pediatric scalp care specialists head lice: the impact on students, schools, and families a research...

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


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.


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


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


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


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


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


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


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


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)


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


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


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)


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.


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


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 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


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


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


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


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


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


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


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


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

pediatric scalp care specialists head lice: the impact on students, schools, and families a research...

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