Program serves neediest children,
saves money
A nationally acclaimed program that provides superior health care to
South Carolina’s most needy children and saves the state money is
opening in Charleston.The Medically Fragile Children’s Program had its genesis in Columbia and expanded to the Upstate. The new Lowcountry facility is located at the old Baker Hospital in North Charleston.
Dr. Kara Bleven,
medical director of the Medically Fragile Children’s Program,
teaches David Smith, 5, how to use his stethoscope. Part of the opening
ceremony on Aug. 15 also included a special check presentation. The Charleston program is a joint effort of the MUSC Children’s Hospital, South Carolina Department of Health and Human Services and the South Carolina Department of Social Services. It will provide comprehensive medical care to children in foster care in Charleston, Berkeley and Dorchester counties who have chronic illnesses and disabilities. It is anticipated that after a year or two, the program will expand its services to all children on Medicaid who meet the medical criteria.
“We care for the most complex of the chronically ill children,” said Pat Votava, manager of the Medically Fragile Children’s Program in Charleston and former director of the Columbia and Easley Palmetto Health programs. “These are children with more than one chronic condition. Medically fragile children require a variety of therapies, medications and medical equipment.”
The Medically Fragile Children’s Program provides primary medical care, physical therapy, occupational therapy, speech therapy, nursing, nutrition counseling, medication, supplies, durable medical equipment, care coordination, family support and education/training under one roof.
The newly renovated 8,500 square-foot facility houses patient exam rooms, therapy rooms, consultation rooms, conference rooms for education and training and a large day room where children can play and interact in a supportive environment.
But more important than the cost savings, the medical outcomes for children enrolled in the Medically Fragile Children’s Program are superior to those for children with a same or similar diagnosis in the fee-for-service system, Votava said. Another benefit is that adoption rates have gone up from less than 5 percent before enrollment in the program to more than 60 percent after enrollment. “To give kids a family for life is a phenomenal gift,” she said. “Offering comprehensive services under one roof assists the caregiver. The families are empowered by the education and training they receive on how to care for their special needs child, and if they can’t handle something, they know they have 24-hour-a-day support from the program.”
The Charleston program is an integral part of the MUSC Children’s Hospital. “This is a huge advantage,” explained Votava. “There is continuity of care between the Children’s Hospital downtown and our facility off campus. Our parents already have established relationships with doctors, nurses and other health care professionals at the MUSC Children’s Hospital. It makes for a seamless transition for our children and their caregivers.”
“The Columbia Medically Fragile Children’s Program has put South Carolina on the map for innovative public/private partnerships in health care,” said John Sanders, administrator of the MUSC Children’s Hospital. “While attending a National Association of Children’s Hospitals conference in Seattle a few years ago, I had an opportunity to hear a presentation by Pat Votava and her colleagues about Palmetto’s Medically Fragile Children’s Program. At that time, I worked at a children’s hospital in another state and I was very impressed with the collaboration between the state agencies and the hospital. We are now very excited to have Pat head up our program here at the MUSC Children’s Hospital.”
The Medically Fragile Program began about 11 years ago when the state Department of Social Services (DSS) went to the state Department of Health and Human Services (DHHS) to discuss the issue of special needs children in foster care who were so medically complicated they weren’t able find homes for them. Children couldn’t be released from the hospital because there was no one to care for them, or they kept coming back to the hospital for lack of appropriate care in a home setting.
DHHS and DSS made arrangements to begin a program for special needs children in foster care with Richland Memorial Hospital (now part of the Palmetto Health System) which already had a comprehensive geriatrics program where all medical needs of geriatric patients were addressed at one location. The Medically Fragile Children’s program began in Columbia in 1996 and now enrolls 80 children. In 2003, another program was started at Palmetto Health Baptist in Easley, which now serves 70 children in the upstate.
“The S.C. Department of Social Services is happy to participate with MUSC Children’s Hospital and the S.C. Department of Health and Human Services in the expansion of the Medically Fragile Children’s Program to Charleston, Berkeley and Dorchester counties,” said Marcus Mann, program manager, DSS, who was instrumental in starting up the Columbia program. “The Medically Fragile Children’s Program not only improves the medical care for special needs children in DSS custody, the program also improves their lives and the lives of their foster parents and gives the children a chance to function more fully in society.”
The South Carolina Department of Health and Human Service also takes pride in its role both in the Charleston program and the development of the other South Carolina programs.
“For the past nine years, the South Carolina Department of Health and Human Services has monitored the progress of the demonstration Palmetto Health Medically Fragile Children’s Program in Columbia,” said Robert M. Kerr, director, “The program has had close to a 99 percent approval rating by care givers in their annual satisfaction surveys while realizing significant per- child savings over less-coordinated fee-for-service treatment. Improved medical outcomes for special needs children and cost savings for the payer result in a model health care delivery system. We are proud that this program was developed in South Carolina. We plan to continue to support it and share the information with other states that have expressed an interest in utilizing this model.”
The Columbia program boasts a long list of accolades including The Premier Cares Award, sponsored by Premier and its member hospitals, recognizing exemplary efforts to improve the health of the medically underserved, and a $700,000 three-year Duke Endowment grant.
Friday, Aug. 19, 2005
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