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A 10,000-MILE CHECKUP : For Many North County Poor, Health Care Comes on 4 Wheels

August 24, 1989|JOHN NEEDHAM | Times Staff Writer

Their parents had brought them:

Danny Perez, 5, for anti-measles shots and other vaccinations before he could enter school.

Pedro Cervantes, 7, for a checkup for possible after-effects from his treatment of a bee sting.

Saul Sanchez, 10, for an exam to determine if he was too small for his age.

None of their families had insurance to cover this kind of treatment. None had cars to get to a clinic. A handful came by bus, but most walked to the Maple Community Human Services Center in Fullerton to wait for the mobile health van from St. Jude Hospital and Rehabilitation Center.

The van with its staff of three, assisted by occasional volunteers, dispenses treatment to children in exchange for donations that their families can afford. In a report this month in the American Journal of Medicine, the van was hailed as a cause for optimism in what the author, Dr. F. Allan Hubbell, otherwise viewed as a crisis in health care for the poor in Orange County.

The study of north Orange County residents, funded by St. Jude, found that 37% of the poor--compared to 27% nationwide--lack medical insurance and fail to get basic medical care, such as vaccinations.

The van has chalked up more than 10,000 miles in bringing medical care to the people who need it the most--those too poor to afford treatment or unable to find transportation to a clinic, hospital or the state Department of Health Services office in Santa Ana that processes Medi-Cal forms for the state insurance program.

Joan Furman, a registered nurse and executive director of the hospital's program providing medical care for the poor, said: "Our basic feeling is that health care is a right, and it's not a privilege."

The hospital, owned and operated by the Sisters of St. Joseph of Orange, has operated the 36-foot van for a year. Initially, the hospital estimated that the van would treat 1,500 children in that time. The actual total: 5,835.

Only one similar medical van operates in the county, according to health officials. Run by the nonprofit Orange County Community Development Council, it hits the road one day a week in South County, tending mostly to homeless adults, said the council's executive director, Clarence W. (Buddy) Ray.

St. Jude's van operates four days a week in North County, shifting its location daily. On Tuesdays it heads for the Maple Center, where Danny Perez, his mother and sister arrived at 6:30 a.m., an hour and a half before the van.

His mother, Consuelo Perez, said the family had health insurance, thanks to her husband's job making batteries, but it didn't cover immunizations or routine physicals. For more serious treatment, the family would still have to pay a $100 deductible before the insurance took over, she said. Asked to contribute what she could, Perez paid $6; the shots would have cost her $90 or more at a private doctor's office.

Perez brought her 14-year-old daughter in case she needed a translator. She didn't because the three people staffing the van full time speak Spanish.

By the time the van rolled up to the Perez family, more than 30 children and two dozen adults were waiting. Tugging at mothers' skirts, laughing and shouting, the children were the beneficiaries of a $200,000-a-year program run largely on donations.

Jennifer Young, the nurse-practitioner who conducted the exams and dispensed prescriptions and advice--to be reviewed later by a doctor--said as many as one-third of the pregnant mothers she sees have had no medical care in the first three months of their pregnancy. She said much of her work is in educating parents on the importance of preventive medical care.

Sometimes, though, medical ailments spawned non-medical problems.

Pedro Cervantes, a restaurant busboy with a weekly salary that seldom tops $180, said his 7-year-old son, Pedro Jr., suffered a severe reaction when he was bitten by a bee a few weeks ago. Neighbors called an ambulance to take the boy to a hospital. While Young checked on Pedro Jr. to see if there had been any after-effects, the father mentioned that the ambulance bill had been $162 and that the hospital charged about the same.

Young started telephoning from the van and told him that there was a chance a government program for the poor would pick up the bill. Smiling widely and thanking her profusely, Cervantes said he would check back to do what was needed to get the bill paid.

Rosa Ramirez, 39, of Fullerton, needed help with housing as well as an examination for Francisca, the 9-month-old asleep in her arms. Ramirez receives food supplements through the Women, Infant, Children medical program funded by the federal government. But she was looking to live somewhere other than the house she and her 11 children share with two other families, who have nine children of their own.

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