Fighting substance use through awareness and peer education

Vaping is rampant among L.A. students. According to the CDC, more than 30% of L.A. County high school students have reported using e-cigarettes. 

The Los Angeles Trust for Children’s Health is working with partner Children’s Hospital Los Angeles and funder California Community Foundation to educate and prevent substance use  among Los Angeles Unified students.  

“This is one of our most urgent initiatives,” said Robert Renteria, program manager for The L.A. Trust. “Whether it’s vaping tobacco or using marijuana, alcohol, methamphetamine or opioids, substances are a real threat to our student community —one that’s likely to have grown during the pandemic.” 

The Wellness & Adolescent Substance Use Prevention Project (WASUP) substance use prevention partnership includes Screening, Brief Intervention and Referral to Treatment (SBIRT) training and peer education by student health advocates from The L.A. Trust’s Student Advisory Boards.  

WASUP training for school-based healthcare professionals included a series of webinars discussing vaping and SBIRT. The  SBIRT project  — designed to increase the screening tool’s utilization in L.A. Unified Wellness Center clinics — was deployed at five such clinics, reaching nearly 2,700 students.  

Peer education  

 A toolkit for conducting a preliminary scan of the substance use situation at schools — Conducting a SBIRT Environmental Scan at Your School-Based Health Center — was published last year by Children’s Hospital Los Angeles and The L.A. Trust.  

The toolkit “reflects lessons learned by The L.A. Trust and CHLA during a multiyear initiative to integrate SBIRT into five school-based health centers across South Los Angeles. Funding for this project was provided by the California Community Foundation and the Conrad N. Hilton Foundation.”   

WASUP includes student health advocates and Student Advisory Board members like former Manual Arts High School student Melissa Riaz Reynolds, who is now in college.   

She said her favorite part of being a WASUP advocate was “presenting to the leadership class about underage drinking and making safe decisions.  

“It helped a lot with my personal life as most students are curious and like to experiment, so I am constantly surrounded by drugs or people who abuse drugs,” she said. “The WASUP project taught me how to handle certain situations and protect myself and those around me.” 

Wellness Centers eagerly prepare for school re-openings

Dr. Kevin Fang of CHLA spoke about healthcare inequities at The L.A. Trust Learning Collaborative.

The word of the day was “hopeful” as L.A. Unified representatives, Wellness Center operators and staff from The L.A. Trust prepared for school re-openings at the fourth pandemic-period Wellness Network Learning Collaborative, March 10 on Zoom.

Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health, conducted a roll call of representatives from the 17 LAUSD Wellness Centers, noting The L.A. Trust has been hosting the collaboratives for more than a decade.

Health equals success

Guest speaker Dr. Kevin Fang addressed healthcare inequities, saying, “Zip Codes are better determinants of health outcomes than genetic codes.” Children of parents without a high school diploma are more likely to live in an environment with health barriers, Fang said, noting the direct correlation between education and life expectancy, income and smoking.

Fang said chronic absenteeism was a strong predictor of poor academic achievement. COVID-19 has exacerbated an already high chronic absenteeism rate among California public schools, he said, noting it has risen 89%. Proven solutions include school nurses and other forms of school-based health, physical education and individual education plans. Fang suggested ways to increase collaboration between schools and the medical community, including ACES (adverse childhood experiences) training for pediatricians and Wellness Center clinicians and in-class visits by doctors and medical students.

Fang is an attending physician and an assistant program director for the Pediatric Residency Program at CHLA. The former high school biology teacher is also Fellowship Director for the General Academic Pediatrics Fellowship in Health Equity and assistant clinical professor of pediatrics at USC’s Keck School of Medicine.

Report card

Victor Luna, organization facilitator for LAUSD Student Health and Human Services,  provided a 2020 report card for the Wellness Network.

Visits to the Wellness Centers were down dramatically due the pandemic and facility closures. Visits varied widely — some clinics never closed and some remained closed for most of the year. Organization Facilitator Gloria Velasquez observed that 2020 was not a good year to determine trend lines in the network.

The two-hour collaborative concluded with a group discussion among the clinicians, educators, Student Advisory Board Adult Allies and The L.A. Trust staff. Topics included telehealth, getting students to make and keep medical appointments, and sexual and reproductive health services.

