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Meeting students’ medical needs: Schools stepping in to fill gap

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Earlier this year, two students failed the vision tests at Break-O-Day Elementary School, but their parents couldn’t afford glasses needed to help them see.

Indiana requires schools to conduct hearing and vision tests for students at different grade levels. If students fail the vision tests, their parents are notified and given a referral to see an optometrist.

But this year Break-O-Day counselor Aaron Munson has been seeing more families who either can’t afford insurance or who have coverage but can’t afford the cost of doctor’s appointments, prescriptions or glasses.

When that happens, at Break-O-Day and other Johnson County schools, counselors and school nurses find ways to help families get their children the care they need. Sometimes the assistance involves helping sign parents up for Medicare, but some schools also have money set aside to pay for glasses or medicine for students whose families can’t afford the cost.


Here are the details of the medical services schools must provide:

A vision exam conducted by an optometrist is required for students in either kindergarten or first grade. This is to be sure students can see clearly. Any students who fail are given a recommendation to receive a complete exam by an optometrist.

The state also requires vision screenings to be conducted for students in third and eighth grades by either a school nurse or a recognized organization, such as the Lions Club.

The state also requires hearing screenings, typically conducted by a school’s speech pathologist, for students in Grades 1, 4, 7 and 10.

Collecting this money is now part of what schools have to do to help teach students, Northwood Elementary School guidance counselor Ellen Mae Paris said.

“It’s not the schools’ responsibility. But if a child is in need and you want to educate them, how are you going to do that?” she said.

In recent years, school counselors and nurses at Clark-Pleasant and Franklin schools have noticed the number of families who need help covering medical costs has been rising.

Munson typically helps one or two families sign up for Medicaid per year. But so far this school year year he’s already signed up five families.

“To me it’s just another sign of the economy. It seemed to get better for a little while, but at least in our school population it seems like it’s back to where it was a few years ago when we had the huge recession with lots of job losses,” he said.

Counselors and nurses view helping those families as the school’s responsibility because a child who is always sick or who can’t hear or see the teacher isn’t going to learn.

“How can you educate a kid who is ill all the time? Or can’t see? Or has throbbing pain in their mouth?” Paris said.

Munson recently worked with the family of a student who had been misbehaving in class and who rarely followed the teacher’s directions. He encouraged the family to have the student seen by a physician, who diagnosed the child with a hearing problem.

The student was able to work with a speech pathologist, and the teacher and student now use a special microphone and headset so the student can better hear what’s happening class.

But when families can’t afford to have their children regularly seen by a doctor, hearing, vision and other medical problems can be missed, Munson said.

For about 12 years, Franklin has offered services for students such as dental visits and help affording eye exams and glasses. As the number of students enrolled in the free and reduced-price lunch program has steadily grown — this year, 46 percent of Franklin’s students participate — so has the number of families who need help covering medical costs, Paris said.

“When you’re trying to survive in the day-to-day world, those things aren’t as prominent — the regular care,” Paris said.

Nurses at Clark-Pleasant also are seeing a jump in the number of students dealing with chronic medical conditions such as diabetes or asthma. Parents of these students may be working and don’t qualify for services such as Medicaid but still can’t afford the cost of medical appointments or medication. But nurses don’t always have the kind of medicine, such as asthma inhalers, the students would need, corporation nurse Deborah Johnson said.

To help parents provide regular dental care for their students, Clark-Pleasant, Franklin and Greenwood have a dentist visit some of the schools once or twice a year. The visits typically are for students from low-income families, though all students can sign up for the exams. Low-income families usually aren’t charged for the visits or are charged based on their income level, school nurses said.

At Franklin, the number of elementary school students who see the dentist has climbed, from between eight to 10 students per visit two years ago to 10 to 15 students per visit now. Corporation nurse Beth Arkanoff attributes the spike to working parents who can’t afford to miss work to take their children to a dentist appointment.

Schools also provide help to families to help pay for those appointments and treatments.

Clark-Pleasant and Greenwood both receive 10 to 12 vision vouchers each year from groups such as the National School Nurses Association. The vouchers cover the cost of eye doctor appointments and are given to low-income families in the school districts, Johnson and Greenwood corporation nurse Libby Cruzan said.

Break-O-Day and Northwood also receive donations that the counselors can use to pay for glasses for students who need them or for prescriptions their parents can’t afford.

Munson, who typically receives between $200 to $300 in donations from residents, churches and other groups each year, started receiving the money a few years ago. The donations started after volunteers who worked at the school got to know students and their specific needs. As word spread, Munson started receiving phone calls from people asking if he needed cash donations and how the money would be used.

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