Wellness Centers discuss COVID challenges at virtual collaborative

Pia V. Escudero of LAUSD Student Health and Human Services addressed more than 100 participants at The L.A. Trust’s online Learning Collaborative. 

Wellness Centers online meeting (recording)

Representatives from the Los Angeles student health community met online Thursday, May 7, 2020 at The L.A. Trust’s Wellness Center Learning Collaborative to discuss how to serve students and their families during the COVID-19 health emergency. More than 100 clinicians, educators and healthcare advocates attended.  

The coronavirus is impacting patients — and the clinics that serve them. Nine of the sixteen on-campus Wellness Centers have suspended operations (see list). Fewer students and community members are visiting clinics, putting their long-term health at risk. It also threatens the financial health of some clinics that have been serving high-need communities for years. 

Dr. Yohanna Barth-Rogers, chief medical officer of the UMMA Wellness Center at John C. Fremont High School in South Los Angeles, told the Learning Collaborative that her clinics were moving the majority of patient visits to video conferences and phone calls.  

In-person visits must be approved in advance and be deemed medically essential. Two of the needs deemed essential are vaccinations and contraception. 

One challenge is finding safe spaces to have sensitive conversations with students, she said. “My worry is that we’re missing things, such as violence in the home.” She said the clinic was developing ways to have confidential conversations with students during the coronavirus shut-down. 

Reaching out 

In addition to telehealth, clinic operators have been staying in touch with patients through community networks and social media. “Asian Pacific Healthcare Venture Inc., serving Belmont and John Marshall High Schools, cares about you,” they said in an email to The L.A. Trust. “If you have any health concerns, call us. We’ll make a telephone appointment to talk to a provider or get your medication refilled. We are also open for confidential services. Stay safe!” 

North Hills Wellness Center at James Monroe High School issued a “stay at home challenge” for students: “Eat an apple instead of chips. Get outdoors (with your mask on!). Follow a workout routine on FaceTime or YouTube. Learn a TikTok dance. Be creative and remember that social distancing and face coverings save lives!” 

Dr. Rosina Franco and Student Medical Services reported that while the Hollywood High Wellness Center was closed for safety reasons, “we are currently working on a re-entry plan for when schools, and our clinic, will re-open. In the meantime, please log on to the LAUSD SHHS webpage.” 

Data xChange points way to better healthcare solutions

Dr. Ron Tanimura said The L.A. Trust’s Data xChange would drive new healthcare strategies to better serve students and communities. 

Technologies like telehealth and initiatives like The L.A. Trust Data xChange are key to better student health outcomes, according to speakers at the online Wellness Network Learning Collaborative on May 7, 2020. Dr. Ron Tanimura, director of student health services at LAUSD, and Sang Leng Trieu, wellness program manager for The L.A. Trust, gave an update on The L.A. Trust Data xChange, which compiles and compares detailed Wellness Center patient data. They spoke to more than 100 representatives from LAUSD and the District’s Wellness Centers. 

Pia V. Escudero, executive director of LAUSD Student Health and Human Services and a member of the executive committee of The L.A. Trust, noted that the clinic network was founded almost 15 years ago “to reduce health disparities impacting the lifespans of our children in families.” She said “there’s still a lot of work to do,” and insights like the Data xChange are key to finding effective solutions. 

“The data is so wonderful,” Escudero said. “It gives us a good baseline to start having future conversations and doing some hypothesis working and strategic planning in this transformational time that we’re living in.” 

Tanimura said data was critical. “We have to look at every one of our divisions and departments and integrate and (utilize) some of the resources we have outside, mainly The L.A. Trust. I thank you for the work you are doing, especially on Data xChange.” 

He added, “The more data we get the better. When we look at the Data xChange, this is a thousand times better than just encounter data. We look forward to integrating all the data – dental, mental health, attendance and other academic data. Imagine what we will be able to do for our kids and their communities.”  

