Boulder Community Health is closing its last primarily pediatric unit in early December, and families are wondering how they will find therapists to meet their children’s sometimes unique needs until then.
The Erie Pediatric Rehabilitation Unit, which offers physical therapy, speech therapy and similar services, will close Dec. 9. BCH has not had inpatient pediatric care in years, although it does have pediatricians offering primary care.
Jackie Stone of Lafayette said she called a provider in Louisville the day she learned the BCH unit was closing, but that provider did not take her insurance and had no initial appointments available for six months.
Stone has two children who receive services at the BCH Pediatric Rehabilitation Unit. Nora, 5 months, is receiving therapy for feeding difficulties, which mostly involves teaching her parents how to position her mouth to help her get enough milk. Jackson, 5, had to wait about two months to start therapy in late September to work on his fine motor skills and ways to deal with frustration when he’s overwhelmed, she said.
“We got it in and now we’re closing,” she said.
She said she could pay out of pocket for Jackson to see his current therapist in private — an option many families don’t have — but that could still mean more time between sessions than they would if insurance covered part of the bill. .
“These are not like machines. These are children. They have vendor relationships,” she said.
Larry Novissimo, vice president of ambulatory services at BCH, said that like other providers, the health system is struggling with increased costs for supplies and labor. Before that, they reduced their urgent care locations and closed their home care business to try to maintain essential services, he said.
The Erie facility has 11 full-time employees and 16 who work part-time or on an as-needed basis. Some employees may be able to transfer to other positions, while those who are laid off will receive severance pay, Novissimo said.
“It has become very difficult to manage our health care system,” he said. “The price of everything just skyrocketed.”
Novissimo declined to discuss finances in detail, but said the pediatric rehab unit has been losing money for some time. They tried to increase the number of patients to spread the overhead and at least break even on each patient, but it didn’t work, he said.
“We want to provide a high-quality service, but you also have to be sustainable,” he said.
BCH’s shutdown is part of a nationwide pattern. Hospitals in Virginia, Oklahoma, Massachusetts, North Carolina and Pennsylvania have all closed pediatric wards in the past year, according to The New York Times.
Nationally, the number of designated pediatric hospital units declined by about 19% from 2008 to 2018, according to the American Academy of Pediatrics. Children’s Services generally doesn’t make money, especially since so many children are covered by Medicaid, which pays less than Medicare and private insurance.
Julie Marshall of Lafayette said her daughter Sarah began receiving occupational therapy at BCH as an infant, with speech and physical therapy later added. A gene was deleted while Sarah, now 18, was developing, and Marshall estimated that she worked with more than 30 different therapists to treat her symptoms over the years. Marshall was the opinion editor for the Boulder Daily Camera.
While Sarah would have graduated from the pediatric program soon anyway, it’s disheartening to see families lose an opportunity for therapy for their children, Marshall said. It’s a “full-time job” coordinating care for a child with complex needs, so once parents find a therapist who insures them, works within a reasonable driving distance, and connects with their child, they don’t want to start the process all over again , she said.
“I don’t understand why disabled children are on the rocks,” she said.
Amy Brissett of Broomfield is concerned about how her son will handle the transition. Theo, 3, has trouble swallowing and has to drink thickened liquids so the liquid doesn’t go into his lungs where it can contribute to pneumonia. It took him a month or two to feel comfortable enough to let his current therapist touch his mouth, and she’s worried he’ll lose what he’s gained if they have to switch therapists, especially if there’s a long wait.
“It’s not like I have an allegiance to BCH. He has a rapport with these particular therapists,” she said.
Brissett said she wishes families like hers had received more consideration and more guidance in finding new therapists if the unit were to close. The timing is especially challenging because the holidays shift people’s schedules, making it harder to get an appointment, she said.
“I think people don’t realize how many services are needed until they don’t exist,” she said.
An email sent to families in October suggested they consider Children’s Hospital Colorado, which has a therapeutic care location in Broomfield as well as more limited services on its north campus. Susie Jaeger, chief patient services and access officer at Children’s, said in a statement that some appointments are available in January, but if a family wants an after-school slot, there may be a longer wait.
Children’s is talking with BCH to determine how many patients it might want to transfer and how to serve them in person or through telehealth, Jaeger said. Some therapists at BCH have expressed interest in applying to Children’s, she said, although they haven’t committed to hiring a specific number of people.
A “large group” of patients will complete their course of therapy by early December, and the ward manager is working to help those in the middle of therapy make the transition, Novissimo said.
“We tried to give as much early warning as we could,” he said. “We know how challenging this is. This is not a decision that was made quickly or lightly.”
Jessica Sibley of Longmont said her son Isaac previously had speech therapy at BCH, but in late 2020 he transferred to Inspiring Talkers, a speech-language pathology practice that will help him use an electronic device to communicate .
They planned to transfer back to BCH to work on various aspects of his speech, but after the department’s closure, they would have to find help elsewhere, she said.
Sibley said driving to Broomfield regularly wouldn’t be feasible with her work schedule, school and other types of therapy Isaac, 8, receives. Private providers in Longmont have told her it will take three to six months to get an appointment, and she worries he may lose some of the skills he’s acquired during that time.
“This whole journey has been me, so I’ve learned a lot, but I’m not trained” as a speech therapist, she said. “This is my son’s life. This is his future.”
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