Health services seen lacking

By Shari Rudavsky, Globe Correspondent, 8/17/2003

As nursing supervisor for the Waltham public schools, Marie DeSisto says parents often tell her that a single statistic drew them to the city: the high ratio of school nurses to students.

While budget cuts have led to school health service reductions in many districts, Waltham parents have lobbied hard and persuaded local officials to keep at least one nurse assigned to each school, said DeSisto, president-elect of the Massachusetts School Nurse Organization.

Statewide, many families are not so lucky, the group's leaders say. ``We're not where we should be or where we want to'' be, said Marcia Buckminster, the organization's past president. ``Our goal would be to have at least one full-time school nurse for every school in Massachusetts.''

A national study suggests most parents agree. More than 80 percent of parents polled say they want health services in their children's schools, the survey by the Center for Health and Health Care at George Washington University reported this month.

``We don't want our kids in school all day with no one on site who knows how to take care of them,'' said Julia Lear, the center's director.

Less than half of the nation's schools have a full-time nurse, Lear said. Budget cuts also have forced many school-based health centers, which are primary-care clinics located at a school, to close or reduce their hours, she said.

The only justification for sacrificing school health services that a majority of parents accepted was ``more important priorities'' in education, the survey found. But 43 percent of parents surveyed said they did not find this a very convincing argument.

For parents like Anna Diaz of Lynn, whose young son Christopher has asthma, few issues are more important than children's health. Because the school where he attended kindergarten last year had a nurse just one day a week, Diaz said she opted to stay home from work whenever Christopher felt he might be developing an asthma attack.

``It hasn't been easy,'' she said.

About 42 percent of state schoolchildren require medical care during school hours, Buckminster said. Their needs range from taking medication to attending classes with a feeding tube in their stomach.

But Lear noted it is not only children with preexisting conditions who can require medical attention. Healthy students can suffer accidents and need the assistance of a trained professional, she said.

``It isn't just one kid per school or five. It's not just children in special education. In some ways it's everybody's child,'' Lear said.

Many parents agree. Almost all, or 96 percent, of the more than 1,100 parents surveyed said it is important for schools to provide emergency care. Nine out of 10 said it is important for schools to help children with chronic illnesses.

``This validates how important school health services are to children's well-being,'' said Janis Hootman, president of the National Association of School Nurses. ``We would hope that schools can use this information in their very difficult decision-making in the future.''

Last year, 71 Massachusetts school-based health centers received funding. This year, some of those will not open and those that will have funding guaranteed for only half the year, said Rita Olans, president of the Massachusetts Coalition of School-Based Health Centers. Such centers do not substitute for a nurse on site, but complement the services that a nurse offers, she said. About 1,500 such centers exist at schools across the country.

In Lynn, eight school-based health centers served more than 2,400 public school students last fall. This fall only six will open, said Liliana Silva, administrative director for Lynn Community Health Center's school-based health center program.

``This really is one of the most effective ways to provide health care for kids who are underserved and underinsured,'' Silva said. ``That's where they are - in the schools.''

Knowing that her son had such a center in his Lynn elementary school originally helped ease Denise Brown 's fears last year. When her son Daquan Abernathy, then in third grade, had an asthma attack, he went straight to the school health center.

But in February the center closed. A nurse is still on site, but that offers little solace to Brown. ``The center made me feel 100 percent comfortable,'' she said. ``There's a school nurse there but it's not the same because if she feels he's wheezing, she'll send him home.''