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Medical
Home Listserv Archives
This page provides information on past questions
posted on the Medical Home LISTSERV. Responses are provided
by physicians, allied health professionals and parents of
children with special needs.
The inclusion of any resource or link in these pages does
not imply endorsement. As information changes rapidly, please
check with each sponsoring organization as to whether the
information you are receiving on their Web site is current.
If you have information or resources to add to this request,
please e-mail us at medical home@aap.org.
Posted July 29, 2004
Request: Looking for information on the
presence and status of medically fragile or mental health
early education and child care programs:
- Where are they?
- What ages and conditions do they
accept?
- What services do they provide..ie
OT, PT, Speech, etc.?
- Are their costs covered by private
insurers, state programs etc?
- Do they have funding from grants,
community, state, or federal programs?
- Are they profitable?
Responses:
General Publications
on Child Care for CSHCN:
Child Care for Children with Special Needs
An excerpt from the American Academy of Pediatrics' "Caring for Your Baby and Young Child: Birth to Age 5" (Bantam 1998) this page offers suggestions on finding appropriate day care services for a child with special needs.
State
Policies Impacting the Participation Of Young Children
with Medical Needs In Child Care
A Policy Analysis Conducted In Connection With A Developmental
Disabilities Project Of National Significance By: Dale
Borman Fink, Ph.D., Connecticut UCEDD
Promoting the Medical Home Within Child Care Programs
The AAP Healthy Child Care America Web site offers a variety of resources to promote medical homes and enhance coordination between child care programs and medical homes, such as:
- Immunization tracking and child care health record quality improvement tool: WellCare Tracker
- Promoting the Medical Home Within Child Care Programs- Applicable Standards from Caring for Our Children
- Sample Letters to Help You Communicate With Parents and Doctors
- Information and Resources about Child Care Health Consultation
Projects for
Child Care:
The University of Connecticut A.J. Pappanikou Center for
Developmental Disabilities has completed a project entitled
Map
for Inclusive Child Care.
The goal of the Map for Inclusive Child
Care project was to provide technical assistance to states
as they include children with disabilities (from birth
through age 12) in child care settings. For more information
on this project, please contact Dale Fink, Project Coordinator
at dfink@uchc.edu
Child Care plus+: The Center on Inclusion in Early Childhood
This website offers a number of free and inexpensive resources to help facilitate the inclusion of young children with disabilities in early childhood programs.
Organizations/Resources
by State:
California | Delaware | Florida | Georgia | Illinois | Iowa | Kentucky | Maryland | Missouri | North Carolina | Ohio | Oklahoma | Pennsylvania | Texas | Washington
California
- Caring
Corner is a Pediatric Day Health Care Center, which
provides skilled nursing care under physician orders to
medically fragile, technology dependent children. The
only one of its kind in the Southern Central Valley of
California. Referrals to Caring Corner can be
generated through a Regional Center Case Manager, physician,
CCS or by contacting the facility yourself. The Clinical
Director will make an appointment to meet with the family
and assess the child’s needs. Once the physician
has signed the agreed upon plan of care, services can
begin.
Age & Conditions
Caring Corner will accept clients from infancy
through 21 years of age who have skilled needs that include:
tracheotomies, feeding tubes, seizure disorders, and ventilators.
Services Provided
Children who attend Caring Corner will
receive care such as: skilled nursing, developmentally
appropriate activities to promote socialization, PT, OT
and speech therapies if prescribed by their plan of care,
and educational and psychological services related to
their condition.
Funding for Services
We can help your family access funding from EPSDT/Medi-Cal,
Kern Regional Center, private insurance or private pay.
Scheduled Hours
Children can stay with us Monday through Friday,
before school, after school, or anytime in between.
-
My Friends, is a facility where medically fragile
children are cared for in a safe, cheerful and nurturing
environment designed just for them.
We are locally owned and operated by nurses committed
to nursing and caring for medically fragile children.
Our nurses are fully licensed. All of our staff is pediatric
trained and experienced, many with ten or more years of
caring for children. The My Friends facility
meets or exceeds the numerous stringent facility and personnel
requirements as specified by the State of California's
Department of Health, and we are a fully licensed Pediatric
Day Health and Respite Care Facility.
Funding for Services
My Friends is eligible for both state
and federally funded programs, and we can bill those programs
directly. We have experts on staff to answer questions
about eligibility and to discuss rates, if private payment
is the option chosen.