Appointments for STI prevention and birth control have been most impacted by the pandemic. Without outreach and the confidential setting of the school Wellness Center, students may be reluctant to reach out or use telehealth from home. LAUSD Organization Facilitator Ana Griffin said Wellness Centers and students were countering this through outreach campaigns. “We emphasize to students (who have sexual health questions) that the Wellness Center is a no-judgment zone.”

The L.A. Trust takes action in Children’s Dental Health Month

Los Angeles School Board Member Scott Schmerelson and The L.A. Trust’s Tooth Fairy  Maryjane Puffer brought brushes, toothpaste and healthcare info to Columbus Middle School February 10.

The Los Angeles Trust for Children’s Health launched a public oral health awareness campaign and distributed 58,000 toothbrushes plus other oral care items in observance of National Children’s Dental Health Month in February.

“Poor oral health is the number one cause of school absenteeism – and it’s entirely preventable,” said Maryjane Puffer, executive director of The L.A. Trust. Screenings of 3,399 elementary school students in Los Angeles found that 66% of children had active dental disease, 27% had visible tooth decay and 6% required emergency care.

Puffer said The L.A. Trust is working closely with its partners in the oral health community, including L.A. Unified Student Health and Human Services, LAUSD’s Beyond the Bell division, UCLA’s More LA Smiles, the L.A. County Department of Public Health and other agencies, foundations and dental care providers. Puffer gave special thanks to Crest, which provided toothpaste to go with the thousand of brushes being distributed.

Prevention campaign

Los Angeles School Board member Scott Schmerelson took The L.A. Trust’s Brushing with Billy campaign direct to kids during an online Local District “Twinkle Time” February 3, using the puppet to show young students how to brush, floss and eat right.

“Improving the health and lives of all L.A Unified students and providing access to oral healthcare is a critical element to ensuring student achievement and success,” Schmerelson said. “As we celebrate National Children’s Dental Health Month, we are grateful for our partnership with The L.A. Trust and will continue to support their oral health awareness initiative so our students can stay healthy and benefit from a wealth of resources.”

ORAL HEALTH RESOURCES FROM THE L.A. TRUST

The L.A. Trust is releasing three oral health videos on social media this month. The “Brushing with Billy” videos feature Program Manager Esther Yepez and the kid-friendly puppet. The spots, which focus on brushing, flossing and healthy eating, have been aired 150 times on KLCS-TV, reaching an estimated viewership of more than 1.1 million.

The L.A. Trust also facilitated the broadcast of UCLA More LA Smiles oral health TV spots starring Sesame Street characters, which will be shown on KLCS remote learning channels through February. 

“People don’t understand the disease process when it comes to cavities – it’s insidious,” said Dr. Jim Crall, project director of More LA Smiles. Simple changes in student behavior can make a big difference and education is key, he said.

“Prevention is key to oral health and that includes screenings and education,” Puffer said. “The pandemic has transformed our oral health education activities but not our commitment. We will continue to use every means at our disposal to ensure that kids and teens enjoy the best possible oral health during this pandemic.”

SHHS Organization Facilitator Gloria Velasquez noted that seven Wellness Centers and school-based health clinics are currently providing partial or full oral health services for students and community members: El Sereno Middle School (Western Dental); Hart Street Elementary School (Dr. Samoha); Jefferson Wellness Center (South Central Family Health Center); Maclay and Sun Valley Middle Schools (NEVHC); Monroe (Valley Community Health, appointment only); and Washington Prep Wellness Center (St. John’s Family and Wellness Center). Call ahead for an appointment.

Sharing Brings Hope to L.A. Unified students and families

Local District East Sharing Brings Hope coordinators got fundraising tips on Zoom February 10.

The Los Angeles Unified School District’s Sharing Brings Hope 60-day charity drive has launched with a new state-of-the-art online giving portal.

Last year, thousands of teachers, staff, students and family members contributed to the campaign to strengthen some of L.A.’s strongest nonprofits.

“Over the years the Sharing Brings Hope Combined Consolidated Campaign has raised millions of dollars for charities supporting our kids, teens and families,” said Anna Baum, director of development for The Los Angeles Trust. “This year our campaign activities will be conducted almost entirely online to keep everyone safe,” she said. “We are proud to be part of this campaign and grateful to the LAUSD community for their support.”