Current reports include such measures as unique patient visits, type of patient encounters, co-morbid conditions, demographics and student vs. community visits. The database also tracks services provided and benchmarks on key performance standards, including risk assessments, well-child exams, BMI screening, chlamydia tests and depression screening. 

The L.A. Trust distributed report cards with clinical metrics to each clinic in February and will add new datasets on mental and oral health later this year, expanding the database insights. 

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.

Student Advisory Board allies share best practices to engage students

Program Manager Robert Renteria and other staff members from The L.A. Trust led the spring 2020 meeting of Student Advisory Board Adult Allies on January 29.

Adult allies who work with the Student Advisory Boards of the LAUSD’s Wellness Center network met at The L.A. Trust January 29, 2020 to discuss outreach programs to improve student health.

More than a dozen Adult Allies and healthcare advocates from across the Wellness Center Network attended, including Norma Ahumada, Cassie Angu, Hanna Christianson, Kristie Garrison, Karina Gonzalez, Annette Hernandez, Deannie Moreira, Marina Quintanilla, Adam Renuet, Miriam Villaseñor, Stephan Salazar, Miguel Topete, Michelle Torres and Brenda Villatoro. 

Strategies and tactics

The half-day meeting, facilitated by Program Director Robert Renteria, included tactics to engage students, best practices sharing and a review of resources available from The L.A. Trust and other sources. 

The meeting focused on five student health campaigns prioritized by The L.A. Trust: 

• Healthy Eating and Active Living, designed to reduce childhood obesity and promote healthier eating habits and more active lifestyles.

• Essential Access Health, designed to increase awareness of sexually transmitted disease, increase chlamydia screenings at school-based Wellness Centers and reduce teen pregnancy rates.

• Not Us, designed to encourage vaccination for the human papillomavirus (HPV) and reduce related cancers.

• TUPE (Tobacco-Use Prevention Education), designed to educate students about the health risks of vaping and using drugs, including cannabis and tobacco.

• SBIRT, a Screening, Brief Intervention and Referral-to-Treatment practice used to identify, reduce and prevent the use and abuse of alcohol, tobacco and drugs.

Peer education key

“Our Student Advisory Boards are key to helping students make the right choices, and our adult allies ensure they get the resources they need,” Robert Renteria said. “The L.A. Trusts works directly with these student health leaders and we are looking forward to hearing their ideas March 2 at our annual Y2Y (youth-to-youth) Summit.”

“Every student, like every adult, has the power to improve their health,” Rosario Rico added. “It is up to those of us in the student health community to make sure students have the education and healthcare access they need. 

“I am amazed at the passion of our adult allies and the passion of our student health advocates. They are making a real difference in the health outcomes of LAUSD students.”

Students find a healthcare home at LAUSD Wellness Centers

LAUSD’s network of Wellness Centers, like this one operated by South Central Family Health Center, are on the front lines of student and community health.

When a Delta 777 passenger plane dumped a load of aviation fuel over the Cudahy area last month, students at six LAUSD schools were affected—and the Wellness Center at Elizabeth Learning Center sprung into action.

The clinic, operated by South Central Family Health Center, offered free screenings to everyone in the community, regardless of insurance, immigration status or ability to pay. The clinic is part of Los Angeles Unified School District’s network of Student and Family Wellness Centers, which provide a healthcare home for students and community members in the district’s most underserved neighborhoods. Tens of thousands of students and community members rely on the clinics each year.

“When there’s an environmental emergency, a flu outbreak or a spike in STDs, the Wellness Centers often see it first,” said Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health. “They are on the front lines of student and community health, and the services they provide are indispensable. Nothing is more important to The L.A. Trust than supporting these clinics.”

Partners in health

The L.A. Trust provided direct financial support to the six original LAUSD school-based health clinics between 1994 and 2002. Since then it has worked closely with LAUSD Health and Human Services to support the development of 15 (soon to be 19) new school-based Wellness Centers, focusing on strategies to make them self-sufficient and sustainable. 