Scheduled Hours
They can spend a few hours or all day with other children,
all under the care of fully licensed and experienced nurses.
Delaware
- Prescribed Pediatric Extended Care (PPECS)
is privately owned and the age range is set by
the center, but is generally up through early elementary
school with older children occasionally during the summer
if their school services are unavailable.
Services Provided
The services are bundled and PT, OT, speech, feeding therapy
or special instruction is used as needed and as ordered,
but are not billed separately.
Funding for Services
We bill either private insurance or Medicaid.
Medicaid is usually the main source of funding. Most children
with special needs in Delaware qualify for disabled children's
Medicaid. Occasionally, we may apply for small specialized
grants but this is generally not a big part of funding.
There are two levels paid for by Delaware Medicaid. One
is for children needing skilled nursing care such as:
trachea management, feeding tubes, uncontrolled seizures
etc. The second level is for children with medical needs
but not requiring intense care such as children with asthma,
severe GER and failure to thrive for example. The primary
care physician must order this service, as he would home
nursing.
This has been profitable as long as Medicaid continues
to approve enough children to keep them at full capacity.
A recent new director is less amenable to approving kids
and one center had to close. There is a list of criteria for each level
based on a point system, but its interpretation can be
variable.
Florida
- Alliance of Florida Prescribed Pediatric Extended Care (PPEC)
PPECs, or Prescribed Pediatric Extended Care centers, offer up to 12
hours of non-residential care to children who need skilled nursing intervention as well as physical, occupational and other forms of therapy. There are at least 66,000 medically fragile children in Florida, and many could qualify for PPEC services, according to a 2003 legislative report. However, only 900 children a year are served statewide by PPECs.
Age & Conditions
PPECs care for children from birth to age 21 with complex medical conditions, such as: cerebral palsy, respiratory problems, diabetes, cardiac/kidney disease, severe burns, IV therapy, tracheotomy care, colostomy care, post-transplant care, HIV, and other conditions. About half of the children served are under the age of 3. They are healthy enough to be discharge from the hospital but they still need constant medical supervision. Many of them have feeding tubes or apnea monitors, so traditional day care centers cannot care for them.
Services Provided
These centers are an excellent alternative to in-home nursing care and allow children to interact with others. Each PPEC staff includes a nursing director, registered nurses and caregivers with pediatric experience. The ratio of caregivers to children is 1 to 3.
Funding for Services
Most of they youngsters are on Medicaid at a daily Medicaid reimbursement rate of roughly $160. PPECs are half as expensive as in-home nursing car and have higher quality care offered by licensed medical professionals.
Locations
There are 27 PPECs in Florida.
At Issue
Medicaid funding for PPEC providers is woefully inadequate at $160 a day for up to 12 hours of care. PPEC providers have not received a Medicaid rate increase in 20 years, while labor costs, insurance and the cost of living continue to climb. Medicaid rates have increased for pediatric physicians and specialists in recent years.
PPECs cannot offset their costs by high patient volumes because it is often difficult for families to obtain insurance coverage for these services. Florida Medicaid requires a stringent, bureaucratic approval process for PPEC admissions that is not required of other services for medically fragile children. As a result, it is easier for families to obtain more costly private duty (in-home) nursing care, which places an undue financial strain on Florida’s Medicaid program.
The number of children who born with complex medical problems is rising at a rate of 1,400 a year*, and the state should consider PPECs as a cost-effective way to provide nursing intervention to medically fragile youngsters. In turn, this service will prevent subsequent hospital admissions.
Proposed
Solution
The state should increase Medicaid reimbursement by 20 percent, for a per diem of $192. The state should also review the Medicaid approval process for services offered to children with complex medical conditions.
* “Special Needs Children in Florida – A Report to the Florida Legislature,’’ Feb. 14, 2003, page 8.
For more information, please contact Alisa Snow, director of the Alliance of Florida PPECs at 850-443-1319 or at alisasnow@yahoo.com.
- Kid’s
Medical Club has four locations in Florida (Jacksonville,
Orlando, West Palm Beach, Melbourne). They are a division
of Pediatric Services of America, Inc. The centers serve
medically fragile and complex children in the community
in a PPEC environment.
Age & Conditions
The centers are licensed for children birth
through 18 years of age, but target birth through 6
years of age. Children appropriate for enrollment in
the program include: asthma, chronic lung disease, colostomy
care, complications of prematurity, cystic fibrosis,
gastrostomy tube feedings, metabolic disorders, neuromuscular
disease, oxygen dependency, seizure disorders and ventilator
dependency.
