COACH for Kids – and Its Director – Mark 20 Years of Bringing Healthcare to the Poor

* SENTINEL NEWS SERVICE

Michelle Raisley Pauley remembers her first trip to a public housing development and discovering 5-year-old children who had never been immunized because a clinic down the road sat in rival gang territory.

She recalls meeting mothers who didn't have enough money to buy their children cold medicine. And she recollects boys and girls failing school because their blurry vision had never been diagnosed or corrected.

Rigsby Pauley has tackled these challenges head-on, assisting second generations of some families over two decades of service.

Working initially as a nurse practitioner and later as director of COACH for Kids and Their Families, part of the Maxine Dunitz Children's Health Center at Cedars-Sinai, Rigsby Pauley says it's been a blessing to bring healthcare to the doorsteps of the less fortunate. The program's two mobile medical units visit low-income neighborhoods four days a week, providing vaccines, wellness checkups, vision tests, hearing tests and more to children and parents in need.

"I am very proud that I can be part of something that's making a difference in the lives of people," Rigsby Pauley said. "I am always thinking, 'What more can I do?' 'How do we fix this problem rather than be sad about it?'"

April marked the 20th anniversary of COACH for Kids and Their Families. And, of course, it marked Rigsby Pauley's own anniversary. In that time, the program logged nearly 600,000 patient visits.

Many families know COACH's schedule and use the mobile units as their first line of medical care. COACH nurse practitioners make sure that families receive the medical and social services they need. There are many other components to COACH, including nutrition programs at various after-school centers, dental care programs in public schools and Head Start centers, and health workshops in homeless shelters.

Some families have been COACH patients for its entire 20 years. During a recent visit to the Pueblo del Rio housing development in South Los Angeles, a young mother showed up with her toddler. Rigsby Pauley treated the woman when she was just a little girl.

"The mom knows us and trusts us," Rigsby Pauley said. "She is one of many families who follow the mobile unit because they know they will get great care."

Rigsby Pauley recounts the story of another patient, Olga, as one of COACH's early successes. Olga was homeless at the time and with an infant when she happened upon the medical mobile unit. She came in for a checkup for her baby, but through the ongoing services of COACH she was able to get her life back on track. Today, Olga has a home and a career, and speaks publicly about the importance of medical mobile units for the poor.

Rigsby Pauley said COACH's clients face many obstacles to healthcare, including lack of funds and transportation, language barriers and trust issues. Rigsby Pauley said she is often distressed by the absence of dental health among young children. She routinely sees 3- and 4-year-olds with missing teeth because of baby bottle tooth decay. Some families don't have toothbrushes for their children or mistakenly believe they don't need care for baby teeth because they fall out.

To respond to this need, COACH set up a "Healthy Smiles" program that teaches dental care to young children and their parents in public schools and Head Start centers across Los Angeles. The COACH mobile medical units help refer clients to low-cost dental clinics, often paying for transportation for families to attend appointments.

Another chronic problem is obesity, both among the children and parents. COACH now has a "Be Healthy, Be Strong!" after-school "program in many locations, including the Jordan Downs housing development in South Los Angeles, where kids learn healthy eating habits they can share with their parents. The COACH program there also features monthly blood pressure screening and body mass index clinics for parents. The clinics started with eight people and now have more than 40, many of whom have seen decreases in blood pressure and body mass index, an important first step in fighting an epidemic of diabetes, heart disease and other health problems.

Since last year, COACH staff members have been trained as outreach and educational counselors for Covered California, the state's new online healthcare exchange where the uninsured can buy health coverage. In addition, Rigsby Pauley says many of those who have or will get insurance may still not be able to access healthcare, stymied by other pressing issues such as language and transportation.

"I feel so fortunate to have a dedicated team and Cedars-Sinai quality care that I can bring to neighborhoods that desperately need it," she said. "Over time the neighborhoods may have changed but the need remains great, and Cedars-Sinai is committed to filling that need."