New Orleans health centers, key to Katrina recovery, face closure

Five years after Hurricane Katirina, New Orleans is expected to receive a $1.8 billion FEMA grant to build and renovate about 85 schools. Senator Mary Landreu said in a statement Wednesday that she had been told by an Obama Administration official that the announcement would come later this week.  Schools were devastated after Hurricane Katrina, and many children continue to go to school in temporary or inadequate schools.

Meanwhile, another program seen as key to the recovery efforts in the city is facing cut backs.
When the 2005 flooding destroyed several New Orleans hospitals, School Based Health Centers, along with other neighborhood clinics, stepped in to provide primary and mental health care for New Orleans’ residents - including kids - who needed service.  But as Federal funding for the School Based Health Centers expires, the Centers are forced to close their doors or dramatically reduce services. FSRN's Eve Abrams reports.

TRANSCRIPT

When 16-year-old Jordan Barns needs to go to the doctor, he gets a pass from his teacher.

JORDAN BARNS: Mr. Johnson, may I have a pass to the nurse's office?
MR. JOHNSON: Yes, you can.

Jordan walks out the cafeteria door of New Orleans Charter Science and Math High School, known as Sci High.  Ahead to the left is the school-based health center, where Jordan knows everyone by name.

MISS BODET: Hi, Jordan how are you today?  
BARNS: Hi, Miss Bodet.  
BODET: Do you have a pass?  
BARNS: Yes. 
BODET: Great, would you sign in right here for me, please?  What brings you in today?  
BARNS: I just came to get a sports physical...

Jordan says the  school-based health center has given him training wheels for the real world.

BARNS: Say if I was going to my own doctor once I turned 18, I wouldn't know what to expect.  The clinic gave me a chance to experience a good medical service.  The people here take on I would say like a parental role, in a way. Because if you tell them something they’re not proud of they’ll let you know.  But it's not like they'll judge you.  They'll be like, this is what happened, we need you not  to do this again. and you know, make it better.
MELISSA NASS: I know that what we’re doing here is preventing great and enormous costs to our community and to our children.

Melissa Nass is one of the pediatricians who spends part of her week at Sci High’s school-based health center.  Nass says that when kids are young they usually have regular contact with doctors for shots and check-ups, but by the time kids become teenagers, those medical points of contact taper off.  And without regular doctor visits, teens might lack information about largely preventable sickness, injury and death from car crashes, suicide, homicide, substance abuse, and HIV.

NASS: Those are not typically issues that adolescents would seek out care for. Mom, I have to go to the doctor, I have a substance abuse problem.  Mom, I have to go to the doctor, I feel depressed.  And so by really providing comprehensive health care services on campus where the students have immediate and constant access to the health center, we are able to address those different needs for these kids.

Students--including Jordan Barns--agree having a clinic at school prevents big problems.

BARNS: For instance, if someone had a stomach ache and they just thought it was a regular stomach ache, they don't want to tell their mother because their mother will  have to take off work, have to take them to the doctor, you know, they would feel guilty about it.

The first time Jordan came to the clinic was on assignment from his Health Class.

MYRA CISSY BURSON: We sort of see obesity as what kind of problem first? Physical, mental or social? 
CLASS: Physical.
BURSON: What are the issues associated with obesity?  
CLASS: Diabetes.

Jordan’s health teacher, Myra Cissy Burson, requires her students to have a physical at the health center and also to interview their families about their medical histories as part of their class grade. This contact helps the health center identify a number of conditions which, untreated, could have had a negative impact on students’ lives.

BURSON: Or even their performance in school.  Just this week I had two more students came to me and talk about being given iron pills because they’re anemic–something easily remedied, but if not remedied has a huge effect on learning.

But much of that cost-saving medical care is about to disappear.  A crucial amount of funding from the Federal Department of Health and Human Services [known as the Primacy Care Access Stabilization Grant] is set to expire in the end of September, five years after Hurricane Katrina’s devastation.  These leaves New Orleans’ school-based health centers in dire straits.  Sue Ellen Abdalian is the head of adolescent medicine at Tulane University and she runs a few school-based health care centers in New Orleans.

ABDALIAN: Many of them are not going to open or are going to open with very limited services. What we’ve learned with adolescents is location location location.  You need to be where they are, be there when they’re ready because they're not going to come in at another time.  It’s when they’re having the issue that they will actually walk through your door.

For now, Jordan Barns is one of the lucky ones.  The school-based health clinic at Sci High has had to cut staff and services, but it’s still open – at half the hours it used to be.  At least for the time being.

Eve Abrams, FSRN, New Orleans.