Susan Franzetti was at wits end when she approached The University of Texas School of Nursing to plead her case. It was 1995 and Franzetti found herself in the unenviable position of being the one and only school nurse for the approximately 5,000 students in the Del Valle Independent School District (DVISD), a rural area that encompasses 174 square miles southeast of Austin. An alumnus of the School of Nursing, Franzetti had a hunch that if anybody could help her with the health care crisis, it was the nursing school.

She was not disappointed.

Dolores Sands, dean of 14 years in the School of Nursing, listened to Franzetti’s dilemma and decided that intervention was necessary. Franzetti had taken on the Herculean task of being nurse to an entire school district, and the Del Valle population and school district presented special challenges.

Most children in the area were medically uninsured. More than half of the children in the district who started a school year there moved before the school year was over. There was no pediatrician in the district. Most of the families were Spanish-speaking and employed in low-paying service-industry jobs that offered few or no benefits. Some of the families lived in homes with no electricity or running water. When a child was ill, those families fortunate enough to have transportation drove to Austin and waited in a hospital emergency room to get help for an earache or fever.

“There was very, very little in that district in terms of services, and it was an impossible situation,” says Linda Carpenter, assistant dean of student affairs and clinical affairs in the School of Nursing. “Sometimes children would miss 2-3 weeks of school just in the process of trying to get the required immunizations.”

Although around 71 percent of the children in the district are still considered to be economically disadvantaged, their parents work in low-paying jobs and many don’t have transportation, access to quality pediatric health care is one problem that’s been crossed off of the list.

Thanks to a partnership between DVISD and the School of Nursing, the school-based, nurse-managed Children’s Wellness Center was born in 1996 with a Texas Department of Health grant. It is thriving today.

Pat Budd (right) is a Pediatric Nurse Practitioner and director of the Children’s Wellness Center.

“It’s been a wonderful arrangement,” says Sands. “DVISD provided the site and facilities, which means that we don’t have to pay overhead. We take care of operating expenses and staff, and we get to utilize the center as a teaching and research spot for our students. And, of course, the children in the area get the best care.”

Situated in small portable buildings, the Wellness Center has offered health care—including everything from well child exams to sports physicals and acute care—to about 15,000 patients since it opened and has provided 18,000 children with immunizations. In addition to primary health care services, the center also provides community outreach and behavioral health services for DVISD patients from birth to 21 years of age. No child is denied medical care, even if the family is unable to pay.

Pat Budd, a Pediatric Nurse Practitioner (PNP) and the director of the facility, describes the center’s approach to health care as “beautifully holistic.”

“It’s so wonderful to get to do things the way they need to be done,” says Budd. “When a family comes in with a sick child, our PNPs do more than just diagnose the problem and send them on their way. The PNP or social worker asks how the sickness is affecting their lives. If a family has no money or insurance, how are they going to get a prescription filled? If they don’t have transportation, how are they going to get to the drugstore or clinic? Do they have running water or electricity at their house?”

Every effort is made by the clinic staff to see that each child receives the best care possible. Prescription vouchers are given to families that cannot afford to pick up their medicine, and taxi vouchers may be provided if a family has no form of transportation.

“These families need to be able to follow through,” says Budd. “We like to keep the ball rolling and get the children well and back in school as soon as possible. We also want the families to see that they’re not getting lesser care just because they don’t have a lot of money.”

According to Sands, potential donors who have visited the clinic have noted that the facility in no way resembles a health care center for an “underserved” population.

For example, with a program called Reach Out and Read, every child is given a book to take home at each visit. Also, in order to educate parents as well as care for the children, Wellness Center staff have been trained in a pediatric treatment style called Touchpoints. Created by T. Berry Brazelton, internationally renowned pediatrician, the Touchpoints method teaches that there are predictable places during a child’s development where certain changes occur and that if the family is taught to anticipate those changes, frustration and confusion can be greatly reduced. When staff at the Wellness Center explain developmental changes to parents, they find that informed parents view even fussy or difficult behavior from a child as exciting and wonderful because it signals that “everything’s normal.”

The compassion and commitment of the clinic staff has not gone unnoticed by the community of Del Valle. In March of the first year that the clinic was open, 84 patients were seen. In March of this year, the clinic saw 470 children, an indication that the staff’s efforts to raise awareness and their goal of becoming a vital part of the community have been a success.

“It’s amazing,” says Carpenter. “Appreciative individuals leave little donations and presents on the steps of the clinic after hours. The neighborhood even created a butterfly garden for them in front of the center.”

In addition to giving the community of Del Valle an invaluable resource, the Wellness Center has greatly benefited the School of Nursing. Each semester undergraduate and graduate nursing students are placed at the center for well child and sick child care training. Faculty and students also are able to conduct research at the clinic and have done studies on obesity, asthma and risky sexual behaviors, among other things.

“All three UT missions are exemplified in our work with the Wellness Center,” says Carpenter. “It meets UT’s commitment to respond to the community’s needs. It fulfills the teaching mission - about 160 nursing students a semester are placed there, along with students from other academic areas on campus like business, social work, management science and information systems and the Plan II program. And the center has endless potential for research.”

Although the clinic has the enthusiastic support of the community and The University of Texas at Austin, donations and volunteer workers are always welcome. With a small staff and a seemingly endless supply of children with ailments, the challenges the clinic faces can be overwhelming.

“Every one of us at the clinic is a jack of all trades,” says Budd. “We work long hours, and we work hard, but it’s the best job in the world. I don’t care what, if you’re a kid in the Del Valle area, you’re sick and you come to our center, you’re going to get care.”