The annual campaign benefits The L.A. Trust and 10 other local nonprofit organizations: the Asian Pacific Community Fund, Brotherhood Crusade, Community Health Charities, EarthShare California, Kathryn Kurka Children’s Health Fund, LAUSD Employee Sponsored Scholarship Fund, United Latinx Fund, United Negro College Fund, United Teachers Educational Foundation and United Way of Greater Los Angeles.

There are several ways to give: regular payroll deductions (LAUSD employees only) or one-time contributions by cash or check. Visit the new Sharing Brings Hope website to learn how to give or call (888) 492-4738.

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.”

It was a year that challenged almost everything

Empty classrooms and full intensive care units created a year of unprecedented challenges for Los Angeles students, educators and healthcare providers.

A pandemic. An uprising. An education crisis. And an economic crash. The year 2020 was one of the most challenging years in our history — and an outsize share of those challenges were borne by the students, educators and healthcare workers we serve. 

“Our friends rallied around us, and we rallied around them during this crisis,” said Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health. “But the problems experienced in 2020 — healthcare and income disparity, racial injustice, distrust of our institutions and inadequate public health facilities — did not start in 2020 and will not disappear in 2021. We have so much work to do.” 

The L.A. Trust adapted quickly to the pandemic and school closures in mid-March, transferring in-person outreach to social media and face-to-face meetings to online platforms like Zoom. 

With schools on lockdown and many Wellness Centers closed, The L.A. Trust redoubled its efforts to address the primary, oral and mental health needs of Los Angeles Unified students: 

Held Wellness Center Learning Collaboratives online in May, October and December to discuss urgent issues related to the pandemic. The three online events were attended by a total of nearly 200 healthcare providers, researchers and L.A. Unified facilitators. 

Provided its stakeholders with information about the unfolding pandemic, interviewing experts like Barbara Ferrer, head of L.A. County Public Health, and Jim Mangia, president and CEO of St. John’s Well Child & Family Center, operator of Wellness Centers at Lincoln, Manual Arts and Washington Prep, which have remained open during COVID. 

June: Distributed more than 50,000 toothbrushes as part of Operation Tooth Fairy, garnering widespread media coverage about the importance of maintaining oral health. 

July/December: Conducted virtual convenings of The L.A. Trust’s Oral Health Advisory board to help providers pivot during COVID crisis. An in-person meeting was held in March, pre-COVID. 

July: Moved its nutrition programs online, reaching nearly 80,000 students and community members with Facebook workshops and professionally produced cooking videos. 

August: Trained student health advocates at our first-ever Summer Academy and supported Student Advisory Board members and their allies throughout the pandemic. 

August: The L.A. Trust launched our Student Mental Health Initiative, funded by a $100,000 grant by Cedars-Sinai and a $50,000 grant by Health Net. The initiative will train students as peer leaders through The L.A. Trust’s Student Advisory Boards, increasing awareness of symptoms like anxiety and depression, and building positive coping mechanisms and self-referrals to care. The initiative will include student-run social media campaigns and online trainings such as “Youth Mental Health First Aid” starting in the fall. 

September: Educated more than 40 state legislators and their staff on the need for school-based healthcare during a first-ever virtual Advocacy Day. 

September: Launched a new website for The L.A. Trust with expanded resources and a new rallying cry, “Putting the care in student healthcare.” 

October: Helped promote and conduct the online California School-Based Health Alliance Conference, attended by nearly 1,000 health advocates from across the state. 

October: Released a Data xChange Report on the impact of L.A. Unified Wellness Centers over the past five years. 

Fall: Partnered with L.A. Unified and KLCS-TV to broadcast The L.A.Trust-produced nutrition and oral health spots reaching an audience of up to 2.3 million students and family members. 

Fall: The L.A. Trust’s program managers, adult allies, director of programs and executive director completed the eight-hour Youth Mental Health First Aid (YMHFA) training and received certification as YMHFA providers. The L.A. Trust’s program manager in turn trained dozens of Student Advisory Board members in the How to H.E.L.P. A Friend curriculum. 

November: Worked with the office of Supervisor Mark Ridley-Thomas and the T.H.E. Clinic to distribute thousands of N95 protective masks to frontline healthcare workers at Los Angeles Unified Wellness Centers. 

