School Board Takes Step Toward a Health Clinic

A school-based health and social service clinic was approved in concept late Tuesday night to serve public schools in the East San Diego neighborhoods around Hoover High.

The 3-2 favorable vote by the San Diego Unified School District board of trustees followed almost five hours of debate, at times highly emotional and centering on pregnancy counseling and contraception.

The decision directs Hoover administrators to set up a broadly representative committee of parents and community leaders in the Mid-City area to design a detailed plan with a menu of specific medical services, draw up a contract for a clinic operator and obtain money from private national foundations that support such clinics.

Those specifics, which could require as much as a year to fully develop, would then come back to the school board for final approval before a clinic could open. The clinic would be at Hoover but would serve all kindergarten through 12th-grade students in the area.

Board members Susan Davis, Ann Armstrong and Shirley Weber supported the proposal, which was brought to the board Tuesday by a smaller committee of Hoover teachers and parents seeking to improve student health and counseling at Hoover, its feeder junior high, and seven elementary schools.

Trustees Jim Roache and Kay Davis voted no.

Alternative Proposal Fails

Roache and Davis also failed to win support for an alternative proposal that would have prevented the committee from considering family-planning or reproductive services, including prescriptions for birth-control medications and other devices--with or without parental permission. The potential for such services at a clinic, no matter how small a proportion of total services, was the focus of almost all opponents of the concept.

The board majority said they did not want to rule out those services in advance of detailed discussions within the Hoover community, where preliminary surveys have shown support for some form of counseling for family problems and referrals on pregnancy and sexual issues.

But the approval Tuesday night included language added by Weber that mandates parent involvement in the planning and administration of a clinic as well as parent approval for any type of medical or counseling service before a student would be eligible.

After the vote, Weber said she wants the Hoover community to come up with new ideas for counseling, especially in the area of sexual education and pregnancy matters, that differ from those now followed in most community- and school-based health centers around the country.

“I want them to do something different, that just doesn’t duplicate what is done on the outside now, such as by Planned Parenthood,” Weber said. “I don’t know what that might be, but I want them to try.”

Weber suggested that the clinic tailor counseling and mental-health services along the lines of those put into effect by Yale psychiatrist James Comer in schools in New Haven, Conn. The so-called Comer model uses social workers and a psychologist to bring parents and students together, assuming that improved academic performance follows active parent or family participation in the workings of a school.

Weber left open the question of whether she and the board would limit reproductive services if a final proposal were to include them.

Nevertheless, the vote left opponents crestfallen after hours of vitriolic testimony, although many had feared an unfavorable outcome. Joan Patton, a prominent spokeswoman for anti-abortion groups in San Diego, said the board showed its preference for birth control by rejecting the Roache alternative.

The proposal followed half a year of preparation by the Hoover committee. In a student survey last October, more than half said they have no regular health care. The Hoover nurse sees an average of 1,000 students a month, but can only diagnose and refer for most medical problems. Of students in the area, 54% of their families receive welfare and many are unable to afford private doctors or even public clinic care.

The Hoover committee also conducted a one-page mail survey of 8,000 parents with children at Hoover, at Wilson Middle School and at the seven elementary schools in the neighborhood. Of the 17% of parents who returned surveys, 93% supported the concept for a health and social service center for kindergarten through 12th-grade students as long as the school requires parental consent for general use.

Support of Parents

Parental majorities in the 90% range at both the elementary and secondary levels approved proposed services for counseling on job opportunities; police-related problems and drug and alcohol concerns; medical care for illnesses and injuries; physical exams, immunizations and medications, and referrals for specialized medical and dental care.

In the two most controversial areas of services, more than 80% of parents at the secondary level approved the idea of counseling for family problems and providing information about pregnancy and sexual problems, and necessary referrals. Two-thirds of the parents at both Hoover and Wilson approved the idea of providing contraceptives to their children.

A proposal initiated three years ago by schools Supt. Tom Payzant for school-based clinics as a districtwide policy was turned down, 3 to 2, by a previous board of trustees after a bitter battle that abortion opponents turned into a debate over the morality of providing family-planning counseling to teen-agers.