In 1995, the school district nurse for DVISD approached the UTSoN for assistance with the complex health problems of the children in this area. Ms. Franzetti was the only registered nurse working in the district at that time. After discussions about the health care needs of the DVISD, a community needs assessment, gathering of information such as health status, school attendance, health care resources, and other data from key community members, the Children’s Wellness Center was established in April 1996. Initial funding was from the Texas Department of Health, as a primary health care site for children ages 0-12 who reside in the DVISD.
This rural school district encompasses 174 square miles. There is no town in this area; the community is defined by the school district. There are approximately 10,000 children between the ages of 0-21 years living in the DVISD. Of these, nearly 8,000 are currently enrolled students in the district. This is a poor community with 74% of families qualifying for the school lunch program. DVISD has no public transportation, few public services, no grocery store, pharmacy or library. Transportation is a large factor in lack of access to medical care. There is an exceptionally high rate of transience in the school district; fifty percent of the children who enroll in DVISD at the beginning of the school year do not complete the academic year in the district. The community is predominantly Spanish speaking. The CWC clientele (as identified by the parent) is 74% Hispanic and 11 % African American or bi-racial.
Fifty percent of the men in the community work as contract laborers with an extremely variable income from month to month, affecting the family's ability to obtain or keep Medicaid coverage. Other families are just above the federal poverty guidelines, or have Mexico-born children and do not qualify for Medicaid or the state Children's Health Insurance Program (CHIP). Families without funding pay on a self-selected sliding scale. No child is ever denied services for lack of ability to pay. The cost of using the emergency department at Children's Hospital for a simple respiratory illness costs more than $200. Currently, the CWC cost of treating the same illness, including provision of over-the-counter medications, is $70.
In addition to care for the illnesses and injuries common to childhood and adolescence, the CWC has several special programs. Our medical Social Worker assists families with authorizations, behavioral intervention, parenting issues, advocacy and case management. Asthma and Obesity have been identified as problems in this community, and the CWC has active programs addressing each. The CWC is integral to the health and well-being of the children in this district.
The CWC works with more than 160 students from the University of Texas each year, in various departments. Besides nursing students at all levels, there are students in social work, human development, educational psychology, accounting, and Plan II.