Services Provided
Services in the centers include PT, OT, ST, RT and skilled
nursing intervention. In addition, nutritional and educational
benefits are provided. Services are provided by experienced
pediatric nurses and licensed therapist.
Funding for Services
Funding is available to children who qualify under the
PPEC Medicaid program, Medicaid therapy program, private
pay and private insurance carriers.
Scheduled Hours
The centers are open Monday through Friday,
all day or half day programs exist.
Georgia
- Tender
Healthcare has four locations in the Georgia (Macon,
Grovetown, Marietta and College Park). They are a division
of Pediatric Services of America, Inc. The centers serve
medically fragile and complex children in the community
in a pediatric day health treatment environment and are
the only centers available in the state of Ga.
Age & Conditions
Children served are birth through 5 years. Children appropriate
for treatment at the day care include, but are not limited
to, those with any of the following diagnoses or care
need: asthma, chronic lung disease, colostomy care, complications
of prematurity, cystic fibrosis, diabetes, failure to
thrive, gastric reflux, heart disease, IV therapy, medication
administration, oxygen dependency, sleep apnea, seizure
disorders, short gut syndrome, spina bifida, tracheomalacia
and tracheostomy care.
Services Provided
Services in the centers include PT, OT, ST and skilled
nursing intervention. In addition, nutritional and educational
benefits are provided. For children who qualify, transportation
to and from is provided by the centers. The staffing ratios
are 3:1. The nurse staffing is comprised of experienced
NICU, NICU, pediatric nurses and licensed therapy professionals.
Funding for Services
Funding is available to children who qualify under the
GA GAPP Waiver program, Children’s Intervention
Services Medicaid Program, Child and Parent Services,
private pay and private insurance carriers.
Scheduled Hours
The centers are open Monday through Friday 6:30a.m. to
6:30 p.m.
Illinois
- CoACH
Care Center’s CoACH House does offer medical
day care within their public health licensed Children’s
Community Based Health Care Center in DuPage County, Illinois.
They offer day care with skilled pediatric nursing care,
aide support and volunteers who help bring the every day
social and activity benefits into the program. They care
for all children and youth (0-21) with SHCN’s with
the exception of behavior disorders/autism. This includes
children who are vent dependent and/or medically complex.
Services Provided
We are working to provide PT, OT and speech therapy on
our own or in partnership with a rehabilitation hospital.
As of right now, the child’s therapist visits CoACH
House through the family's connections with the Child
and Family Connections (CFC).
Funding for Services
Private insurance will NOT pay for day care,
but they will pay for private duty nursing (which you
can bill for if the family receives this care at home).
We also get funding through Public Aid for those children
in the Medicaid waiver Title XIX program. It is important
to realize that anything with a program name that refers
to anything other than patient care (i.e. day care, respite
care, etc) is typically not a covered benefit. We do currently
have funding from grants, community, state and federal
programs.
In order to become profitable in a program like a medical
day care, you have to combine it with other programs that
also have revenue streams to support the clinical staff.
In Illinois there used to be a free standing day care
that was not successful I believe for this reason and
because they didn't offer the program to all children
(only those who got nursing at home).
We wanted to offer a comprehensive package so that if
a family needed more than day care, it was available to
them. Medical respite is available for up to two weeks,
transitional care (120 day program between hospital and
home to aide in home care placement), and more. This model
demonstrates continuity and assures families that when
additional services are needed, it’s a one stop
shop with the same staff and policies. Once they are in
the system, we can provide care from beginning to end.
Iowa
- Hand-in-Hand is an integrative day
care program that serves medically fragile children and
children with disorders such as autism. Children range
from 6 weeks to 5 years of age and are taken on a case-by-case
basis.
After school care and other recreational and educational
programs for children with disabilities including a summer
day camp are also offered.
Services Provided
Hand-in-Hand does not directly provide OT, PT,
and other services. If the child is eligible for services
from EARLY ACCESS (a partnership between families with
young children, birth to age three, and providers from
the Departments of Public Health & Human Services,
Child Health Specialty Clinics and Iowa's Area Education
Agencies), the EARLY ACCESS provider can provide the services
at the day care site.