December: Created a new Oral Health Toolkit to put resources at dental providers’ fingertips. 

“It has been a devastating year,” Puffer said, “and the effects are far from over. But last year witnessed unimaginable courage, resilience and resourcefulness. We are so proud of our students, educators, healthcare providers and partners in Los Angeles Unified and beyond.”

Foundations sustain The L.A. Trust through COVID-19

Ballmer Group is among the foundations that have stepped up to support the work of The L.A. Trust during the coronavirus pandemic. 

In the midst of the suffering and uncertainty of our multiple pandemics, the outpouring of community support from the philanthropic world has been heartening and reassuring. We continue to receive grants that make the difference for students between empty days and much-needed healing and enrichment. The following funders have committed grants this past quarter to benefit those we serve:   

Ballmer Group notified us of their intention to invest on a large scale in student mental health through a two-year, $300,000 grant that will support our Student Mental Health Initiative, including Youth Mental Health Collaboratives. The purpose of The L.A. Trust project is to increase mental health education and prevention among Los Angeles Unified students within the Wellness Network by launching a collaborative made up of LAUSD leaders, Wellness Center staff, and community mental health organizations to identify and resolve obstacles to care. Student input will be a key component informing the group’s work. The group will also advocate for needed policy change at the district and county level. Much like our Wellness Network Learning Collaborative, our Oral Health Advisory Board and Data xChange Expert Advisory Council, this collaborative aims to improve students’ well-being through increased cooperation among stakeholders.  

Ballmer Group supports efforts to improve economic mobility for children and families in the United States who are disproportionately likely to remain in poverty. This generous grant reflects their belief that building pathways to opportunity requires broad, systemic change.  

Dignity Health is also making a significant investment in mental health, through a three-year effort funded in part by UniHealth Foundation to increase the awareness, skills and capacity of local community organizations and individuals to identify mental distress, address the impacts of trauma, reduce stigma and increase resiliency via delivery of mental health awareness education. The project focuses on children and youth of color and the adults who care for them in areas where high health disparities persist. Through a grant of $65,000, The L.A. Trust is joining in the second year of the project and will train after-school and academic support programs in Youth Mental Health First Aid and students in peer-to-peer outreach. We’re honored to work with the many organizations pioneering this effort.   

FCancer awarded The L.A. Trust $12,000 to expand HPV education and increase HPV vaccinations during the fall semester at the schools we serve. This is an extension of FCancer’s Take a Shot campaign. FCancer is dedicated to prevention, early detection, and providing emotional support to those affected by cancer. We have been working with FCancer since 2016 and are proud to continue this key cancer prevention initiative in spite of the limitations imposed by COVID-19 precautions.  

QueensCare is partnering with us for the first time through a $50,000 grant to support oral health education for children and their caregivers associated with nine local elementary schools. The L.A. Trust will share information via educational branded videos and live video chats with our community members. A nonprofit organization with compassion at its core, QueensCare offers direct patient care through a mobile dental program at many LAUSD schools and in the community. Understanding that tooth decay is the most pervasive, yet preventable, chronic disease among children in the United States, we are very grateful to continue our long-standing commitment to oral health for children through this grant. The support from QueensCare comes at a critical point in the COVID-19 pandemic, allowing The L.A. Trust to deliver much-needed educational outreach when many cannot access adequate dental care.  

Satterberg Foundation has been a key supporter over the last three years through its seminal Core Support Grants. The Foundation recently let us know that they intend to provide another five years of general operating support in the form of $125,000 a year. The mission of the Seattle-based foundation is to promote a just society and a sustainable environment. The founders, board members, and staff of the Satterberg Foundation have a highly progressive, inclusive approach to grant-making. Their goal is to help organizations achieve their goals, to adapt to change, to innovate and to improve their ability to serve the community. They have been foundational in The L.A. Trust’s growth over the past three years, and we’re deeply honored to be continuing this relationship.  

Our current times illuminate with great clarity the ways in which all of us are interconnected. The interdependence of student services, social progress, and philanthropy can be seen in these generous grants from committed, forward-thinking institutions. We remain grateful for and inspired by these sustaining relationships.

Oral Health Advisory Board focuses on prevention education

Dr. Jim Crall of UCLA More LA Smiles (and friend) discussed public oral health campaigns during the final Oral Health Advisory Board meeting of 2020.

