Shortage of nurses in Philadelphia schools costs everyone

WITH a 25 percent poverty rate ($23,050 or below for a family of four) - up from 18.5 percent in 2000 - Philadelphia is the country's biggest poor city. Seventy percent of its children have public health-insurance coverage.

Yet, since the summer, the Department of Public Welfare has removed 25,000 city children from the medical assistance rolls, kids whose family incomes are believed to still fall within the qualifying guidelines. For these now-uninsured children - and every other child who attends the city public schools - the district's layoff of 47 school nurses means that the children's health and educational prospects have taken a step backward.

The result - predicted a school nurse who barely escaped losing her job - will be "more chaos" added to an already overburdened system of no-fee health services that acts as a safety net. "The public needs to understand our function," she said. "The role of the school nurse is to keep children healthy enough to be educated and make sure they have no barriers to education from a health-care standpoint."

Identifying health care needs before students get an illness - that is, prevention - is critical, the nurse explained, recalling a school open house last fall at which she distributed vision and dental paperwork, and Children's Health Insurance Program (CHIP) applications. "I had more parents stop for CHIP forms than I ever had before," she said. "People are suffering, getting jobs without health insurance, so they don't qualify for medical assistance. But so many kids are medically fragile."

Sick children going to school is "nothing new," happening even when she was a child, noted a veteran Philadelphia teacher with 50 years of classroom experience. "Kids would get sick on Saturday and the parents would say, 'Go see the school nurse,' especially during tough economic times. Nurses were a mainstay during the Depression, when parents didn't have money for the doctor."