The L.A. Trust joins allies and providers marking school-based healthcare month

L.A. County leads the state in school-based health centers, providing critical care during the coronavirus crisis.

The Los Angeles Trust for Children’s Health is joining healthcare providers, educators, allies, students and community members in celebrating National School-Based Healthcare Awareness Month in February.

Tracy Mendez, executive director of the California School-Based Health Alliance, stressed the impact of school-based health centers (SBHCs) during COVID-19, as students and communities face pandemic stressors, including isolation and anxiety.

“Our SBHCs and Wellness Centers are more critical than ever,” said Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health. “Supporting these centers has been a core part of our mission since our founding, and it’s important we redouble our efforts during this incredibly challenging time.”

There are 75 SBHCs in Los Angeles County serving schools with more than 83,000 students, more school-based clinics than any other California county. The total includes 17 Wellness Centers, with three more on the way. “Since the first Wellness Center opened in 2012, more than 550,000 patient visits have taken place, a key accomplishment for the consortium of organizations for which The L.A. Trust serves as the backbone,” Puffer said.

Stepping up

“During the pandemic, school-based health centers are stepping up to provide students with behavioral health services via telehealth, and they continue to provide immunizations for students,” Mendez said. “School-based health centers have always provided healthcare access to students who would otherwise go without, but now the need is so much greater.”

There are 17 Wellness Centers serving Los Angeles Unified’s under-resourced communities and dozens of other school-based healthcare facilities operated directly by the district. Wellness Centers serve Belmont High School, Carson High School, Crenshaw High School, Elizabeth Learning Center, Fremont High School, Gage Middle School, Garfield High School, Hollywood High School, Jefferson High School, Jordan High School, Locke Early Education Center, Maclay Middle School, Manual Arts High School, Maywood Center for Enriched Studies, James Monroe High School, Santee Education Complex, and Washington Prep High School. All but Hollywood High are operated by Federally Qualified Health Centers.

Advocacy is key

“School-based health providers have performed heroic work to keep students connected to care during this pandemic,” Mendez said. “This is a month to advocate for the funds, personnel, equipment and vaccines our school-based health clinics need to serve their students and families. We are pleased that the Governor, state legislators, and state departments of health and education are recognizing the critical value of school health services and have endorsed plans to invest much more in them.”

Puffer quoted Dr. Martin Luther King, Jr. who said, “Of all the forms of inequality, injustice in health is the most shocking and the most inhuman.” She said, “School-based health is the path to greater health equality and we cannot let down our kids and teens in the hour of their greatest need.”

The L.A. Trust and Mark Ridley-Thomas protect Wellness Centers with PPE

Maryjane Puffer of The L.A. Trust distributes protective masks to Dr. Anitha L. Mullangi, MD, MHCM, chief medical officer of St. John’s Well Child and Family Centers.

The L.A. Trust and Los Angeles County Supervisor Mark Ridley-Thomas have joined forces to distribute 5,000 N95 protective masks to frontline workers at L.A. Unified Wellness Centers in the 2nd Supervisorial District. Ridley-Thomas will join the L.A. City Council next year.

A total of 1,300 masks were distributed by Ridley-Thomas to the mobile clinic at Susan Miller Dorsey Senior High operated by T.H.E. (To Help Everyone) as part of a socially distanced get-together November 2.

Maryjane Puffer, executive director of The L.A. Trust, has taken personal charge of distributing the remainder of the critically important personal protective equipment, stopping at South Central Family Health Center at Jefferson High School and then at St. John’s Well Child and Family Center, where she was met by Dr. Anitha L. Mullangi, MD, MHCM, the group’s chief medical officer.

“We take care of our providers”

Supervisor Mark Ridley-Thomas said, “School-based health centers are culturally sensitive, safe and accessible places where high-quality care is being provided to students and families, oftentimes in areas that have historically suffered from inadequate access to quality care. The pandemic has only exacerbated health disparities and made the need for these services more profound.”

He added that “youth are not immune to this virus and we also know that this pandemic has created serious mental health impacts for youth that require attention. We can’t grow complacent about making sure that the providers in these settings continue to be equipped for the job,” he said. “We take care of our providers, so they can take care of our communities.”