Representatives of the L.A.’s student oral health community met online December 15 at the fourth and final 2020 meeting of The L.A. Trust’s Oral Health Advisory Board.  

More than three dozen oral health providers and stakeholders attended the event, which focused on public health campaigns and best practices for student oral healthcare in the midst of the coronavirus pandemic. 

Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health, discussed The L.A. Trust’s oral health education campaign on KLCS featuring Program Manager Esther Yepez and her kid-friendly puppet, Billy. The campaign has generated up to 1.5 million views to date.  

Puffer thanked QueensCare for funding upcoming student oral healthcare education by The L.A. Trust at nine LAUSD sites and introduced The L.A. Trust’s new Oral Health Toolkit, providing useful resources for student and community dental care providers.  

Dr. Maritza Cabezas, dental director for L.A. County Department of Public Health, and Dr. Abrey Daniel, walked attendees through the development of a County oral health education campaign. She outlined the campaign development process, including: determining the need; selecting the audience; developing the message; and crafting the final creative with the help of focus groups. The County’s campaign’s goals are to increase awareness among caregivers of children under 5, demonstrating the importance and ease of at-home oral health habits.  

“People don’t understand the disease process when it comes to cavities – it’s insidious,” said Dr. Jim Crall, project director of UCLA More LA Smiles. He said “there are a lot of disconnects in oral health treatment” for children. Simple changes in student behavior can make a big difference and education is key. He previewed a series of TV spots featuring Sesame Street characters, which will be shown on KLCS remote learning channels through February. The L.A. Trust helped facilitate the broadcast of the Sesame Street spots.  

Doors still open 

Gloria Velasquez, organization facilitator for LAUSD Health and Human Services, said  seven Wellness Centers and school-based health clinics were still providing partial or full oral health services for students and community members: El Sereno Middle School (Western Dental); Hart Street Elementary School (Dr. Samoha); Jefferson Wellness Center (South Central Family Health Center); Maclay and Sun Valley Middle Schools (NEVHC); Monroe (Valley Community Health, appointment only); and Washington Prep Wellness Center (St. John’s Family and Wellness Center). 

Crall noted that the Medi-Cal Dental Transformation Initiative would continue but local DTI pilot programs would not. UCLA’s More LA Smiles LADRRS program (Los Angeles Dental Registry & Referral System) would be sustained for now and potentially integrated into the Department of Health Care Services.

New tool will help integrate schools and health centers

Dr. Kenny Ferenchak presented “School-Based Health Integration with Schools” at The L.A. Trust’s Learning Collaborative December 2. 

A new tool to measure the integration of school-based health centers with their schools was presented at The L.A. Trust’s Wellness Network Learning Collaborative December 2. More than 50 representatives from Los Angeles Unified, Wellness Center operators and The L.A. Trust attended the online event. 

“The L.A. Trust believes there’s a strong correlation between student health and student achievement, and school-based health centers are key,” said Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health, which helped support the research. 

“Integration of health centers with schools adds an extra element,” said Dr. Kenny Ferenchak, underscoring the fact that the whole is greater than the sum of the parts. Dr. Ferenchak, a former UCLA researcher and pediatric resident at Seattle Children’s Hospital, University of Washington, notes that no measure currently exists to quantify the degree of integration for clinics and their partner schools.  

The presentation included remarks by Dr. Rebecca Dudovitz, a board member of The L.A. Trust and associate professor in general pediatrics and vice-chair of the Primary Care College at the UCLA David Geffen School of Medicine. 

“Measuring school health integration can drive practice improvement initiatives among SBHC-school partners, identify SBHC and school characteristics that are associated with better integration, and test whether better integration is associated with better student health and academic outcomes,” they reported. 

Scanning the environment 

The Learning Collaborative included presentations by three organization facilitators with L.A. Unified Student Health and Human Services: Ana Griffin gave an update on Wellness Network performance; Gloria Velasquez conducted a whiteboard exercise on successes in outreach and services; and Victor Luna led a resiliency exercise.  

Robert Renteria, program manager of The L.A. Trust, and Erika Hernandez, project specialist for Children’s Hospital Los Angeles, gave a presentation on Conducting an Environmental ScanPreparing for Implementation of Screening, Brief Intervention, Referral to Treatment (SBIRT) at Your School-Based Health Center. 

