Children without health insurance lose out on learning at school

Andi Devine, a registered nurse practitioner since 1972, gives medical attention to a Palm Beach Lakes High School senior at the school's clinic.
Andi Devine, a registered nurse practitioner since 1972, gives medical attention to a Palm Beach Lakes High School senior at the school's clinic. Tom Ervin / MCT

WASHINGTON — While Congress and President Bush squabble over health insurance for low-income children, school officials nationwide are scrambling each day to find affordable medical care so that sick and needy students can continue to learn.

Growing numbers of uninsured children have made it harder for educators to focus on classroom achievement without first addressing the medical needs of their students who lack health insurance or dental coverage.

Instead of notifying parents when their children are ill, school officials increasingly must help find health care, arrange transportation for sick children and often advise beleaguered parents about the health consequences of their inaction.

Schools that don't accept the extra responsibility can lose those students to prolonged absences that jeopardize their academic advancement.

In the nation's capital, school psychologist Chandrai Jackson-Saunders got a psychiatrist to provide free Ritalin to a fourth-grade boy with Attention Deficit Hyperactivity Disorder (ADHD). The boy had become a behavioral problem and missed more than 50 days of school when he could no longer get the drug after his mother's insurance expired.

In New Prairie, Wis., school social workers got the local Lions Club to provide corrective eyewear for a nearsighted fifth-grader whose parents had no insurance. Nancy Wells, a former school nurse in Dover, N.H., once got her own dentist to perform a free root canal on an uninsured student with an infected, abscessed tooth.

And in West Palm Beach, Fla., high school principal Nathan Collins persuaded the local school board to help fund a full-time, school-based health clinic because so many of his uninsured students were missing school because they couldn't get medical care.

"Now a kid can come in with a headache and we can give them the medicine they need, and they go back to class instead of going home or going somewhere to lay down. We think that's really going to make a difference," Collins said.

Experts say these unorthodox and sometimes desperate responses have become routine in school districts across the country as health care grows more unaffordable for working parents.

The number of uninsured children age 18 and younger grew by 710,000 to a total of 9.4 million in 2006, according to new research by the Urban Institute. Seventy percent of these newly uninsured children came from families earning more than twice the federal poverty level — that's $41,300 for a family of four.

More than 3 million of these uninsured youngsters would get full health insurance under legislation Congress passed to renew and expand the State Children's Health Insurance Program by $35 billion over five years. About 6.6 million children are now covered under the program.

But after watching President Bush twice veto the legislation, citing cost and programmatic concerns, many school officials say the president has misplaced priorities.

"To me, this looks like educational neglect on the part of the government," said Jackson-Saunders. "'No child left behind.' 'Poor children first.' We've had it up to here with these (slogans). We as a country want things, but we don't want to support what it takes to make it happen. It's a very disheartening situation."

While the SCHIP program was designed to cover children in families that earn less than twice the poverty level, the new legislation would allow states to cover children from families earning up to three times the poverty level, or $61,950 for a family of four.

Wells, who's now a school health supervisor for the Department of Health in Manchester, N.H., said she'd like Bush and lawmakers who oppose the bill to visit a school health clinic themselves.

"These kids don't walk in with colds and scrapes anymore," Wells said. "They walk in with pneumonia and other communicable diseases. It's hard to realize how difficult it is for them not to have the appropriate care. You have to see sick kids to understand what it's like."

When an uninsured student at Palm Beach Lakes High School in West Palm Beach, Fla., passed out last year, Principal Collins ended up driving the youngster home because his mother couldn't afford an ambulance ride to the doctor.

Once at the boy's home, Collins learned that the child's father had similar fainting spells that had never been properly diagnosed.

"That just made me more aware of the problem we had," Collins said. "When our kids get sick, they'd go home, not get treated and they wouldn't come back to school for two or three days. And if they're not in school, that's academic suicide."

After asking the school board for a full-time clinic at the school, officials financed a $400,000 office renovation to make it happen. With board help, the state health department agreed to fund the clinic staff, which includes a licensed social worker, a medical assistant, a staff assistant and a registered nurse practitioner, Andi Devine.

Unlike most school nurses, Devine can write prescriptions, diagnose medical conditions and make referrals, if necessary. More than 420 parents have given consent to have their youngsters treated there.

Glenn Schmidt, a special-education teacher at Northside Elementary School in New Prairie, Wis., said it took school social workers nearly three months to get an eye exam and glasses for an uninsured nearsighted boy who was having trouble seeing the blackboard.

After the local Lions Club paid for the glasses, Schmidt said the boy's attitude improved as much as his vision. "It wasn't so frustrating for him any longer to walk into the classroom and know right away that he was walking into a failure situation. He was very proud of his glasses."

But over time, the glasses took a beating and the boy needed a new pair by the end of the year. So Schmidt called the social worker at the middle school that the boy would attend next year to get the same process rolling again.

In the world's richest nation, needy children shouldn't have to wait months for corrective eyewear from a charitable organization, Schmidt said.

"These are children who have not been favored by nature or by economics or by great family situations, and it's one more instance where their needs are not being met," Schmidt said.

That's why Schmidt and other educators came to Washington recently to urge Bush to stop vetoing the SCHIP legislation.

"I think the president should take into account the needs of these children," Schmidt said. "This is something he can do to help them if he chooses."