CHILDREN’S HEALTH CARE
Working with Community Providers to Respond to Child Health Challenges Philip Ziring, MD
T
he Maternal, Child and Adolescent Health (MCAH) unit at SFDPH has served the community for many decades by providing important, well recognized services such as Women Infants and Children’s Nutrition program (WIC), California Children’s Service for children with disabilities (CCS) and the Child Health and Disability Prevention program (CHDP). Recent years have brought new challenges to the children and families of our community, especially for our most vulnerable populations, and the MCAH program has developed a variety of new programs to meet these challenges. SCHOOL HEALTH PHYSICIAN LIAISON
The San Francisco Unified School District serves 60,000 children in more than 100 schools and Child Development Centers throughout the city. Children with disabilities in the special education program (including, for example, several who are ventilator-dependent and a rapidly growing number who have autism spectrum disorder) receive special services from the district’s Special Ed teachers, psychologists, speech therapists, OTs and PTs, and a group of specially trained nurses who, in cases of special medical need, may provide one-on-one care in the child’s classroom.
Other nurses in the district’s school health program provide health care coordination and health education in areas such as diabetes management, immunization and medication monitoring, asthma management, monitoring the community physician’s emergency care plans, and training in nutrition and physical activity. Other nurses and therapists provide services in several high school Wellness Centers, and in Child Development Centers for preschool children. For the last two years, I have served in the capacity of physician consultant to this complex system at the SFUSD and have assisted the district in a number of projects, including the recently revised guidelines for tuberculosis screening. I have also served to strengthen links between important DPH programs (such as communicable disease, immunizations, etc.) and assisted community physicians in gaining easier access to SFUSD health services through presentations at grand rounds and discussions at our MCAH Pediatrics Advisory Committee. I remain available to assist community physicians as needed. Please contact me at philip.ziring@sfdph.org or by telephone at (415) 575-5709. CHILD CARE HEALTH PROJECT
A group of dedicated MCAH public health nurses have been providing child
health and safety services in a number of child care centers for several years. Designed to enhance child care staff’s knowledge of child health (nutrition, immunizations, infectious disease, disaster preparedness) in centers located in some of our most economically challenged neighborhoods, the nurses also carry out screening of young children’s vision, hearing, dental and, more recently, developmental needs. It is anticipated that they will be starting to measure children’s BMI at some centers and offer training in child nutrition and physical activity to carry out primary prevention and early intervention efforts in this childhood obesity epidemic. FOSTER CARE NURSING AND UNIVERSAL HOME VISITING PROGRAMS
Public health nurses and a medical consultant from the MCAH program have provided health consultation to Department of Human Services staff in the foster care program for several years. Of the thousands of children in foster care in the city, a substantial number have significant health care needs and the staff assures that these children have access to a medical home and a wide range of other health services. The Universal Home Visiting staff of public health nurses visits the home of new parents and their babies to assist with breastfeeding, general
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SAN FRANCISCO MEDICINE / NOVEMBER/DECEMBER 2005
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