School-based health centers are encouraged to use the Environmental Scan to ensure they are providing accessible substance use prevention and treatment services. It reflects lessons learned by Children’s Hospital Los Angeles and The L.A. Trust from a multi-year initiative to integrate SBIRT into five school-based health centers across South Los Angeles. Funding for the project was provided by the California Community Foundation and the Conrad N. Hilton Foundation.

Oral Health Toolkit puts resources at providers’ fingertips

The L.A. Trust Oral Health Toolkit includes links to our new “Brush with Billy” video series as seen on KLCS TV.  Billy is pictured with Esther Yepez of The L.A. Trust.

The L.A. Trust has released a new multimedia Oral Health Toolkit featuring links to kids’ oral health videos, local dental services referrals, state oral health assistance programs and more. 

The Toolkit was created by Eddie Hu, oral health program manager for The L.A. Trust, and Esther Yepez, program manager, as part of the organization’s Oral Health Initiative.  

Hu said, “The purpose of this toolkit is to address the barriers to oral health access being experienced by many L.A. students — barriers that have been worsened by the COVID-19 pandemic. During this pandemic, many children and families are not receiving information regarding their oral health. Many school-based clinics are closed; students are not on campus; and they have additional priorities when it comes to health issues.” 

He noted that “oral health is critical component of overall health. It is extremely important to take care of our oral health and teeth to prevent disease and illness,” he said. 

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.”

Wellness Centers confer on impact and inclusion

Senior LAUSD Physician Dr. Rosina Franco provided an update on the District’s coronavirus response at The L.A. Trust Wellness Network Learning Collaborative.

Representatives from Los Angeles Unified and its Wellness Centers discussed how to reach and treat students during the COVID-19 pandemic at The L.A. Trust’s online Learning Collaborative October 14.

Download presentation

Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health, welcomed the participants. Noting that inclusion was the theme of the gathering, she quoted Dr. Martin Luther King, Jr., who said, “Injustice anywhere is a threat to justice everywhere.”

Report card

Gloria Velasquez, an organization facilitator for L.A. Unified’s Student Health and Human Services, presented a Wellness Network Report Card for academic year 2019-2020. She reminded the attendees that the purpose of the Wellness Network was to help students and families “where there is a gap in healthcare” and thanked The L.A. Trust Data xChange “for gathering and presenting these metrics so they could be shared in so many different ways.”

Velasquez noted that student patients comprised more than 28% of all patients seen by the Wellness Clinics and they averaged 2.1 visits per year. More female than male students visited the clinics (55.6% vs. 44.4%) and the overwhelming number of student patients were teens 14-19. The top services provided to students were well child exams, overweight and obesity concerns, contraceptive management and vaccinations and pre-exposure prophylaxis (PrEP).

Return plan

Senior LAUSD Physician Dr. Rosina Franco provided an update on the District’s coronavirus response and prospects for school reopening. She noted that Los Angeles County was still in Tier 1, reflecting widespread case and positivity rates, and outlined the state’s requirements for re-opening. As of October 13, Los Angeles County had 9.0 new COVID cases per 100,000 population — the county’s positivity rate was 3.7% and rising.

Franco said L.A. Unified was laying the groundwork for a safe return to in-person instruction. LAUSD is currently testing teachers, staff and children in childcare to establish an initial COVID-19 baseline. The second phase of initial baseline testing will include all staff working from home. The third phase will include all students.

The District will do another return to school baseline test and periodic testing thereafter. Contacts of students and staff who test positive will be notified by the District as part of its robust Community Engagement effort.

Inclusive engagement

Two representatives from the Carson Wellness Center presented ideas on how to engage students and community members and drive visits to Wellness Centers.

Kristie Garrison of Healthy Start and Suzanne Markey of LAUSD School Mental Health offered marketing and communications tactics, including virtual clinic tours media to be shared on classroom Zoom meetings and social media. The team is focused on promoting clinic services to students, especially sexually transmitted infection and HIV prevention education.

Rosario Rico and Robert Renteria of The L.A. Trust gave a brief presentation on inclusive strategies to increase student use of LAUSD Wellness Centers.

They emphasized “location, location, location,” which includes virtual environments like Schoology, Zoom and social media, and more traditional methods like putting printed fliers in places where students are still checking in. They said messaging should include Wellness Center hours, available services, minor consent services and how to make an appointment.