Funding for Services
Very few are covered by private insurance. If the child
were on a Medicaid Home and Community Based Services waiver,
some of the medically needed services could be provided
in the day care according to the rules and regulations
of the waiver the child is on. For example, monitoring/treatment
of a medical nature requiring specially trained caregivers
beyond what is normally available in a day care setting
for persons age 21 and under might be an item covered
under some waivers. There is a nurse on-site or on call
but she cannot serve every child. Hand-in -Hand
is a nonprofit organization. Some scholarships are available.
- Handicare
(meaning convenient for care) has grown from 15 children
daily to 190 children daily. Before the ADA was actively
enforced, fifty percent of the children enrolled had a
diagnosed disability but now families often want to choose
a child care setting close to their own home or work.
This has resulted in 1/3 of our 190 children having disabilities
and the other 2/3 in typical development. Full time day
care ranges in age from six weeks to five years old. We
also have a six to twelve years of age group for the school
complement program.
Medical Care
Types of care for families that have children
with fragile medical conditions are:
Trachea and G-tube care
Care for seizures that occur from six to 24 times per
day
Juvenile Diabetes with blood sugars that frequently drop
or rise resulting in monitoring and injections needed
three to four times a day and
Children with mental health problems resulting in the
need for them to have individualized interventions away
from the group and a classroom full of peers.
Services Provided
First families may choose just day care with individualized
adaptations that are provided during the time they are
in day care. Those may include PT, OT, Speech, Play Therapy,
as well as the G-tube feedings, trachea care etc.
Second, the family may choose individualized Respite,
Interim Medical Monitoring/Treatment, or Supported Community
Living Skill Development for their child at home. Handicare
trains, supervises and sends a staff to the home do the
above services.
Third, the family may choose a school complement wrap
around service for children attending the public school
but needing care when the school is not in session or
around the parents work schedule.
Fourth, a family may purchase "Sick Bay" services,
which is when the child is too ill to attend school or
be in a day care classroom but the parent must work. The
child is put into a stand -alone room often with one staff
member to one or three children depending on the number
of children needing "sick bay" that day until
the child is able to be put back into the regular classroom.
Funding for Services
The parent pays typical child care rates and their insurance
or Medicaid pays for the individualized adaptations if
they are enrolled in Iowa's Home and Community Based waiver
program. If they are not enrolled and their insurance
does not cover the individualized costs we have our local
United Way or County MH/MR/DD program cover the cost.
Our program is profitable with
its broad funding base. We also supplement our staff to
child ratio in the classrooms with the Federal Foster
Grandparent program and college students doing practicum
or student teaching hours, as well as nursing students
learning about chronic illnesses. We also have a contract
with our local school district and Area Education Agency
to provide least restrictive environment preschool for
children three to five years of age, and a summer program
for autistic children.
- St. Ambrose University Children’s Campus
is an integrative day care program that serves medically
fragile children. We decide on a case by case basis children
who could be served and assist in finding a resource for
a family if we cannot serve the child. Children served
are from birth–5 years of age.
Services Provided
We are affiliated with St. Ambrose University, which has
a PT and OT program. Children might receive some PT/OT
services by students under the supervision of an instructor.
Otherwise no direct PT/OT services are provided. If the
child is eligible for services from EARLY ACCESS, the
EARLY ACCESS coordinator could help provide these services
at the day care.
Funding for Services
No costs are reimbursed by insurance. The Iowa Department
of Human Services may provides some costs for those eligible
if the parent is in school or the child is in protective
custody. If a child were on a Medicaid Home and Community
Based Services waiver, some of the medically needed services
could be provided in the day care according to the rules
and regulations of the waiver the child is on. For example,
monitoring/treatment of a medical nature requiring specially
trained caregivers beyond what is normally available in
a day care setting for persons age 21 and under might
be covered under some waivers.
They do receive some funding from USDA, United Way, small
community grants and some subsidy from St. Ambrose University.
They do not make a profit.
Kentucky
- Kidz Club: www.thekidzclub.cc/
The Kidz Club provides quality care for medically fragile
children in a stimulating typical day care environment.
We are a Prescribed Pediatric Extended Care (PPEC) facility.
Our mission is to provide the safest, most inclusive and
cost effective medical treatment available in a day care
setting. We accomplish this by integrating medically fragile
children and our professional medical staff with the children
and staff of a typical day care.
