Gov. to Propose More School Health Clinics

Criticized for failing to offer substantial remedies for California’s healthcare problems, Gov. Arnold Schwarzenegger today will propose installing new medical clinics in as many as 500 elementary schools, his aides said.

The multimillion-dollar plan is related to an election-year decision by the Republican governor to embrace healthcare as an issue. Schwarzenegger’s aides said he also hopes to propose ways to cut medical costs industrywide.

California already has 140 school medical clinics. Schwarzenegger would add to those and use them, in part, to enroll more children in government insurance programs such as Healthy Families and Medi-Cal, which are used by low-income families. Students could receive treatment there or elsewhere.

“We have too many uninsured people in California,” Schwarzenegger said at a news conference Friday. “There are still a lot of children uninsured.”

Of the 6 million Californians without health insurance, about 800,000 are children, according to state officials. An estimated 420,000 of the uninsured children qualify for state assistance programs but have not been signed up.

The new clinics would be built on school grounds and offer basic services such as immunizations. Some could also provide mental health or dental services. Bigger clinics could include labs and pharmacies and offer treatment for adults as well as children.

Aides said Schwarzenegger would introduce the idea today at a healthcare conference that his office organized in Los Angeles.

The governor’s opponents view the event as an election-year stunt, given what they say is Schwarzenegger’s lack of attention to the issue since he took office in 2003.

On Sunday, state Treasurer Phil Angelides, the Democratic nominee for governor, said he “welcomed the debate” with Schwarzenegger on healthcare. But he said the governor has been absent on the issue and “should be charged with political malpractice.”

When Schwarzenegger first ran for governor, his campaign included proposals on education, the economy, energy, the environment, immigration, political reform and workers’ compensation, but nothing on healthcare. As governor, he has signed legislation to remove junk food from school vending machines and spoken in support of anti-obesity programs but offered no major proposals to improve the healthcare system.

Administration officials said Schwarzenegger has embraced the idea of adding hundreds of new school clinics but would likely not make a formal proposal and flesh out details of the plan until next year, if he is reelected.

Health and social services have been offered at some California schools since the 1990s through the Healthy Start program, though in recent years the state has cut back sharply on those grants. The state does not keep track of how much the existing 140 school clinics cost taxpayers. Administration officials said it would be impossible to estimate the cost of an additional 500, because expenses would vary by clinic.

But there are clues. Santa Clara County operates six school-based clinics at a cost of $2 million a year, 17% of that from government grants. Most of the funding comes from health foundations and fees charged at the clinics.

New York, which has the most school clinics of any state, operates 187 at an annual cost of $23 million in public funds plus the salaries of four state employees.

Administration officials envision a variety of funding sources for the clinics: federal money, grants from healthcare foundations or hospitals, support from HMOs and other managed care companies, state general fund money, state mental health funds, available bond money, and other government programs such as Healthy Families.

Existing school clinics in California serve more than 250,000 students -- out of about 6 million attending public schools. Officials broke ground last month on an 11,000-square-foot clinic at Sun Valley Middle School in the San Fernando Valley. The $7.3-million facility is a joint effort by Los Angeles County, the L.A. Unified School District, the UCLA Geffen School of Medicine and the Northwest Valley Health Corp.

Experts said clinics in schools can be extremely helpful in communities where many children lack health insurance.

“There are clearly children that don’t have access at all,” said Michael Cousineau, director of the division of community health at the USC Keck School of Medicine. “This is a source of care they wouldn’t get anywhere.”

But the idea has been controversial. Schwarzenegger’s plan could put him at odds with some fellow Republicans. Religious conservatives, in particular, have opposed school clinics as a potential source of birth control for teenagers.

Some opponents consider updated textbooks an equally good, or better, use of public money, especially as educators face such challenges as high dropout rates and unwieldy class sizes. A better use of funds, those critics say, might be programs to provide referrals to clinics that offer comprehensive medical care.

A separate proposal to expand school health clinics is circulating in the Legislature. Assemblyman Mark Ridley- Thomas (D-Los Angeles) is offering AB 2560, which would create a statewide office on school clinics, a sort of clearinghouse for information. The bill has been approved by the Assembly and is awaiting action in the Senate.

Ridley-Thomas said he welcomed the governor’s interest in school clinics.

“There is an abundance of data that support the claim that healthy students are more likely to perform effectively than those who are unhealthy or sickly,” he said. “Teachers want their students to be vibrant.”

The subject at today’s conference at UCLA will be affordability. The governor views cost-cutting in the medical industry as generally the best way to expand health insurance programs and access to care. Costs have spiraled for prescription drugs, hospital operations, medical recordkeeping and other services.

Californians “can talk all we want about insuring more people,” Schwarzenegger said Friday. But “there are some people that just can’t afford healthcare. So, really, bring the costs down and become more innovative and more creative is how we go about it.”

Supporters of Angelides said they planned to protest outside today’s event. They said they question the governor’s sincerity and his ability to implement any plan, given his spotty record on other proposals.

Inside, the day will be dominated by healthcare businesses and hospitals, many of them donors to Schwarzenegger’s campaign. John Cogan, a fellow at the Hoover Institute who has been an advisor to Schwarzenegger and President Bush on economic and budget matters, will address the conference.

Andy Stern, president of the Service Employees International Union, said he would also speak. Stern has been an outspoken advocate of replacing the current employer-based healthcare system with universal coverage.

The national presidents of unions representing carpenters and farmworkers will participate as well.

Rose Ann DeMoro, executive director of the California Nurses Assn. and a staunch opponent of the governor, criticized labor leaders who plan to participate.

“They shouldn’t allow themselves to be used by Arnold on this because it is a disgrace and it is a political maneuver,” she said. “This is a political stunt.”

Times staff writer Rong-Gong Lin II contributed to this report.