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Pediatric Scalp Pediatric Scalp Care SpecialistsCare Specialists
Head Lice: The Impact on Students, Schools, and Families
A Research Report developed by Pediatric Scalp Care Specialists
Head Lice: The Impact on Students, Schools and Families 2
$3,725,052 ?
The amount of money LAUSD loses every year due to head lice among grammar school students alone
Head Lice: The Impact on Students, Schools and Families 3
Pediatric Scalp Care SpecialistsPediatric Scalp Care Specialists
Mission
To provide under-served children and their families with free, safe, and effective head lice screening and treatment services – keeping kids in school, taking the burden off parents, school nurses and administrators.
Head Lice: The Impact on Students, Schools and Families 4
Pediatric Scalp Care Services – OverviewPediatric Scalp Care Services – Overview Nonprofit, charitable organization established in Los Angeles by Hair Fairies’ founder in order to serve lower-income families
Providing free head lice screening and treatment services – primarily to children – with an emphasis on under-served areas
Educating parents, school officials, community leaders, policymakers and the general public about head lice including treatment and prevention methods
Treatment regimen based upon the research and information provided by the Harvard School of Public Health, the American Academy of Pediatrics, the Center for Health and Health Care in Schools, and the National Pediculosis Association (NPA)
Developed a unique partnership with Harvard’s School of Public Health
Advocates of regulations and professional standards for providers of head lice treatment and comprehensive, and affordable health insurance coverage
Affiliated with well-established head lice treatment center Hair Fairies of Los Angeles, now with a treatment center in Manhattan
Head Lice: The Impact on Students, Schools and Families 5
Pediatric Scalp Care Specialists - ObjectivesPediatric Scalp Care Specialists - Objectives
Services: Free screening and treatment for head lice
Education: Programs to educate parents, school nurses, pediatricians, school administrators, and the general public
Research: Support scientific and clinical research efforts to identify effective head lice treatment and prevention methodologies, and track head lice outbreak trends
Advocacy: Promote and lobby for policy changes regarding insurance coverage, regulation of head lice treatment professionals, and toxic chemicals used in head lice removal
Head Lice: The Impact on Students, Schools and Families 6
Background on Head LiceBackground on Head Lice Transmission occurs through person-to-person contact, and sharing of
clothing, combs, and towels and from contact with bedding and furniture
used by someone with an infestation
No head lice product is completely ovicidal according to a toxicology
report by the University of Massachusetts at Amherst, with 50 – 90% of parasites surviving
A 1998 Harvard University study found that most strains of head lice are resistant to permethrin, the active ingredient in leading over-the-counter
anti-lice products
The previously widely-used product, lindane, has been banned in
California and in other places around the U.S.
The Harvard study found families spending up to $1,200 on ineffective
treatments
Health insurers do not typically cover head lice treatment costs
Head Lice: The Impact on Students, Schools and Families 7
Background on Head Lice – Survey DataBackground on Head Lice – Survey DataPSCS’ partner, Hair Fairies, began surveying patrons in September 2004. Below and inthe following slides are the aggregate results†
CONCLUSION #1: Head lice is a burden on students and parents
How many days of work have you missed?
1 to 344%
3 to 65%
6 to 102%
Other49%
1 to 3
3 to 6
6 to 10
Other
How school days has your child missed?
1 to 3
70%
3 to 6
16%
Other
14%
1 to 3
3 to 6
Other
† Based on a total 247 respondents
Head Lice: The Impact on Students, Schools and Families 8
How many members are in your family?
One6% Two
6%
Three22%
Four48%
Five16%
Other2%
One
Two
Three
Four
Five
Other
How many in your family have contracted head lice?
One37%
Two21%
Three17%
Four4%
Other21%
One
Two
Three
Four
Other
Background on Head Lice – Survey DataBackground on Head Lice – Survey Data CONCLUSION #2: Head lice affects the whole family as
transmission often occurs between siblings and even to parents, creating a cyclical process of transmission if not properly treated†
† Dr. Richard Pollack, Interview, March 17, 2005
Head Lice: The Impact on Students, Schools and Families 9
Background on Head Lice – Survey DataBackground on Head Lice – Survey Data
CONCLUSION #3: Hair Fairies patrons preferred not to make a visit to the doctor’s office even when leading treatments proved ineffective.
What products or homeopathic remedies have you used before coming to Hair Fairies?
Nix29%
Rid34%
Tea Tree Oil7%
Vaseline6%
Other24%
Nix
Rid
Tea Tree Oil
Vaseline
Other
How many visits to the pediatrician have you made for this particular lice infestation?
71%
19%
4%6%
Zero
One
Two
Other
Head Lice: The Impact on Students, Schools and Families 10
Background on Head Lice – Survey DataBackground on Head Lice – Survey Data
CONCLUSION #4: Head lice has financial costs and can possibly result in harmful exposure to toxins
Approx. how much have you spent on lice fighting products, household cleaning, disinfectants, and other preventions or
remedies?