Puffer agreed. “It is critical that we protect our frontline heroes right now. I want to thank our Wellness Center staff for fighting this pandemic in our communities, and I want to salute Supervisor Ridley-Thomas and his team for backing them up with this protective equipment and support.”

Data xChange report shows growth of Wellness Centers

The L.A. Trust Data xChange has issued a new report showing the impact of L.A. Unified’s Wellness Centers since 2015.  

The Los Angeles Trust for Children’s Health has released a new Data xChange report demonstrating the widespread impact of L.A. Unified’s 16 full-service Wellness Centers on students, families and community members in the District’s highest-need areas. 

According to the Data xChange report, 11 school-based Wellness Centers reported more than 229,000 visits from 86,000 patients in the past five years. Visits grew 143% in the past half decade and patients averaged 2.7 visits per year, demonstrating “a strong bond between clinics and patients.”  

The statistics in the Wellness Center 5-Year Impact Report were produced by The L.A. Trust’s Data xChange, which is designed to measure the impact of Wellness Center investments, improve the allocation of health resources and connect the dots between student health and academic achievement. 

Vital services 

Quality healthcare is essential to student success, the report noted. The L.A. Trust supports these clinics by offering best practices, prevention education programs, learning collaboratives and other vital infrastructure. In addition, it has independently raised more than $1.5 million to create the Data xChange, which The L.A. Trust views as key to the future of school-based health in Los Angeles and throughout the nation. 

Common student services include Well Child Exams, contraceptive management, weight and obesity management, immunization and vaccines, sexually transmitted infection testing and management, and mental health and substance use services. 

Because students are only as healthy as the communities they live in, Wellness Centers treat family and community members, too. Community members are more likely to be treated for chronic conditions such as diabetes and hypertension. 

There are currently 16 LAUSD Wellness Center clinics with two more on the way. They bring high-quality medical services into traditionally underserved communities, provide culturally competent care and reduce transportation burdens by putting the clinics on school campuses. (Most of the clinics have a street-facing door to admit community members and a school-facing door to admit students.) 

COVID-19 response 

The coronavirus pandemic has hit Los Angeles hard, especially predominantly Black and Latinx communities served by the Wellness Centers, the report stated. Six Wellness Centers have remained open during the height of the school lockdown and received more than 12,000 visits between March and June of this year. 

“As many of our Wellness Centers pivot toward telehealth and incorporate more specific coding practices related to COVID-19, The L.A. Trust Data xChange will stay in step with them by working to create new reports and insights,” the impact report affirmed.  

The Data xChange is guided by an Expert Advisory Council that includes: Manal Aboelata, The Prevention Institute; Mayra Alvarez, The Children’s Health Partnership; Grace Kim Crofton, L.A. Care Health Plan; Rebecca Dudovitz, UCLA; Pia Escudero, LAUSD Student Health and Human Services; Mehrnaz Davoudi, Kaiser Permanente; Art Garcia, First 5 Los Angeles; Will Grice, Kaiser Permanente and board president of The L.A. Trust; Lyndee Knox, PatientToc; Hayley Love; James Kyle, L.A. Care Health Plan; Anitha Mullangi, St. John’s Well Child and Family Health Center; Kevon Tucker-Seeley, LAUSD Office of Data and Accountability; Mollie Rudnick, LAUSD Chief Strategy Office; Nina Vaccaro, Community Clinic Association of Los Angeles County; Ron Tanimura, LAUSD Student Medical Services; Kimberly Uyeda; and Lynn Yonekura, L.A. Best Babies Network

Q&A with Jim Mangia: “South L.A. has been hit hard by COVID”

Jim Mangia is president and CEO of St. John’s Well Child & Family Center, operator of Wellness Centers at Lincoln, Manual Arts and Washington Prep, all of which have remained open during the COVID-19 pandemic.  

Maryjane Puffer is executive director of The Los Angeles Trust for Children’s Health and has led the organization since 2009. The former pediatric nurse is a recognized expert in student health programs and community outreach.  

Question from Maryjane Puffer: COVID-19 has been especially devastating to communities served by the Wellness Network. Can you describe the impact of COVID-19 on the communities you serve? 