Age & Conditions
Cerebral Palsy
Complications Related to Prematurity
Gastrointestinal Disorders
Immobilization Syndrome
Myeleomeningeocele
Nervous System Disorders
Neurological Disorders
Neuromuscular Disease
Oncology
Renal Disease
Respiratory Disorders
Visual Impairment
Services Provided
Early Detection of Pending Problems
Nursing Assessment
Ostomy and Wound Care
Apnea Monitoring
Administration of Medicine
Central Line and Port Care
Peritoneal Dialysis
Cast Care
Emergency Protocols
Tracheostomy Care
Chemotherapy & Post Care
Enteral & Parental Nutrition
Implementation of Therapies
Case Management
Education and Family Support
Insurance Reimbursement Assistance
Funding for Services
Medicaid/Passport and Commercial Insurance Accepted
Related Articles:
Kidz
Club to add four sites, one in Jefferson County. Business
First: Exclusive Reports. November 30, 2001 print
edition.
Maryland
- World of Care is the only medically-based
child care center in the Baltimore metropolitan region
for children ages 6 weeks to 5 years of age. The center
is specially equipped for children who are medically fragile
and/or developmentally delayed. We are a licensed child
care center with the State of Maryland and are also accredited
by the Maryland State Department of Education. Our child
care staff all must be credentialed by the state and receive
ongoing training in a multitude of different areas regarding
children, their families and special needs. The center
is also staffed by nurses who provide daily nursing assessments
and interventions. Our nurse coordinator ensures that
each child's medical care is coordinated with their medical
care providers.
Services Provided
We consider our program a "one stop shop" as
we offer PT, OT and speech services and the child receives
them on site. In addition to meeting the children's physical
needs, World of Care provides multiple opportunities
for social, emotional and cognitive growth. We have a
special educator on staff for children who have IEP's.
Our Family Service Coordinator who is a licensed clinical
social worker, helps families deal with the issues of
raising a child with special needs and balancing the demands
of working and raising a family. She also provides the
service coordination among agencies. We also have a transition
coordinator who helps families transition their children
into school programs and other settings.
Our program is partially funded by The Department of Health
and Mental Hygiene, United Way, Department of Human Resources
(DHR), Maryland State Department of Education (MSDE),
Medical Assistance (carve out for Medical daycare/Nursing
services), Private Foundations & Contributions and
parent payments. We are a non-profit children's organization.
We are one part of a wonderful program called,
PACT: Helping Children with Special Needs.
Growing Together is PACT's supported parenting program
for mothers and fathers who are intellectually limited
and have young children. This is the only supported
parenting program of this type in Maryland. PACT's Therapeutic
Nursery is the only child care program in Baltimore
specifically designed for homeless infants and toddlers.
The Therapeutic Nursery developed a strong mental health
component based on parent-child attachment and now offers
training in this model to other organizations that serve
children who are at high risk for developing emotional
and developmental disabilities.
PACT's Comprehensive Therapy Center offers center-based
physical, occupational and speech/language therapies
as well as service coordination, educational transitional
services, and counseling for parents and their children.
We affiliated with the Kennedy Krieger Institute in
1998.
Missouri
- Triality Tots located in Pleasant Valley
Missouri (near Liberty). We serve children from birth
through kindergarten. We serve children with a very wide
variety of diagnosis and needs. Some of the following
are examples of diagnosis the children may have, or procedures
we may perform throughout the day: Ontogenesis Imperfecta,
Suedo De Lange Syndrome, Sensory processing disorders,
autism, hydrocephaly, neurological impairments, tube feedings,
catheterization, suctioning, standing programs, and many
others.
Services Provided
We provide PT, OT and speech developmental therapy on
site as well as in the community.
Funding for Services
We are a non profit agency and receive funding through
the First
Steps program in Missouri, state grants, private donations
and parent pay. We continue to incur a gap between the
cost of the services we provide, and the funding that
is currently available. We have a full time nurse who
trains the teachers and monitors the overall medical care
that we provide, as well as performing procedures that
require nursing expertise. At this time we have not been
approached by a family that we have not been able to serve.
At times, we must implement additional training prior
to a child’s enrollment at our center.
North Carolina
Ohio
- Collaborative Agencies for Learning and Innovative
Childhood Options (CALICO)
is a community based, educational center and
day care for toddlers and preschoolers who have special
needs, or are typically developing. A special focus is
placed on children that require nursing services and qualify
as medically fragile. Nursing services are available on
site. The Center is also designed to meet the needs of
children whose technological and medical care may exclude
them from other day care opportunities. CALICO currently
serves over one hundred children in eight classrooms.
