With the cost of health care spiraling out of control, it becomes increasingly more important to not duplicate services and the cost of the oversight required for those services.
Currently in our state we have two types of therapeutic day-care programs where children with special developmental or medical needs can attend: Child Health Management Services (CHMS) and Development Day Treatment Clinic Services (DDTCS). CHMS facilities are mostly for-profit organizations, while DDTCS facilities are nonprofit organizations that are aligned with the school systems. Both are governed by different sets of rules and regulations, but serve very similar populations.
A child has to qualify to be eligible for services through these programs, and the cost for providing services can be upwards of $70,000 to $90,000 a year.
It is impossible to place a price tag on the improvements these facilities make in the lives and futures of the children they serve. However, it is time to even the playing field for both programs and place them under the same set of rules and regulations.
The Department of Human Services is proposing that CHMS and DDTCS be joined together as one entity and the new name be Early Intervention Day Treatment. The joining of the programs into one will allow the best of both programs to emerge.
All children in these programs between 0-6 years of age will be required to be screened for all developmental delays and, if eligible, receive physical therapy, occupational therapy, speech therapy, or developmental therapy in addition to nursing services. There will be positive changes on both sides for the children served by these programs, which is the true goal. Additionally, costs associated with these programs will decrease due to a new, singular set of rules and regulations to which the new entity will adhere.
For CHMS programs that already provide the full array of services, this change will allow them to add developmental therapy as a qualifier for their program. However, it will also require them to have improved teacher-to-student ratios in the classroom.
For some DDTCS facilities that do not currently have the capabilities to provide the full array of needed developmental services, they will have to evolve into a program that can address all the needs of the children they serve. If children qualify for services, these facilities will provide them. If children do not qualify, they will be transitioned to a less expensive form of early intervention. For our DDTCS facilities that already provide all these services and more, it will allow them to operate with less oversight and improved reimbursement.
Our DDTCS programs that are going to be at risk for not surviving will of course be in our most rural areas. I expect these small programs have tremendous community support, as well as employees who love their jobs and the kids they serve. These are the programs we have to help evolve. We can do this by helping them attract needed therapy providers to their areas, or by helping them come up with matching funds so they can qualify for federal grants and evolve into more of a Head Start-type facility.
Change is hard, and very few of us embrace it well. However, it is inevitable, and we need to keep ourselves educated on these topics and realize there will always be controversy with change, but that there are also times to compromise.
Arkansas is a wonderful state, with some of our programs providing innovative care that matches that found in major cities across the country. We need to be proud of what we have, improve what needs to be improved on, and continue to work toward striving to be the best we can be.
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Jane M. Sneed, M.D., of The Children's Clinic-Jonesboro, is a board member of the Arkansas Foundation for Medical Care.
Editorial on 06/07/2018