Answer from Jim Mangia: The South Los Angeles community has been hit hard by the COVID pandemic in so many ways. We have the highest rates of COVID cases in the county. Some days over the summer, 30% of the people who came in to be tested were infected with COVID. Frontline workers, essential workers, factory workers were called back to work in June and July, were not given masks and protective gear and got infected at work. They brought it home to their families. And then the employers wouldn’t let them back to work until they showed a negative test result, which could take months. In addition to being sick, or seeing loved ones die, people lost their homes, their jobs.  It was devastating.

Q. How has COVID and the school and economic shutdown impacted your three Wellness Centers? Are you still seeing a lot of students or are you seeing greater numbers of community members? 

A. People still need healthcare. And since we’re offering free COVID testing for students and their families, our Wellness Centers have been extremely busy. We erected sterilized isolation tents at all of our sites to reduce the possibility of infection during the COVID test. We’ve had no cross-infection at any of our clinic sites or Wellness Centers because of the rigorous protocols we put into place. But we’re seeing more patients than we were before the pandemic hit, because in addition to people needing their diabetes medicine or their hypertensive care, tens of thousands of people depended on St. John’s for their COVID testing.

Q. What services are you offering to students and community members? Have you noted a change?

A. We’re continuing to offer the full range of medical, dental and behavioral health services to students, their families and the community at large, in addition to COVID testing, triage and follow-up care. We have added telehealth services so we can better triage patients with symptoms. If a patient tests positive for COVID, our doctors can call them every day and monitor their symptoms. If their symptoms start to worsen, we can get them into a hospital immediately. We know that once symptoms occur, the sooner you get to a hospital, the better chance you have for survival. We’ve saved hundreds of lives through the telehealth monitoring we’ve been doing, in addition to the testing and regular primary care services that have continued.

Q. Are people foregoing treatment they should otherwise be getting?

A. Initially yes. About one-third of our patients were foregoing treatment and cancelling appointments. We were able to provide telehealth to them and have medicine delivered to their homes, which allowed our doctors to stay on top of their health status and health conditions. Our screening protocols are so rigorous, and the fact that we have two isolation tents at every site also made patients feel more secure coming in for their visits. Now our cancellation rate is under 5%, so patients are feeling safe and keeping their visits. We take every patient’s temperature before they enter the clinic and ask a set of screening questions.  If they answer yes to any questions or have fever, they are sent to the isolation tent for their visit, where we also administer a COVID test.

Q. How has student and community mental health been impacted by COVID? What can be done about it?

A. We’re seeing a significant increase in depression and anxiety disorders as a result of the pandemic. It’s most acute with patients who have lost a loved one to COVID, but there is widespread stress, anxiety and depression as a result of the pandemic. Many residents have lost their jobs. Many have lost loved ones. Many have been sick. The pandemic is having a direct and significant impact on the mental health of the South Los Angeles community.

Q. What is the most important thing students and community members should know about your services right now?

A. That we are open to serve them and can provide whatever health services they need — medical, dental, behavioral health, in addition to COVID testing and triage. We are also participating in a clinical trial with UCLA to provide a very effective and free COVID treatment to patients who have symptoms and are infected.

Join California School-Based Health Conference online October 6-8

Staff from L.A. Unified Wellness Centers can register for the CSHA virtual California School-Based Health Conference free of charge.

The California School-Based Health Alliance’s Statewide School-Based Health Conference will take place online October 6-8 this year, and all student healthcare providers and supporters are invited to join The L.A. Trust in attending. This year’s theme is “School Health on the Frontlines: Navigating Pandemics & Building Equity.”

Staff from L.A. Unified Wellness Centers can register for the conference free of charge. (Click Tickets and then Enter Promo Code TRUST20.)

Dr. Tichianaa Armah, renowned school-based health provider and Yale School of Medicine professor, will be the keynote speaker. The event schedule will include more than 35 workshops and leading healthcare providers and others will appear in a Virtual Exhibit Hall. 

“School-based health centers are stepping up to provide critical support and healthcare access to the students most impacted by the intersecting pandemics of COVID-19 and the public health crisis of racism,” organizers said. “This conference is an opportunity to connect, learn and grow as we face unprecedented challenges.”

For more information visit the CSHA conference website or register now.

This post was updated 10/05/2020 at 11:24 a.m.

