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No Entry Without a Physical

Physicals available for uninsured children for new school year.

With the start of a new school year, how many children will be denied entrance on opening day because they have not passed the required physical examination? That is the challenge of Partnership for Healthier Kids (PHK).

To enroll in school, Virginia law requires proof of a recent physical examination as well as up-to-date immunizations for diphtheria, tetanus, pertussis (whooping cough), polio, measles, mumps and rubella. Hepatitis B is required for those born after Jan. 1, 1994 and any student in grades six through nine. Chicken pox vaccine is a must for all students born after Jan. 1, 1997.

"Inova Health System is joining with Alexandria Public Schools, Fairfax County Health Department, Faith Health Coalition, Greater Springfield Community Partnership and the Mount Vernon Community Coalition to provide free physicals and immunizations so that uninsured students will be able to attend classes this fall," said Beth Visioli, Inova public information.

It is a joint effort under the aegis of PHK, according to Shelby Gonzales, PHK director. "We are not a health provider. We are an outreach organization," she said.

"The idea is to make a real impact for helping kids. The program is limited to low income families and Virginia residents who do not have access to Medicare, Medicaid or health insurance," Gonzales said. "We started with one school in April 1998. We are up to more than 200 schools today."

PHK prefers to get the students into FAMIS [Family Access to Medical Insurance Security] or FAMIS Plus, also known as Medicaid, but in most cases the family income is just enough to exclude them from eligibility, according to Gonzales. They fall into the sociological category of the "working poor."

Gonzales said eligibility for FAMIS is based on incomes up to 200 percent of the Federal Poverty Guidelines. FAMIS Plus is up to 133 percent of Federal Poverty Guidelines.

Since its commencement, PHK has aided more than 50,000 students, according to Gonzales. "Inova is the lead partner and major funder for PHK," she said. "In essence Inova is my employer."

"But, PHK doesn't go through the hospitals. Inova does fund it and some of our physicians and nurses participate in a professional capacity," Visioli said.

"Student physicals got started three years ago when the Greater Springfield Partnership became concerned that many students would not be able to start classes on time because they had no access to medical services," Gonzales said. "The major reason for that was that the families could not afford them."

PHK OPERATES year-round at schools as an outreach program to connect students and their families with on-going medical services. It is done not just through Inova but also in conjunction with a series of clinics operated by local and county governments, according to Visioli.

Recently, the Mount Vernon area started their own program through the Mount Vernon Community Coalition. The volunteer organizer is Bonnie Lilley who, as a social worker, worked with the original PHK program in the Springfield area.

"We needed something like this in the Route 1 corridor. So we started it last year," Lilley said. "It is under the combined sponsorship of Inova Health System, Fairfax County Health Department and MVCC."

MVCC provided service to 109 children last year and is hoping to increase that to 150 this year. "But, we need to get more physicians and nurses to volunteer. Presently, we have a combination of six doctors and nurse practitioners involved," she said.

MOUNT VERNON AREA services are provided at the South County Government Center, 8350 Richmond Highway, on the second floor where the County Health Department maintains offices. "We do the complete physical right there," Lilley said.

"We also have to have a lot of interpreters present due to the large immigrant population in the Route 1 corridor area," she said. This language barrier brought about the program's only problem last year, according to Lilley.

"While the physicians were helping one child, a three year old got away from the mother and pulled the fire alarm. We had to evacuate the entire building until the fire department was sure there was no problem. The fire chief then had a talk with the mother and child. Somehow, I don't think we'll have that problem again," Lilley said.

The program is geared to children who were falling through the cracks because of lack of access to medicare and medical insurance," she said. MVCC's next physicals are scheduled for Aug. 21 from 8 a.m. to 1 p.m.

In Alexandria the program, known as Alexandria Medical Care for Children Partnership, is operated under the Northern Virginia Family Services umbrella. "We've been working with PHK for several years to provide medical service for Alexandria families and to get them allied with a physician," Elizabeth Smith, nursing supervisor, Alexandria Health Department, said.

However, due to a lack of funding, the Alexandria program was put in jeopardy, according to Carol Jameson, director, Health Access Program, Northern Virginia Family Services. "We knew from the beginning that in order for the Alexandria program to function we would need to receive funds from the City. We were not able to get them."

The program did receive funding from several foundations. But as for city funds, "There were more needs and demands than available money," Jameson said. "We had to close the program."

"Starting three years ago we brought in a variety of community groups as well as physicians who were willing to provide services for a very low fee. We also sought to find a medical home for children and families," she said.

"THIS WHOLE PROGRAM grew out of the realization that children with a medical home do better in school because they stay healthier," Jameson said. But, the program has been transferred to the Arlandria Community Health Center, formerly known as the Arlandria Center for Women and Children, due to its receipt of a large federal grant, according to Jameson.

"The Center is funded by a variety of sources. Their revenue is not just dependent on federal money. We are planning on transitioning children to that free-standing clinic in the Fall," she said.

"We are extraordinarily grateful to the community physicians and their staff for the care they are providing to these children and their families. Presently, we are providing 24/7 access to care for 45 children. We have served over 100 children since we started," Jameson said.

According to Inova, PHK health screenings and immunizations will be available:

* Aug. 7, 8 a.m. to noon, Medical Education Center, 6699 Springfield Center Drive, Springfield

* Aug. 21, 8 a.m. to noon, Mount Vernon Health Department, South County Government Center, 8350 Richmond Highway, Second Floor

* Sept. 1, 9 a.m. to 2 p.m., Hammond Middle School, 4646 Seminary Road, Alexandria

Appointments are required due to limited space. To make an appointment call Inova PHK at 703-321-1990. PHK will have staff on hand to help uninsured children and families find a source of coordinated care, Visioli said.