$0 - 5065%
$50 - 10013%
$100 - 1506%
$150 - 2008%
Other8%
$0 - 50
$50 - 100
$100 - 150
$150 - 200
Other
Head Lice: The Impact on Students, Schools and Families 11
A National Problem…and beyondA National Problem…and beyond “No one safe from head lice,” Ottumwa Currier, 11/15/04 (Iowa)
“Sequim: School district deals with head lice in children,” Pennsylvania
News, 12/08/04 (Pennsylvania)
“Paying the price for lice,” Bristol Herald Courier, 12/15/04 (Tennessee)
“Staffers battle to keep kids in class,” Rapid City Journal, 12/16/04
(South Dakota)
“Health Matters: If head lice goes untreated, it’s an itchy situation,”
Billings Gazette, 1/19/2005 (Montana)
“Lice Outbreak Hits Schools, Angers Parents,” Local Channel 6,
3/2/05, Brevard County (Florida)
“Head lice problem frustrating parent,” The Roanoke Times, 3/30/05 (Virginia)
“Head lice ‘defy common lotions’, BBC News, 3/21/05 (United Kingdom)
Head Lice: The Impact on Students, Schools and Families 12
Background on Head Lice in SchoolBackground on Head Lice in School Head lice infestations result in U.S. public schools losing roughly $500
million in funding every year (L.A. Times, August 22, 2001)
Head lice is the number one public health problem in U.S. schools,
according to principals (National PTA study, 1998)
According to the National Pediculosis Association, 6 million school-age
children contract head lice every year
80% of public schools in the U.S. report at least one outbreak of head lice
during the school year
Students from low-income households are not more likely to become
infected, but when they are, the burden of treatment is much greater
Head lice is the most contagious condition after chickenpox among
school-aged children
Head Lice: The Impact on Students, Schools and Families 13
LAUSD’s Head Lice ProblemLAUSD’s Head Lice Problem
Louse infestations are the number one reason for school absences in LAUSD, according to Karen Maiorca, Director of Nursing
A study by Cheryl Fayson, District 7 PSA Field Coordinator, found that 92% (34 out of 37) of absences due to exclusion factors at a grammar school in her District were due to head lice
An estimated 10% of LAUSD grammar school students will contract head lice during the school year (Sue Rue, CDC District Nurse for LAUSD )
Each case of head lice results in an estimated four-day absence from school (Sue Rue)
Grammar student enrollment in 2004-05 is 358,082
LAUSD is provided $26 per student, per day they attend school (Sue Rue)
10% of students with head lice (35,808) x number of days absent per case (4), x the amount LAUSD loses per day, per absence ($26) = the estimated amount LAUSD loses per school year due to head lice among grammar school students only: $3,725,052
Head Lice: The Impact on Students, Schools and Families 14
LAUSD Constituent InformationLAUSD Constituent Information 61% (1999) of school-age children live below the poverty line1
28% (2002) of children in LA County face “General Neglect”2
Los Angeles County's poverty rate is 22% - the U.S. poverty rate is 13%3
There are 115,000 households headed by single mothers in LA county4
75% of AFDC recipients are minority women5
In LA County, an estimated 350,000 children 18 and under lack health insurance coverage
36% of children are on Medical, but Medical does not cover head lice
The number of working uninsured is projected to grow by 300,000 to 3 million in 2005
72% of LAUSD students qualify for free or reduced fare lunches (Esther Wong, LAUSD Records Department)1 – 3, 5 LA County Department of Children’s & Family Services4. U.S. Census (2000)
Head Lice: The Impact on Students, Schools and Families 15
LAUSD Constituent ScenarioLAUSD Constituent Scenario An uninsured student living under the poverty line is
determined to have head lice and sent home from school
The student’s single parent working an hourly-wage job without
sick or vacation time leaves work to stay at home with their child,
forgoing the household’s only source of income
Over the course of the next 4 days, the parent misses work and
spends time and money on ineffective over-the-counter
treatments
The student misses valuable school time, the parent loses
income, and the school loses revenue
PSCS’ solution of bringing free treatment to kids
solves all these problems.
Head Lice: The Impact on Students, Schools and Families 16
ProposalProposal
Provide free screening and treatment to a pilot group of LAUSD elementary schools via a mobile unit/van that will travel to their location
Document and track screening results and cases treated, providing monthly reports to LAUSD administration and Harvard researchers
Provide educational material and prevention training to parents throughout the LAUSD and LA County
Throughout the pilot project, work closely with school nurses, LAUSD administrators, other health service providers and advocates to refine it for wider implementation at private schools, community centers, summer camps and other places where children interact in large numbers.