The two-hour event concluded with breakout rooms discussing “How to expand outreach efforts in a more inclusive manner?” Suggestions included involving parents and past student clients as ambassadors; engaging teachers; and utilizing ConnectEd, Schoology and other platforms.

Conference attendees committed to exploring the techniques and increasing clinic visits next semester.

Board members of The L.A. Trust will work up a sweat to raise funds

Board members and supporters of The L.A. Trust are challenging their friends and colleagues to sponsor them in a fall fundraiser Up to Us.

Board members and other supporters of The L.A. Trust will be biking, running, walking, swimming and participating in other activities November 16-29 to raise funds as part of the organization’s Thanksgiving fundraising campaign, “Up to Us: The L.A. Trust.”

Donate now

The participants are asking friends and colleagues to help them meet the campaign’s goal of $15,000. All donations will go to The L.A. Trust to support its student and community activities, including prevention education, Oral Health Initiative, research and best practices, mental and behavioral health, Wellness Center support and other needs.

“The coronavirus has required us to devise new ways to continue preventive healthcare education and access at a time we need it most,” said Will Grice of Kaiser Permanente, board president of The L.A. Trust. “The mission of The L.A. Trust is to bridge the gap in healthcare in our underserved communities, and that mission is more important now than ever.” 

To sponsor a Board member or supporter Donate Now. To register as a Truster and ask your friends and colleagues to support your activity Register Now.

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

COVID testing key to L.A. Unified’s return-to-school strategy

L.A. Unified return-to-school plan encompasses testing and tracing for nearly 800,000 students and employees.

The Los Angeles Unified School District has begun an unprecedented coronavirus testing program, part of its developing return-to-school plan for nearly 800,000 students and employees 

Los Angeles Unified Superintendent Austin Beutner said, “Health practices are in place. Classrooms and facilities have been electrostatically cleaned top to bottom, air-conditioning systems have been upgraded with the equivalent of N-95 filters, personal protective equipment is provided to all individuals on campus, and classrooms and facilities have been reconfigured to keep all at a school a safer distance apart.  

“When students do return to schools, they’ll be kept in small cohorts to reduce the risk of spreading the virus. And as we learn of other ways to enhance health practices, we’ll incorporate them as quickly as possible.”

‘Taking the lead’ 

“Once again, LAUSD is taking the lead nationwide in protecting our students, teachers, staff and community members,” said Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health. “It is essential that we open our schools as soon as it is safe to do so.” 

Beutner added, “While unprecedented, the virus testing, community engagement and contact-tracing program is necessary and appropriate as we must do everything we can to protect the health and safety of all in the school community.”  

Among those collaborating on the program are UCLA, Stanford University, Johns Hopkins University, Microsoft, Anthem Blue Cross, Cedars-Sinai Medical Center and Health Net.

School-based health conference focuses on multiple threats

California State Superintendent of Public Instruction Tony Thurmond addressed nearly 1,000 registered guests at this year’s CSHA statewide School-Based Health Conference.  

Nearly 1,000 student health advocates addressed the multiple pandemics facing California’s kids, teens and communities at “School Health on the Frontlines: Navigating Pandemics & Building Equity,” the California School-Based Health Alliance’s first-ever virtual School-Based Health Conference October 6-8. 

Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health and board vice president of CSHA, opened the conference by stating, “School-based health centers have always been on the frontlines of healthcare by serving students and communities with the most challenges and least access to our healthcare. This year has been a real test of that system.” 

She pointed to the COVID-19 pandemic, which “has brought families to the brink,” and to “the unending racial injustices faced by Black, Indigenous and People of Color.” She said, “Our youth are resilient, but they are under incredible strain.”  

She noted that not one of the state’s one thousand local education entities has the recommended number of mental health professionals and only 4% of California school children have access to school–based health centers. 

“The ultimate equity issue” 

Dr. Tony Thurmond, California State Superintendent of Public Instruction said, “These are some of the toughest challenges we’ll see in our lifetimes.” He called “healthcare the ultimate equity issue” and said school-based health was “a top priority.”  