“Our Wellness Center support mission today includes a broad range of prevention programs, best practices and research,” Puffer said. She cited The L.A. Trust’s groundbreaking Data xChange initiative, student engagement efforts and Wellness Network Learning Collaborative workshops as examples of how The L.A. Trust supports the clinics.

The Wellness Center Network is overseen by LAUSD Health and Human Services, headed by Executive Director Pia V. Escudero. Professional services are provided by these Federally qualified health centers: Asian Pacific Healthcare Venture at Belmont; Eisner Health at Santee Education Complex; Kaiser Permanente, LAUSD Student Medical Services and Planned Parenthood Los Angeles at Hollywood High; Mission City Community Network at Maywood Center for Enriched Studies; Northeast Community Clinics at Gage Middle School; St. John’s Well Child and Family Center at Manual Arts High and Washington Prep; South Central Family Health Center at Elizabeth Learning Center and Jefferson High; South Bay Family Health Center at Carson High; T.H.E. (To Help Everyone) Health and Wellness Centers at Crenshaw High; UMMA Community Clinic at Fremont High; Valley Community Healthcare at North Hills-Monroe High; Via Care at Garfield High; and Watts Health at Jordan High and Locke Early Education Center. 

Primary care plus

In addition to primary and dental care, most LAUSD Wellness Centers provide mental health services to students and community members. LAUSD School Mental Health provides intervention, care and referral at the Belmont, Carson, Crenshaw, Elizabeth, Gage, Locke, Maywood and Washington Prep Wellness Centers.

Other mental health services providers include Aviva Family and Children’s Services at Hollywood High; Child and Family Guidance Center at North Hills-Monroe; Children’s Institute at Jordan; Los Angeles Child Guidance Clinic at Manual Arts; and Weber Community Center at Fremont.

“Our kids hold all the promise in the world,” Puffer said. “Helping support them with access to care—whether it’s asthma, anxiety, depression or substance use—is part of the holistic wellness mission of The L.A. Trust. ”

Latest Wellness Center opens at Santee Education Complex

L.A. Trust Executive Director Maryjane Puffer addressed the importance of school-based wellness centers at the Santee Education Complex ribbon-cutting, December 2, 2019.

The newest LAUSD Student and Family Wellness Center opened December 2, 2019 at Santee Education Complex in South Los Angeles—and educators, students, clinicians and healthcare leaders welcomed the new facility in style.

Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health, said the benefits of school-based health centers are proven: “Students who get quality healthcare have better outcomes and less chronic disease than those who don’t.”

Puffer said. The L.A. Trust was proud to support the establishment of the new clinic early on, and to assist the growing LAUSD Wellness Center network, she said. 

The ceremonies were led by Los Angeles Unified Board Member Mónica García, who noted that the District has invested ten of millions of dollars building school-based wellness centers in high-need areas. An ebullient García led the crowd in applause for everyone who helped make the new center possible, from students and staff to advocates and taxpayers.

Speakers and ribbon-cutters included Kristina Tokes, LAUSD deputy chief facilities executive; Alicia Garoupa-Bollinger, representing Pia Escudero, executive director of LAUSD Student Health and Human Services; Martine Singer, CEO of the Children’s Institute; Joan Sullivan, CEO of the Partnership for Los Angeles Schools; and Santee Principal Susana Gutierrez.

Power of partnership

Three more Wellness Centers are currently on the drawing boards: Mendez High School in Boyle Heights (ground-breaking  held December 9), Maclay Middle School in Pacoima, and Hyde Park Elementary in South Los Angeles. A wellness center at Telfair Avenue Elementary in Pacoima opened in October.

The Los Angeles Trust for Children’s Health has supported the Wellness Center network since its inception in 2009, advocating for new centers, bringing programs, resources and education to students and community members, conducting clinician training, conducting research and establishing Student Advisory Boards to promote youth engagement. 

A program staff of nine is currently working on more than a dozen different initiatives impacting the health of L.A. students. In October, The L.A. Trust hosted its semi-annual Wellness Network Learning Collaborative focused on innovative approaches to HPV prevention, contraception awareness, and other urgent student health issues.

