Wanted: school health clinic 

Coalition seeks private money for what was once a public priority.

SCHWARZ: Seeking clinic help.
  • SCHWARZ: Seeking clinic help.

The Little Rock School District had 49 pregnant teen-agers enrolled when the 2005-2006 school year opened in August.

Ten of them were at Central High School, and nine of those were African-American girls.

There are 278 teens with asthma, 10 with seizure disorders, five with diabetes, five with hypertension and five with peanut allergies at Central.

One in three Central High students, the largest school in the district with 2,400 students, is overweight. One in three Central High School students does not have health insurance. Those students are likely to use an emergency room when they’re sick. Kids whose parents have insurance but work low-wage jobs may find it difficult to take time off to get their kids to the doctor.

A coalition of health care providers and Little Rock School District personnel have added up those numbers, and come to the conclusion that there is a clear need for a school-based health clinic at Central — like those that operated in 20 public schools across the state prior to 2001.

That was the year Fay Boozman, Health Department director at the time, closed the clinics to help make up the department’s nearly $7 million budget shortfall. Though the decision was met with dismay in the affected regions of the state — even Boozman’s native Northwest Arkansas — it was an easy one for the conservative appointee of a conservative governor to make: Some of the clinics distributed condoms to their teen clients.

The Community Health Partnership is “one of the most extraordinary coalitions in Arkansas,” Planned Parenthood vice president of community affairs Marvin Schwartz said. Besides Planned Parenthood, members include the Little Rock School District; the state department of Health and Human Services; Arkansas Children’s Hospital’s Adolescent Clinic; the state College of Public Health and the University of Arkansas for Medical Sciences’ pediatrics and OB/GYN departments; La Casa (a southwest Little Rock health service for Hispanic residents); SIECUS, the Sexuality Information and Education Councils of the United States, and the Arkansas Community Foundation. The Community Foundation’s role is to be the recipient of grant funds.

The CHP (which members call “chip”) coalition formed in 2004 to reduce teen pregnancy and sexually transmitted infections. CHP oversees an unwed-birth prevention program in various schools and communities under a grant from the state Department of Health. It’s one of the few programs the department funds that is not strictly abstinence-based.

CHP is now seeking private funding to staff a student health clinic to deliver primary health care, including mental health, and serve as a model for school districts in the rest of the state. A nurse practitioner and licensed social workers would be added to current staff; uncompensated operating costs are estimated at $150,000, Schwartz said.

“The entire Little Rock School District is 100 percent behind this,” Schwartz said.

Nancy Rousseau, Central’s principal, said the state’s decision to dismantle its clinics left the school “with a huge void.”

“Our job is to deal with the whole child. If the child is not well, he cannot be successful academically. We’re kidding ourselves if we say the only thing we’re supposed to focus on is academics.”

When health professionals are on campus and part of the school culture, children feel more comfortable taking their problems to them, rather than an anonymous person at the Health Department. It’s because of that comfort level, Rousseau said, that when a student having problems with drugs and alcohol needed help in the middle of the night, her parents called Rousseau. By midnight, Rousseau said, she and the school social worker got the girl into a substance abuse facility.

Afterward, “her dad built an extra room for us down there” in the clinic because he was so appreciative for the emergency help.

“As big as we are, there’s a really strong link between school community and our school,” Rousseau said. “We really miss that link.”

Now, Central’s Wellness Center is staffed by a social worker and a secretary; it relies on volunteers to offer group counseling on stress management, drug abuse and depression. Two school nurses perform the requisite hearing, eye and scoliosis tests and provide minimal episodic care for kids who get sick during the day with minor ailments like sore throats.

Margo Bushmiaer, coordinator of student health for the school district, who keeps track of student health data, sees a huge need for a clinic, whether to treat chronic diseases, offer nutrition advice or treat an STD like chlamydia, currently at epidemic numbers.

A clinic would allow them to get the care they need when they need it and not have to leave school or go untreated. Many students “have nowhere to go,” Bushmiaer said.

When the clinic operated at Central, half the students used it for mental health care, and many had accompanying problems such as drug or alcohol abuse.

Addressing asthma is important because the illness keeps more kids out of school than any other ailment — and an Arkansas Children’s Hospital study that said those who care for kids with asthma need at least 18 hours of education to manage the disease, Bushmiaer noted. When a child’s asthma isn’t fully managed at home, he or she would be well served by access to a health professional’s care during the school day.

CHP was turned down recently by Blue and You, a foundation operated by Blue Cross Blue Shield, for a much-hoped-for grant to start Central’s model clinic. (Blue and You has awarded grants for obesity, prenatal access and children’s health care programs around the state, including a $107,510 award it made recently to the Arkansas Education Television Network for its “Fighting Fat” programming.)

Rousseau was keenly disappointed. “I think that our children are our future and it surprises me the decision was made to exclude this opportunity for our kids,” she said.

Schwartz said the coalition hopes community support will reach the “critical mass” needed to get the attention of would-be funders, public and private.

“Our mantra,” he said, is “healthy students are better learners.”



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