CALICO Center was founded by the County of Summit Board
of Mental Retardation and Developmental Disabilities,
the
Hattie Larlham Foundation and Children's
Hospital Medical Center of Akron in April of 1995.
Services Provided
Children who are eligible may also receive: nursing services,
occupational and physical therapy, speech and language
therapy, case management and service coordination.
Funding for Services
Center fees are based on full and partial days attendance.
Some families may be eligible for services on a sliding
fee scale, check with us to verify your fees. If a child
has special needs, transportation can be provided for
an additional fee. Transportation is the responsibility
of the parents for children who are typically developing.
Scheduled Hours
Center hours are 6:30 a.m. to 6:00 p.m. Monday
thru Friday.
- Max’s House Brochure
 |
Fact
Sheet 
A family centered, comprehensive nursing and learning
center dedicated to providing a safe environment where
children with special health care needs are “encouraged
to be kids.” Max’s House is a division of
Maxim Healthcare Services.
Services Provided
The program blends skilled nursing care with an adaptive
education curriculum in a way that meets today’s
growing needs of families who have infants, children,
and young adults with special health care needs. Children
benefit from increased socialization and developmental
stimulation that the integrated center offers, while
having their medical needs met by trained pediatric
professionals.
Eligibility
Children eligible for treatment and/or care at Max’s
House are infants and children (ages 6 weeks thru teen-age
years) who have complex health needs. The following
are some of the health care issues our children face:
Respiratory Disorders Neuromuscular Disorders
Gastrointestinal Disorders Cardiac Disorders
Seizure Disorders Cerebral Palsy
Neurological Disorders Premature /Low Birth Weight
Metabolic Disorders
Funding
Max's House works with each family to coordinate funding
for services provided. Current funding sources include:
state programs such as Medicaid and county run programs
as well as private insurance and private pay.
What are some of the skilled nursing services
available?
Medication Administration Apnea Monitoring
Tube Feeding Administration and Care Infusion Therapy
Tracheostomy Care Colostomy/Catheter Care
Ventilator Dependent/CPAP/Oxygen Care Peritoneal Dialysis
IV Therapy/Central Line Therapy
What other valuable services are accessible?
Nutritional Guidance Physical Therapy
Occupational Therapy Speech Therapy
Family Support & Education Case Management
Developmental Intervention Transition Planning
Respite Care
Additional Services
Before and after school care for students attending
preschool, elementary and middle schools. Max’s
House provides valuable medical treatment and specialized
developmentally based education, as well as respite
for families whose children have special health care
needs. Our center provides an environment that allows
for the independence of both the caregiver and child,
while contributing to and promoting the functionality
of the family.
For more information on Max’s House, including
referrals and enrollment opportunities, please call
(513) 782-0100 or email maneumey@maxhealth.com
or besteele@maxhealth.com.
Max’s House is located in Cincinnati, OH
2479 Crowne Pointe Drive
Sharonville, OH 45241
New Locations - opening Max’s House in IL –
specifically Peoria and Chicago-land to start (Noted
February, 2006)
- Toledo
Public Schools Early Childhood Program offers a play-based
preschool program for children with special needs and
other neighborhood children of the same age, 3-5 years
old. Based on the belief that all children learn through
hands-on experiences and active learning, the program's
child-centered curriculum and staff are responsive to
the individual abilities and interests of the children.
A variety of classroom sizes and settings are available
to suit a child's individual needs.
Services Provided
After a preschool child's special needs have been identified,
a variety of free programs and services are available.
The early childhood program involves parents with a
team of professionals including teachers, therapists,
psychologists and social workers. Teamwork is necessary
to evaluate a child's overall development and to help
each child make progress at school and at home. Preschool
classes meet four half-days for AM or PM sessions at
these locations: Cherry Annex, Crossgates School, Glendale-Feilbach
School, McKesson School, and EduCare Center.
Other options include itinerant teacher services providing
support for children with special needs in Head Start
and community preschool or day care settings.
Funding for Services
Cost to families is based on a sliding fee scale.
Oklahoma
- Special
Care and Special Kids Care is part of the OASIS, which
is the Oklahoma statewide information and referral system.
Both are recognized as serving children who require more
services and have greater health needs.
Special Care Inc.
12201 N. Western
Oklahoma City, OK 73114
Phone: (405) 752-5112 Faxr: (405) 752-8963
Program Details:
Hours: 7-6 Monday-Friday
Eligibility: 6 weeks. - 16 years of age. All disabilities
- except emotionally disturbed.