PSCS provides an outbreak response team available to be called in on short notice to conduct in-school screenings and treatment throughout the district upon request
Head Lice: The Impact on Students, Schools and Families 17
GoalsGoals
Reduce the average length of student absenteeism due to head lice by 75%, from four days to zero
Reduce LAUSD’s overall financial losses due to head lice (average absence of 4 days x $26 per day is $104 per case.)
Protect children from exposure to toxic chemicals often used in a fruitless effort to solve the problem
Eliminate the need for parents to stay home from work to care for and treat a child diagnosed with head lice
Reduce the burden on school nurses by working with them to screen and treat students
Head Lice: The Impact on Students, Schools and Families 18
Head Lice Identification and Removal ProcessHead Lice Identification and Removal Process
Initial screening takes 2 – 3 minutes, with emphasis on
making an accurate assessment
Nits and live lice are removed manually from the scalp with
special combs and non-toxic rinses, with each treatment
taking up to an hour
A non-toxic, organic shampoo is then applied as a breeding
inhibitor to reduce the likelihood of the re-emergence of lice
before the next treatment
To ensure complete removal, up to three separate manual
removals are conducted over the course of 10 days
Head Lice: The Impact on Students, Schools and Families 19
Principles - S.A.F.E. Scalp CarePrinciples - S.A.F.E. Scalp Care ®®
S - Safe products for children and the environment
A - Affordable services so that income and access to health care are no longer barriers to treatment
F - Friendly health services professionals who will screen and treat kids in school
E - Effective, patent-pending process for eliminating head lice that is guaranteed to work
Head Lice: The Impact on Students, Schools and Families 20
PersonnelPersonnel
All staff receive extensive training and are certified providers of head lice treatment services
Our service providers and staff are carefully screened and undergo law-enforcement background checks
The policies and practices of PSCS are overseen by an advisory board that includes pediatricians, school nurses, and parents of children who have been successfully treated
PSCS is led by an experienced management team committed to the mission of helping kids stay in school
Head Lice: The Impact on Students, Schools and Families 21
Track RecordTrack Record
Hair Fairies has served over 10,000 clients since it was founded in 1999
Hair Fairies has worked with 18 LAUSD charter schools (7,200 students) and 60 private schools (15,000 students) in the LA area
Hair Fairies has developed relationships with more than 3,000 pediatricians in the Los Angeles area, which represents a primary source of client referrals
Accurate identification: 20% of walk-in clients are determined not to have head lice
Head Lice: The Impact on Students, Schools and Families 22
What Others Say About UsWhat Others Say About Us
“A huge thank you for donating your time to our school. You were so productive and helpful.” – Stephanie Schulman, Principal, Westwood Charter Public School, Los Angeles
“After unsuccessfully trying to get rid of head lice – 8 hours trying and about $300 in over the counter products – we finally found Hair Fairies. It didn’t cost as much as I thought. Hair Fairies are quick, thorough and efficient. I love the parent and kid friendly environment. I’m extremely happy with the results. Hair Fairies, you are God sent! – Gloria Soble, North Hollywood
“We refer many of our patients to Hair Fairies for head lice removal. We always receive positive feed back from our patients regarding their work.” – Pediatricians Jay Gordon and Linda Nussbaum, Santa Monica
Head Lice: The Impact on Students, Schools and Families 23
Research PartnershipResearch Partnership
Established a partnership between Pediatric Scalp Care Specialists, Hair Fairies and researchers at the Harvard School
of Public Health
Three ongoing research projects:
1) identification and collection of head lice samples 2) socio-economic study on the impact of head lice on families3) epidemiological study on prevalence of head lice
Assist in creation of efficacious head lice identification and collection protocols
Consult in development of model regulations for head lice removal professionals
Head Lice: The Impact on Students, Schools and Families 24
The Bottom LineThe Bottom Line
Keep kids in school and treat the head lice problem
Ease the burden on parents and school nurses
Prevent further cases through education programs
Reduce LAUSD’s estimated $3.5 million in lost
revenue due to head lice among grammar students
Treatment is 100% guaranteed
Head Lice: The Impact on Students, Schools and Families 25
Pilot Project - OverviewPilot Project - Overview
Between January and June of 2006
Select, with LAUSD administrators, 50 schools to be screened on two separate occasions and provide treatment to all affected students
At the end of the project, assess the results with LAUSD and decide on next steps
LAUSD administrators receive periodic reports
Data is collected regarding the extent of the problem in target schools
Educational material is distributed, raising awareness
Head Lice: The Impact on Students, Schools and Families 26
Pilot Project – Pathway to SuccessPilot Project – Pathway to Success
Sign a Memorandum of Understanding with the LAUSD
Obtain an Operating License from the LA County Health Department
Gain the endorsement of key stakeholder groups such as the California School Nurses Association, California School Board Association, Parent Teacher Association, and California Teachers’ Association
Engage local political and community leaders to gain their support of the project