Budget ills befall full-service schools
By MELANIE AVE, Times Staff Writer
TAMPA -- The skinny boy with a rattling cough slumped over the table after telling the kindly nurse he didn't feel so well.
The 9-year-old boy had been sick for days, was struggling to make it through the morning and was now inside the clinic at Oak Park Elementary, hoping the woman in white would deliver him from sickness.
"You've been out all week," prodded registered nurse Kay Behen, after finding his temperature to be normal. "Don't you want to try and make it today?"
But the coughing boy sank deeper into his big plaid shirt, shaking his head.
With his lack of words as an indicator, the boy was sent home to get well. On this day inside the classroom-turned-clinic, he was just one of the dozens of young patients who trotted through the clinic, a steady stream of the sick and the "I think I'm sick."
By 11 a.m. Behen had seen a 7-year-old girl with head lice, a vomiting kindergartener and a 6-year-old with a bumped head.
That's not to mention the three routine eye exams, two upset stomachs, a loose tooth, a skin rash and a headache. And the four students who had come to take their prescribed medicines.
At the end of the day, 21 students had visited the clinic.
"Actually," Behen said, "it's kind of slow today."
Here at Oak Park Elementary in East Tampa, where the majority of students get free lunches because of low family incomes, children can see nurses as well as psychologists and social workers through a special state program known as full-service schools.
Full-service schools such as Oak Park are found in all districts across Florida. The goal: to bring health care and social services to at-risk children and their families and free some of the obstacles to learning.
But legislators whittled $1.5-million from the $11-million Department of Health program during a November special session because of a revenue shortfall. More cuts are expected next year.
The cuts are playing out in different ways depending on the district, though many have yet to determine where to make reductions. Layoffs are planned in some counties. Others have delayed filling vacancies.
But most everyone agrees who will suffer the most.
"Social workers may lose their jobs, and that's unfortunate," said Donna Sicilian, Pinellas County's supervisor for school social work and full-service schools. "These are bright people. They'll find another job.
"It's the children in the end who are really going to take the brunt of this."
Marilyn Koop, supervisor of student health services for Pasco County, said less money equals fewer nurses and that means "fewer families and children who will be able to avail themselves of medical services."
Without the school-based services, many students "would go without medical care or delay medical care," Koop said. "If families don't have that, they often show up in emergency rooms."
School districts are able to tailor their full-service schools depending on the needs of the children. Some schools only offer nurses. Others offer a full range of services, including family counseling, adult education and tutoring.
Some of the sites, such as Just and Kimbell in Hillsborough, house government and nonprofit agencies so low-income parents can receive services for their children at one location.
In Pasco, full-service funding pays for a nurse practitioner who splits her time between eight schools and doctor and dentist visits for needy children.
Pinellas has 10 full-service sites, including a clinic at Northeast High School and a countywide truancy program. The funding also pays for six social workers and six nurses.
Hillsborough has eight nursing positions and services at 10 sites such as Oak Park.
Kenneth Gaughan, Hillsborough's director of supportive services, said the schools are one-stop centers and keys to the success of the children.
In any given month, an average of 5,500 children visit the various clinics just to see nurses.
"It's to our benefit to have children be healthy," Gaughan said. "This just makes it real easy to keep kids in school."
Yet schools struggle to provide for the needs of all the children, Sicilian said. She said lawmakers need to add money to the program, not take it away, especially when considering the key role health care and social services play in a child's academic performance.
"If you have a child in school whose physical needs are not being met, who's been abused, is malnourished or not feeling well, then it doesn't matter how well the district does at math and reading," she said. "These kids are not going to be able to sit down and do well on a test."
Back at Oak Park, a 6-year-old reclined on a blue sofa with an ice pack hugging her head after tripping on a chair in class. She rested for about 30 minutes before the nurse sent her back to class.
When nurses are in the schools, most children are examined and found to be well enough to return to the classroom, said Sandra Gallogly, a Hillsborough school health official. But without nurses, about half are sent home.
Nurse Behen said she tries to keep the children healthy so they can stay in school and learn. But sometimes, that is impossible.
For two hours on this day, Behen ran through a list of numbers trying to locate the parents of a girl with head lice.
The girl had been diagnosed with lice two days earlier and sent home with a medicated shampoo. But Behen said she returned to school with lice, saying she hadn't used the shampoo and wasn't sure why.
"It's a whole other world," Behen said, explaining how many of the children don't have phones or how they live with distant relatives. "I had one family that lived in a car. They're worried about where their next meal is coming from. Head lice is on the back burner."
One school official eventually went to the girl's home before her father came to pick her up.
Throughout the medical crises of the day, Behen said, she worried about how the funding cuts would affect the care the district provides.
"It's going to do a lot of harm," she said. "There's definitely a need here. We're the only medical care some of these kids come into contact with."
Just before noon, Behen was confronted with yet another ailment.
"What's up?" she said, bending to talk to her newest patient, a girl rubbing her stomach.
"She's got a belly ache," a friend of the sickly girl said.
And it was back to work for Behen, with no time to worry about things like funding cuts.
-- Melanie Ave can be reached at (813) 226-3400 or firstname.lastname@example.org.
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