Services Provided
PT, OT, speech therapy can be arranged for on site. Special
Care also provides training for day care providers for
special needs children.
Funding for Services
Fees: Sliding Scale. Some Scholarships available. DHS
reimbursement.
Intake Process: Call to get on waiting list (12 - 18 months).
Special Kids Child Care
Special Kids is a licensed special needs child care home
providing day care for children up to age 12.
Address: 4717 E. 2nd. Tulsa, OK 74112
Phone: (918) 402-4949 Fax: (918) 902-4578
Hours: Monday - Saturday 6:00 am - 6:30 pm
Eligibility: Children birth to age 12 with special needs
or children up to age 10 with no special needs.
Funding for Services
Fees: Private pay, DHS payments and sliding scale is available
Intake Process: Call to reserve space and enroll Service
Area: Tulsa area
Pennsylvania
- Child's
Way is a Pediatric Extended Care Center (PECC) for
medically fragile children. A program of The Children's
Home of Pittsburgh, Child's Way offers medically
centered day care, a critical service for parents of medically
fragile children who attend school and/or work outside
the home.
Ages & Conditions
Child's Way accepts any child, up to age eight,
who is medically fragile or medically at risk. The Child's
Way team is able to care for children who have a
wide range of chronic physical conditions and symptoms,
including: seizures, ventilator use, cerebral palsy, respiratory
problems, congenital heart defects, swallowing or digestion
disorders, injuries from accidents, and a variety of syndromes.
Services Provided
Early intervention therapies for ages birth to three
Special programs for visually impaired children
One-to-one physical and occupational therapy
Nursing care
Child development specialist
The center works closely with families, pediatricians
and other professionals involved in the child's ongoing
care. At Child's Way, each child has a medical
plan of care and receives daily medical assessments.
Funding for Services
Therapy services are provided for children who are deemed
eligible - including early intervention services to qualifying
children ages three to five. These services are supported
by the child's local school district. Medical services
are covered by health insurance. Child's Way
is a recognized provider with most plans, including Gateway,
Best, Three Rivers Med+, UPMC Health Plan, all Highmark
products, and many others. Day care services are a separate
fee. It is paid by the parents and/or guardians. We also
accept TANF and Child Care Partnership payments for these
non-medical services.
- Lauren's
House is a licensed Prescribed Pediatric Extended
Care Center (PPECC) by the Commonwealth of Pennsylvania
located in Boothwyn, Delaware County.
Ages & Conditions
Any child that is 0-5 years of age who is medically
fragile, currently receiving or who qualifies for in-home
private duty nursing or is technology dependent.
Care at Lauren's House must be ordered in a letter
of medical necessity by the child's primary care physician
or specialist as an option to in-home skilled nursing.
Approval from the child's insurance company is necessary.
Lauren's House case management staff will assist
the family and ordering physician in obtaining the approval.
The child's plan of care must be reviewed and approved
by Lauren's House medical director.
Services Provided
Quality nursing care provided by pediatric registered
nurses
Physical Therapy
Occupational Therapy
Speech Therapy
Case Management Services.
Coordination of care with the ordering physician.
Funding for Services
There is ZERO cost to the family. We bill your insurance
carrier for the care provided. The charges will be determined
by the complexity of care provided to the child.
Texas
- Respite House is a unique hospital
based program, providing short-term breaks for families
of children who are clinically stable despite their developmental
disabilities and multiple medical problems. Children are
accepted as young as two years of age and onward who are
cognitively less than 17 years of age.
Most are neurologically impaired and require assistance
with all daily living needs. Some have visual and hearing
impairments, other requires frequent suctioning or breathing
treatments. Still others are fed via a G-button and are
incontinent. Many receive routine medications. Each child
is cared for at home by a family member, and may or may
not have in-home care support.
Funding for Services
The majority of the families have funding for
respite care from various agencies such as: Mental Retardation
Association of Harris County, Texas Department of Human
Services - Medically Dependent Children's Program, CLASS-
Community Living and Support Services and HCS-Home based
Community Services.
Fees for families without funding are based on a sliding
scale according to financial status. Medicaid and Private
Insurance do not pay for respite care. At one time Respite
House did receive funding through grants. However, support
is now received by Memorial Hermann Children's Hospital,
which houses Respite House. Families without funding,
provide financial information on their application. Fees
are based on an hourly rate up to 12 hours then revert
to a day rate. Annual income less than $15,000 there is
no charge. Income of $20,000 would be $2.00 an hour/$12.00
per day, increasing $1.00 per hour to a maximum hourly
rate of $8.00, for an annual income of $80,000. Fees are
often waived if a family is experiencing difficulties,
i.e., serious illness, loss of a job.
