Why did you decide to retire from private practice?The way I put it to folks is medicine was changing, and I wasn’t. I went into medicine because I wanted to be somebody’s pediatrician, and I wanted to have the opportunity to follow that child along through (the) entire pediatric age range. That was taken away from me about 17 years ago when managed care came into Springfield. I went into (medicine) because I wanted to have a relationship with families and my patients. I come from an era when physicians were called doctors, not providers, (and) patients called patients, not clients. That whole atmosphere has changed.
What is your role with Integrity Home Care as a pediatric medical consultant?We’re kind of creating the position as we go along. ... Originally, I thought, “OK, (Integrity serves) 180 kids around the state who have special health care needs. I will be a resource for those families, and perhaps for the primary care doctors and specialists who serve the child, as well as the staff at Integrity.” I was looking at myself as being more of a case manager, overseeing education of the staff. But I went to a meeting at one of our outlying offices, and there was a mother who (said) that it wasn’t until her child was 5 and a half years of age that another mother told her that the child probably would qualify for [home health] services. And I keep hearing that story repeated. … The real issue is getting home health care services if you qualify, and I’m finding that I’m a vehicle to get that information out.
Which children may be eligible for home health care?It’s always “medical necessity” that dictates whether somebody qualifies, either through the Bureau of Special Health Care Needs [for those Medicaid-eligible] or through their third-party payer. The other aspect of that is, does the mother or the family need assistance meeting those medical challenges. And there are two levels of care: Personal care aides help with basic needs – grooming, toileting feeding – then there is advanced care that comes under skilled nursing, where the child needs medical intervention (such as) tracheal suctioning, gastrostomy feedings – feeding tubes. Some of these children are on ventilators. With medical necessity, we’re going to be talking about medical conditions (such as) cerebral palsy, traumatic brain or spinal cord injuries, spina bifida.
When we get into the areas of cognitive deficits such as autism, unless the child has medical needs or developmental needs that (families) need assistance with, they probably won’t qualify.
Do you think more special needs families don’t use home health because they’re unaware that it’s an option for them?That’s exactly the point. I was a specialist in neurodevelopmental disabilities. I was on the executive committee for the American Academy of Pediatrics that dealt strictly with special health care needs … but I never was aware of (home health options). Physicians don’t know about it, even specialists like myself. … I’m trying to develop a simple card that I’m going to be leaving at physicians’ offices that gives a basic outline of what may qualify for services.
Why should parents of special needs children consider home health care?Parents have been (caring for their special-needs children), but parents also have been extremely stressed. It doesn’t take much to jump to the fact that there’s a high risk of divorce in these families. Other children suffer because they don’t get the attention they need … because one child requires so much care. I dealt with these families for more than 30 years, and I’ve seen the stress and what it does to families. What if they did have some assistance? Integrity has allowed me to go all around the state and see what is available for families with disabilities. I’m excited because I’m able to now help them. … Not only do people not know about home health care services, they don’t know about (other resources).