The future is data-driven

“The L.A. Trust provides a bridge between the education and healthcare community, and the Wellness Centers are the front door, for both students and community members,” said Puffer. “Our priority is prevention and education, especially in the critical areas of oral health, nutrition, tobacco and drug use, sexual and reproductive health, and, increasingly, mental health. We are proud to partner with government agencies, LAUSD and leading health and dental care providers to help make a difference in student health.” 

Going forward, The L.A. Trust’s Wellness Center support will be driven by data. The L.A. Trust’s innovative Data xChange initiative will link healthcare and educational performance data to find ways to improve healthcare strategies and educational outcomes. “This will not only help us deliver on our promise of improving the health of the LAUSD communities we serve, it will give us the insights we need to design programs and services that connect better healthcare to improved educational performance,” said Puffer.

Funding for the Data xChange comes from grants from Cedars-Sinai, Kaiser Permanente, DentaQuest and the Ralph M. Parsons Foundation , among others.

“The L.A. Trust is an independent nonprofit devoted to the students of the LAUSD, but the vast majority of our budget comes from outside funders and agencies,” Puffer said.  “These relationships help us serve as a bridge between the education and healthcare and connect the dots in student health.”

Wellness Center leaders collaborate on student health

School-based managers and clinicians from Los Angeles school-based Wellness Centers learned best practices for student health at The L.A. Trust for Children’s Health Fall Learning Collaborative, October 19, 2019, at LAUSD headquarters. The semi-annual event focused on innovative approaches to HPV prevention, contraception awareness, and other urgent student health issues.

The meeting featured a detailed update on The L.A. Trust’s new Data xChange, an initiative that will link real-world clinical data with student performance data to gain insights and find new ways to improve outcomes.

Maryjane Puffer, executive director of The L.A. Trust, said new insights are needed to drive student healthcare in Los Angeles to the next level.

The ambitious initiative has finished its initial phase (gathering clinical data) and laid the groundwork for Phase 2, linking clinical data to student performance data. Rigorous privacy protocols for the data have been established.

Wellness Center leaders poured over reports from their Wellness Centers, including stats on unique patient visits, services provided and demographics. Dr. Ron Tanimura, director of Student Medical Services for L.A. Unified, and Dr. Sang Leng Trieu of The L.A. Trust, led the discussion on Wellness Center metrics and discussed the history and future of the network.

Sexual health

Dr. Kathleen Tebb of the University of San Francisco released results from “Health-E You/Salud iTu,” a computer-based, patient–centered contraception awareness program focused on Latina youth. The awareness program, deployed in partnership with The L.A. Trust, resulted in a substantial increase in clinical visits and a 117% increase in the use of Long-Acting Reversible Contraceptives among the target group. Version 2.0 of the program will switch genders and focus on young Latino males.

Heather Kun from the nonprofit “Fu*k Cancer,” unveiled the group’s HPV vaccination campaign, “Take Your Shot.” Kun noted than HPV causes 43,000 cancer deaths per year in the U.S., and all are preventable with the vaccine. The group is enrolling students to take the lead in an on-campus peer-to-peer campaign to get students vaccinated and save lives.

 Engaging students

 Two Wellness Center leaders shared how they involve students in their operations. Stephan Salazar, manager of adolescent education for Valley Community Healthcare, serving James Monroe High School in North Hills, discussed how his Student Advisory Board members intern at the clinic and provide advice for the operation and an informal support group for each other. Cassie Angus, Adult Ally at Fremont High School and program associate for its UMMA Community Clinic, also encourages student initiative, observing that “the best way to lead kids is to let kids lead themselves.”

The half-day conference included a briefing on school health integration by Dr. Rebecca Dudovitz of the David Geffen School of Medicine at UCLA, and an update on upcoming School Well-Being Centers presented by Frances Valdez and Gloria Velasquez, organization facilitators for Student Medical Services at Los Angeles Unified.