Scheduled Hours
Respite House is open every weekend, Friday at 11:00 a.m.
until Sunday at 7:00 p.m. Once a month there is a four-day
weekend to include Monday holidays, i.e. Labor Day, Martin
Luther King Day, and President's Day. During school winter
and spring breaks, Respite House is open for the week.
Summer hours are every weekend from Thursday at 11:00
a.m. until Sunday evening. Families can leave their child
for a few hours or for the entire period. Average stay
on a weekend is 48 to 56 hours.
- Sammy's
House - A Special Place for Special Children is a
non-profit developmental, childcare center for special
needs and typical children 8 weeks - 3 years of age. Established
in November of 1999, Sammy’s House began as a family
home child care center specializing in the care of infants
and toddlers with special needs in the home of Isabel
and Julian Huerta, the parents Sammy Huerta, a medically
fragile child with Down Syndrome.
Child care for children with special needs is not readily
available in the Austin area. High-quality child care
for children three and under is scarce even for typically
developing children. The demand from other families identified
an empty niche that Sammy’s House could fill by
expanding the service from a small family home child care
center to a licensed facility.
Services Provided
Learning is nestled in a play environment encompassing
development in gross motor and fine motor skills, social-emotional,
self-help, cognitive, and language development. Keeping
our child-to-adult ratios low ensures high-quality care.
Low ratios allow time for personal care and curriculum
development.
Funding for Services
As a non-profit organization, Sammy’s House relies
on community contributions and corporate support to
maintain the high quality of childcare and to provide
tuition assistance to families in need.
Scheduled Hours
Sammy’s House is open from 7:00 AM until 6:00
PM to accommodate our parents’ demanding work
schedules.
- The House That Kerry Built is a center
for medically fragile children, located in Temple, Texas.
They serve children from infancy through age 12. The state
allows for them to serve older children but at this time,
they do not have any in their care. They accept most conditions.
They also care for the siblings of the medically fragile
children.
Services Provided
They provide PT, OT and speech, most of these services
are provided by volunteers from the professions.
Funding for Services
Some services are paid for by private insurance, some
by state programs, and some by county monies.
Washington
- Northwest's
Child is designed to be geared around the public school
day. The goal is to serve the "out of school"
hours of the day when children and youth continue to require
proper supervision and care. Northwest's Child operates
12 months out of the year and works with each student's
school schedule. Doors are open when the school lets out
on typical days as well as all early-dismissal and teacher
in-service days. Includes a full day program during summers,
Christmas, mid-winter break and spring breaks and the
majority of the holidays.
Northwest's Child
1823 N 85th
Seattle, WA 98103
Phone: (206) 526-2493
E-mail: darcyh@earthlink.net
- Pope’s
Kids Place in Centralia, Washington has been providing
day care and respite care to medically fragile children
since 1998. Named for its founder, Dr. Isaac Pope, Pope's
Kids Place provides a "home away from home"
for medically fragile and disabled children with special
health care needs. Parents and caregivers can bring their
children to us for safe, nurturing care while they restore
and rejuvenate their own energies.
Day Care & Respite Center
Designed to meet the needs of families who have children
with special needs, Vivian's House (named in
memory of Vivian Roewe-Adolphson for her untiring work
as one of our first Board of Directors) provides day care
during the weekday for children from birth to age 18 and
respite care the third weekend of every month.
Services Provided
Activities are planned for each child according to his
or her developmental stage and the nursing staff attends
to medical needs and emergency situations quickly and
with loving care.
Funding for Services
The Office of U.S. Rural Health Policy, Health Resources
and Services Administration (HRSA) awarded us a grant
that made the project facilitation Health Care for Rural
Special Needs Children in Southwest Washington State possible.
Funding from this grant allows us to identify special
needs children in Lewis, Cowlitz, Grays Harbor, Mason,
Pacific and Wahkiakum counties to help families obtain
access to medical and dental care.
Scheduled Hours
Care is provided during the day or for a few days and
nights. Children do not have to be residents of Lewis
County. Designed to meet the needs of families who have
children with special needs, Vivian's House provides day
care during the weekday for children from birth to age
18 and respite care the third weekend of every month.
Last Updated
March 14, 2007
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