Nothing can begin without them.

Karen Maiorca, director of nursing for the Los Angeles Unified School District, estimated that about 10% of kindergarteners enrolling in the district’s schools show up without their required immunizations. Statewide, 7.7% of kindergartners arrive without all of their required immunizations. In Los Angeles County, about 9.3% still need shots.

“Many times we have to help them find a place to complete their immunizations,” Maiorca said. “Either they’re new to the country, new to the state, or new to LA. Unified.”

Because of recent budget cuts, she said, it has gotten harder for new immigrants or low-income parents to find places where children can receive immunizations and other health care. With local health departments slashing hours or closing locations and districts laying off nurses, Maiorca said, schools have had to look for alternatives.

COACH for Kids -- and three other mobile medical and dental programs that visit Los Angeles schools -- help close the gap.

“It’s an invaluable service to us because many of our parents don’t have any kind of health insurance, nor do they have a primary clinic where they can take their kids to,” said 9th Street’s principal, Eleanor M. Vargas-Page. “The majority of our students, if there was an emergency, would go to county hospital, which means they would spend one full day out of school getting an antibiotic for an earache or a toothache.”

Maiorca agreed. “If we have the mobile clinic provided on campus, we have almost 100% that will make it to the clinic appointment,” she said. “Usually the parents trust the school, and they’re convenient because the clinic is already there.”

But youngsters need more than just the shots to enter school; they need follow-ups to stay in school, Maiorca added.

Immunizations often become a gateway to the rest of the COACH for Kids services. The program’s more than 100 community partners include shelters for the homeless and job-training programs.

“I went for immunizations for my daughter and got so much more,” said Olga Turnage, who first met the COACH for Kids staff at First Church of the Nazarene in 1995.

Turnage, who had just gotten out of a drug-treatment facility, said a social worker aboard the van had helped her turn her life around, starting by asking her to make some short-term goals. The social worker then helped her sign up for janitorial classes, helped her reunite with her children in foster care, counseled her when her mother died and attended her graduation from American Career College.

“They care beyond the call of duty,” said Turnage, who now heads customer service at Cedars-Sinai’s finance department. “They’ve been there for every endeavor I’ve ever attempted.”

Such care for all facets of health won COACH for Kids a national award for improving community health from the American Hospital Assn. last month.

“With COACH for Kids, the health-care intervention just becomes the trigger,” said Rick Wade, senior vice president of the American Hospital Assn. “The Nova Award honors hospitals that connect to others in the community, improving health in the broader sense of the word.”

The vans bring in families at schools, missions for the homeless, housing developments and churches in skid row; in South Los Angeles, West Los Angeles and Pico-Union, according to the program manager, Michele Rigsby. The 9-year-old COACH program operates on a $1.1-million annual budget with grants from Cedars-Sinai, individuals and organizations such as the California Community Foundation.

“Many families are not able to access health care,” Rigsby said. “Take the homeless population here -- there’s the transportation issue, lack of insurance and financial resources.”

On a recent Monday, 9-year-old Ceclia Wortham lifted up the sleeves of her orange T-shirt to reveal bandage strips on both arms. She had received polio and hepatitis B shots that morning when the COACH van stopped in the skid row area of downtown Los Angeles.

Their mother, Chiquita Wortham, who lives at the Union Rescue Mission with her four children, estimated that she visits the van about twice a month for everything from advice on 7-month-old Ahmaad’s asthma to treatment for Dylan’s strep throat. It is much easier to manage the children’s health when she doesn’t have to tow them on a bus to Baldwin Park to see their doctor on their state-funded health plan, Wortham said.

Wortham’s children nodded as they said how much they liked the COACH staff. Ceclia said she had learned a lot from them. “Don’t eat junk food,” she said, repeating some of her nurse’s advice.

She looked at the half-bitten caramel apple in her hand. “They’d be OK with the apple part, not the caramel,” she said.