The opening keynote speaker was Dr. Elisha Smith Arrillaga, executive director of The Education Trust–West, a research and advocacy organization focused on educational justice and supporting the high achievement of all California students. She said, “I want my son to say in the face of this epidemic that we stood by him. We must do much better, much faster. We must be co-conspirators for justice.” 

The closing keynote was given by Dr. Tichianaa Armah, medical director of Behavioral Health at the Community Health Center Inc., one of Connecticut’s top school-based health center providers, and assistant clinical professor at the Yale School of Medicine. Armah outlined the impact of racism on the health and mental health of BIPOC students and communities. She shared compelling evidence of how stress of racial injustice has real health consequences, from stress and negative emotions to low-grade inflammation and chronic disease. 

The CSHA Convention included three days of sessions on topics ranging from sexual and reproductive health to school mental health. The L.A. Trust’s Program Manager Robert Renteria headed a panel on “Implementing SBIRT in SBHCs” and three staff members from The L.A. Trust served as room hosts. Sixty attendees registered for the conference as guests of The L.A. Trust. 

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.

Student advocates prepare at The L.A. Trust Academy

Student advocates, shown here at The L.A. Trust’s Y2Y Conference in March, discussed how to conduct peer campaigns in the new school year on August 4-7.  

Two dozen Student Advisory Board members from five Los Angeles high schools met with staff members of The L.A. Trust for its first-ever Summer Academy learning session August 4-7, 2020. 

The students learned how to conduct peer-to-peer health campaigns, discussed ways to encourage visits to L.A. Unified Wellness Centers, and gained greater knowledge of healthcare disparities. The four-day pilot event was attended by SAB members from  Crenshaw, Jordan, Locke and Washington Prep, as well as students from John Marshall High School.  

The online Academy was facilitated by four staff members from The L.A. Trust: Robert Renteria, program manager; Eddie Hu, program manager; Mackenzie Scott, student engagement program coordinator; and Dannielle Griffin, student engagement program assistant.  

Organizational facilitators from L.A. Unified Student Health and Human Services helping to inform and guide the students included Gloria E. Velasquez, Victor Luna, Rene Bell-Harbour and Maggie Yu-DiPasquale. 

Impressed  

Renteria said he was impressed by the students’ commitment to the 20-hour learning program. Scott said the students were knowledgeable (“they could have presented my learning modules”) and engaged (“the chat was blowing up like crazy.”) 

Students discussed mental health, sexual and reproductive health, substance use prevention, public health, and their own career development. Wellness Center staff logged on to brief the students on updated hours and services and how to refer peers to the clinics. 

Students took a break from their learning to share their insights with The L.A. Trust Board of Directors at their annual retreat, August 6. Maryjane Puffer and Board members thanked the students for their frank accounts of how the pandemic is affecting them and their communities. 

The L.A. Trust’s Student Advisory Boards have met since August 18, the first week of L.A. Unified’s 2020-2021 school year. Renteria said, “Thanks to the Summer Academy, we have students ready to conduct campaigns about student and community health and to help increase awareness and use of the primary, mental and oral healthcare services offered by L.A. Unified’s student and family Wellness Centers.”

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.

The L.A. Trust launches new website and campaign

The L.A. Trust’s new website and rallying cry — Putting the care in student healthcare — is the culmination of a reinvention and rebranding initiative started last year.

The Los Angeles Trust for Children’s Health has launched a new rallying cry, website and outreach to help it better serve students, community members, allies and healthcare partners throughout the region.

“This website is the part of a reinvention process we began last year,” said Maryjane Puffer, executive director of The L.A. Trust. “Since then, we’ve developed new strategies, values, vision and mission statements. We introduced new branding, communications and outreach. Today we introduce a new website and a new rallying cry, ‘Putting the care in student healthcare.’

Multiple pandemics

“We’re fighting multiple pandemics.” Puffer said. “Our students are hurting, our communities are struggling and many of our institutions are reeling. Our new rallying cry represents The L.A. Trust’s commitment to help our kids and teens address the challenges they face.”

Rob Wray, associate director for communications and media at The L.A. Trust said, “Our new website tells the story of The L.A. Trust. It outlines our missions, showcases our work and provides important resources on student health,” he said.

“This site, developed in-house and by LeftBrainRightBrain Marketing, is the beginning of the process, not the end,” he said. “We will add more resources, more news and more stories going forward, evolving with the needs of our constituents  and partners.