Student leaders and The L.A. Trust advocate for school-based health

Mayra Alvarez, president of The Children’s Partnership, rallied more than 50 school-based health advocates at the CSHA’s first-ever virtual Advocacy Day. 

More than 50 school-based health advocates briefed 42 California lawmakers and their staffs August 5 during the California School-Based Health’s Alliance’s first-ever virtual Advocacy Day. 

Students from several of The L.A. Trust’s Student Advisory Boards joined staff members from The L.A. Trust, CSHA and other organizations at the legislative briefings, which focused on top policy priorities made more urgent by COVID-19. These priorities include healthcare and SBHC funding, student mental health, substance use prevention, and coordination by state departments (Education, Health Care Services and Public Health) to strengthen partnership with School-Based Health Centers. 

Mayra Alvarez, president of The Children’s Partnership, rallied the online advocates. Noting that California is a national leader in health insurance coverage with 97 to 98% of all kids covered, “you all know it’s not enough to be covered.” She saluted those working on the frontlines of student health and said, “we have shared goals and a shared partnership.” 

A time of reckoning 

Alvarez tied the issue of health equity to the larger issue of race. “This is a reckoning — a racial reckoning,” she said. “It is truly wiser when we listen to those marching in the streets. Going back is accepting the status quo — we can pave a better path forward for California and the nation.” 

Maryjane Puffer, executive director of The L.A. Trust, stressed the importance of school-based health and thanked all the attendees for speaking out. Puffer and six other staff members from The L.A. Trust participated in the legislative briefings. 

Lisa Eisenberg, policy director for CSHA, noted that one-third of all California legislators were reached — five lawmakers attended in person. 

“While we really wanted to host in-person advocacy visits earlier this year, the COVID-19 pandemic prevented those plans,” CSHA said. “As this pandemic has disproportionately impacted people served by school-based health centers, it’s more important than ever to share challenges and experiences with policymakers as schools grapple with a changing environment.”  

There are 277 school-based health centers in California, and 274,000 California students have access to high-quality healthcare through these clinics. There are 75 school-based health centers in Los Angeles County, including 16 LAUSD Wellness Centers supported by The L.A. Trust. 

Many Wellness Centers (and The L.A. Trust) will stay open

Many LAUSD Wellness Centers will remain open during the COVID-19 health crisis, according to a survey of the Wellness Network by The Los Angeles Trust for Children’s Health.

OPEN WELLNESS CENTERS*
Belmont
Carson
Fremont
Gage Middle School
Jefferson (Wednesdays only)
Manual Arts
Monroe
Washington Prep

CLOSED WELLNESS CENTERS
Crenshaw
Elizabeth Learning Center
Garfield
Hollywood High
Jordan
Locke Early Education Center
MaCES
Santee Education Complex

*Some Wellness Centers have modified schedules. Call for details.

The County of Los Angeles advises anyone with flu-like symptoms to call their doctor or 2-1-1 to see if they need testing — they should not visit any healthcare facility without checking that it is safe for them to do so.

The L.A. Trust open

In a letter to stakeholders, The L.A. Trust announced it would remain open during the coronavirus emergency.

“This is an unprecedented time in our city, nation and world,” Executive Director Maryjane Puffer said. “As we all take steps to stop the spread of the COVID-19 coronavirus, we want you to know what The Los Angeles Trust for Children’s Health is doing in response:

• The L.A. Trust is open for business during regular business hours, with staff working remotely. We will continue our day-to-day operations and reschedule on-campus and community outreach when we can safely resume these services.

• We have postponed our Spring Wellness Network Learning Collaborative and cancelled our Summer Solstice 2020 fundraiser.
  

• We will closely monitor the situation and provide updates from The L.A. Trust, the Los Angeles Unified School District and our Wellness Center and healthcare partners.

• We will share fact-based content on how to mitigate the effects of the coronavirus crisis that is impacting our students, communities, clinics and healthcare providers.

“Nothing is more important to The L.A. Trust than the health of our children — or the well-being of the educators and healthcare professionals who care for them,” Puffer said. “I want to thank them for all they’re doing to help our students and protect the health of our community in this difficult time.”

This story was updated March 27 at 9:30 am PDT.