Pilot projects will allow testing of enhanced “medical home” models
by Sandy King
Like most boys their age, Mitch and Spencer Russo love baseball. They play it, they watch it and they cheer for it. Not only can they tell you the stats of their favorite ball players, but these boys also love video games, popping wheelies on their bikes and shooting spitballs. They probably remind you of someone you know – a neighbor, a nephew, a friend or even your own son. But unlike most boys their age, Mitch and Spencer have Cystic Fibrosis.
Cystic Fibrosis (CF) is a genetic disorder that causes mucus in the body to thicken and become sticky. Thick, sticky mucus causes problems with the body’s organs, especially the lungs and pancreas. Children with CF have breathing problems, lung disease and problems with nutrition, digestion, growth and development. CF is considered a chronic condition – meaning these boys will have this condition for the rest of their lives. There is no cure for CF.
Mitch and Spence need specialized pediatric care for their complex condition that only a free-standing children’s hospital can provide. Fortunately, Mitch and Spence are able to get the advanced care they need at Miller Children’s Hospital Long Beach, one of only eight free-standing children’s hospitals in California. It also serves as the boys’ “medical home.”
Children’s hospitals, such as Miller Children’s, have California Children’s Services (CCS) approved care centers, where other kids like Mitch and Spence receive care for their complex conditions. Miller Children’s has 19 special care centers representing almost every system in the body from a renal center (kidney) to cardiology center (heart). These centers serve as the medical homes for thousands of children in the region, including the South Bay and North Orange County. For additional kidney guidance visit thekidneydocs.com.
These Outpatient Specialty Centers at Miller Children’s are a major referral center and house the majority of Miller Children’s sub-specialists. With doctors representing more than 30 different pediatric specialties and subspecialties, the centers provide care for infants, children, adolescents and transitioning adults with chronic and complex medical conditions. Each center is designated to an exclusive specialty with physicians and care teams trained specifically in certain childhood illnesses.
Mitch and Spence attend the CF specialty center throughout the year, including a comprehensive multispecialty visit four times a year. They have close to home access to a wide range of pediatric experts – not just expert doctors – but experts in social work, nursing, and psychosocial care whose primarily goal is to use preventative medicine to keep Mitch and Spence well and out of the hospital. But, should the need arise, that same expert team can help to monitor and manage their condition, along with their parents. This partnership in care helps prevent complications and decreases the risk of secondary illnesses or complications. Without Miller Children’s, the boys would probably be referred to different community clinics throughout the region and would not have access to expert medical care teams.
The State Department of Health Care Services (DHCS), with its current budget concerns, is looking at the best way to use available health care dollars, while still providing care to its citizens and children. DHCS is working on special pilot projects that will allow us to test alternate systems and methods for the delivery of health care including an enhanced medical home model.
CCS is an important health program providing care to the most chronically ill children in the state. It is vital that this effort to improve the program be well thought out and that sufficient time be provided to ensure success. We share the goal of DHCS of ensuring these pilots are successful, especially for the children served by the program.
In areas as large and diverse as Los Angeles and Orange Counties, it will be important to have multiple pilot sites. This will ensure that the design of new delivery systems meets the needs of the children. Timely access to specialty pediatric health care for children who have pre-existing conditions will be vital. Key provisions within the plans for health care reform will protect them from a loss of health care coverage when their parent’s coverage is altered or lost and ensures the child’s coverage continues throughout the year, and their lifetime.
Mitch and Spencer shouldn’t have to worry about the future of their health care or wonder if they will be denied access or have delayed specialized care. They should only have to worry about whether mom catches one of their spitballs stuck to the bathroom mirror.
Help us. Help them. Join our advocacy efforts today and stand up for California children’s health. Visit MillerChildrens.org/advocacy or call Sandy King, Miller Children’s government relations representative at (562) 933-8019.
Sandy King is the government relations representative of Miller Children’s Hospital Long Beach. ER
