THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Sunday, April 23, 1995 TAG: 9504220097
SECTION: PORTSMOUTH CURRENTS PAGE: 04 EDITION: FINAL
TYPE: Cover Story
SOURCE: BY VANEE VINES, STAFF WRITER
LENGTH: Long : 152 lines
THE SUNSHINE Health Center - with its sparkling white walls and aqua trim - is a sharp contrast to the run-down weight and locker rooms that preceded it.
The center, based at Hunt-Mapp Middle School, is now ready to serve its first student patients.
Organizers say it will provide important services for city schoolchildren who would otherwise go without medical care. And they point out that a healthy child is more likely to do well in school.
``We won't be the main place children should go, the `medical home' in other words, but we will help those who otherwise wouldn't receive anything at all,'' said Phyllis F. Bricker, the school district's medical services supervisor.
The center, a venture between the district and the Portsmouth Health Department, will teach students how to take better care of themselves and offer what's known as primary care: screenings, treatment for simple illnesses and injuries, sports physicals, immunizations and mental health counseling.
Students who need other types of care may be referred to city agencies in the center's network, Bricker said. Unlike some school clinics, the Sunshine center doesn't provide any reproductive health services.
Parents must sign a consent form and pay a one-time, $5 registration fee. Costs are based on family income and size. Consent forms will be distributed this week.
In addition to Bricker, the clinic staff includes Dr. William G. Lowell and pediatric nurse practitioner Anita Wall. A clerk will soon be hired and officials also hope to bring an ``outreach'' worker on board to link the center with students, parents, school officials and other community organizations.
Most of the clinic's equipment, and at least $48,000 for first-year operating costs, was donated by charitable groups and local hospitals.
A nearly $200,000 state grant covering last school year and this school year gave birth to the center. Like most in the nation, it plans to exist on foundation money and revenue from fees. School clinics also can bill health insurance networks for some services they provide.
Dr. Venita Newby-Owens, director of the city Health Department and a member of the center's advisory board, has long pushed for the creation of a school-based clinic.
Adolescents, especially those from low-income families, are a medically underserved population. Primary care in a secondary school makes sense, she said, explaining that school clinics are convenient for parents and students alike.
``We've also found problems with the accessibility of health care services for children in Portsmouth, particularly with regard to those from low-income backgrounds.''
About 60 percent of city students are poor enough to qualify for free- or reduced-price lunch.
In 1990, Newby-Owens said, the Mayor's Health Services Advisory Committee found that less than half of the city's primary care physicians accepted Medicaid, a federal and state program that helps cover health costs for low-income families with children.
Many working-class parents can't afford higher insurance premiums for health coverage that includes their kids. They often turn to emergency rooms for treatment.
The need is undeniable, said the Rev. Leon J. Boone, a member of the center's advisory board.
``When people have to make choices between, say, food and medical care, sometimes the needs we have as human beings will cause us to reach for food instead of a prescription,'' he said. ``We want to get our kids healthy so they can perform better in school and grow up appreciating the importance of healthy living.''
``I think it's a good idea,'' said 15-year-old Matthew Baker, an I.C. Norcom sophomore. ``I think there would be more people to work with you.''
National studies show that, as a group, those between the ages of 10 and 19 are most likely to lack health insurance. They also make the fewest visits to a doctor although an estimated one in five teenagers has at least one serious health problem, such as heart disease.
Communities are turning to clinics in or near public schools as a way of bringing needed primary care to a captive audience.
There are now about 600 school-based clinics across the country, according to Making the Grade, a Washington-based program that tracks them. Since 1992-93, Virginia has earmarked $1.5 million annually for grants aimed at helping school districts and community agencies start health services programs.
Norfolk's student clinic at Lake Taylor High opened in 1987. Chesapeake will soon open a mobile health clinic for students in that city.
The traditional school nurse's office at Hunt-Mapp will remain intact. But for many children, simply having a school nurse available hasn't been enough, experts say.
``What most school nurses are able to do is identify where further diagnosis and treatment probably needs to occur,'' said John Schlitt, Making the Grade's associate director. The assumption is that kids will get adequate primary care outside school.
That's not always the case, he said, especially among those with limited access to medical care, little knowledge of how to tap community resources or little support to make sure medical advice is followed.
``The primary care clinics expand the care and the range of services that can be delivered,'' Schlitt said.
School clinics mushroomed in the 1980s, when the child-poverty rate jumped dramatically.
The nation's first school clinic opened in the mid-1960s for preschool and elementary students in Cambridge, Mass. The first secondary school clinic opened in 1972 in Dallas.
In some areas, school clinics have been controversial because opponents said their offerings promoted teenage sexuality.
Critics fought the Lake Taylor clinic's opening because it provides birth-control prescriptions, for example. Portsmouth officials backed away from such offerings.
``The focus is...just basic, routine health care,'' Newby-Owens said.
But helping students with their emotional problems will be equally important, Dr. Lowell said.
The middle school years in particular are often most difficult for youngsters as they deal with puberty; grapple with issues like drug abuse and violence; and struggle to fit in. School-based clinics aren't a cure-all, Schlitt said, but they can help students stay on track. MEMO: [For a related story, see page 4 of the Currents for this date.]
ILLUSTRATION: [Cover]
STITCHING UP THE HEALTH CARE GAP
Staff photo by MARK MITCHELL
The sign in the reception area of Sunshine Health Center stresses
its goal: healthy children.
Staff photos by MARK MITCHELL
Phyllis F. Bricker, right, school district medical services
supervisor, and pediatric nurse practitioner Anita Wall will work at
the center.
SUNSHINE HEALTH CENTER
Location: Hunt-Mapp Middle School, 3701 Willett Drive.
Number: 393-5412
Hours: Open 8 a.m. to 4 p.m. Monday through Friday. The center
will have limited summer hours.
What's offered: The center will teach students how to take better
care of themselves and offer them what's known as primary care:
screenings, treatment for simple illnesses and injuries, sports
physicals, immunizations and mental health counseling, for example.
Cost: A one-time, $5 registration fee. Fees for services are
based on a sliding scale. Call for details about Medicaid billing.
Getting started: A parent or legal guardian must sign a consent
form for students to receive treatment. Still, school officials will
call parents before offering any treatment - on every occasion.
Who can use it: The center is for students at Hunt-Mapp Middle
School, as well as other city schoolchildren who are referred by a
school nurse. A parent can refer his or her child directly.
by CNB