What about the children?

If state medical assistance is cut, many disabled kids will have nowhere to turn

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Imagine you're the parent of a child terribly injured in an auto accident. Your child has survived but needs intensive rehabilitation in order to regain any independence. However, your insurance coverage has run out. Your heart breaks as you're told that your child can make no more progress.

Sadly, many parents don't have to imagine that scenario: They live it. And when they come to The Children's Institute, they waver between hope and despair: hope because they know we can help; despair because they do not have the means to pay for their children's treatment.

But, like most hospitals, we do not turn our backs on children and families. For more than 100 years, our mission has been to help children with significant special needs reach their maximum possible levels of independence. Today, we are the only free-standing pediatric rehabilitation specialty hospital in Pennsylvania, and one of only 20 in the entire country.

Some of our programs are unique in the world and, while most of our patients come from Pennsylvania, we regularly draw from around the globe. Parents of our young patients often say that we work miracles; we say only that we work hard, well and passionately.

We believe that our mission includes delivering excellence even when families cannot pay. Each year, about 12 percent of our budget represents uncompensated care -- care that is not reimbursed at all or that is under-reimbursed, with Pennsylvania's medical assistance program making up for much of the under-reimbursement. Given our specialized services, the 12 percent figure is double the national average, and, over the past nine years, has added up to nearly $35 million.

Unreimbursed care also adds up to tremendous stress on our budget -- but, so far, through prudent management and great commitment from our staff and board of directors, we have been able to make it work.

Now that delicate balance is threatened. At a time when the economy is forcing more and more people to rely on medical assistance, Gov. Tom Corbett is proposing a state budget that slashes medical assistance payments and their federal match by more than $333 million.

That is unacceptable. At The Children's Institute, our impact on the lives of children and families is enormous, but, at $40 million, our annual budget is not. The proposed cuts could strip up to 10 percent of our revenue.

We are not alone. In Pittsburgh and across Pennsylvania, we're fortunate to have some of the most exceptional and innovative medical care in the country. Offering everything from primary and emergency care to world-renowned specialists and rehabilitation services, the nearly 250 hospitals and health systems in the state are essential to the health and well-being of our communities -- and all will feel the pain of the proposed cuts.

Every citizen deserves access to these outstanding medical resources.

Medical assistance insures 18 percent of Pennsylvanians -- 2.2 million individuals -- of whom 44 percent are under the age of 18.

If the proposed cuts take effect, where will those people turn? And consider Pennsylvania's children with disabilities -- the most vulnerable among us. Protecting them and helping them become all they can be is a core state function, but Mr. Corbett's proposed budget denies that responsibility.

Preserving the ability of families to secure health care and rehabilitation services for their children with disabilities is simply the right thing to do. That should be enough, but if it is not, it's also the cost-effective thing to do. Helping people become independent enough to require less care over a lifetime saves a lot of public money.

Whatever the motivation -- morality or money -- we hope that every Pennsylvania citizen will pick up the phone or send a letter or email to the governor and his or her state legislators. Make it clear that medical assistance should not be cut. Speak up for the children.

If a specialty organization like The Children's Institute is no longer able to provide vital services to young patients who desperately need them, there is nowhere else for those children to turn.


David K. Miles is president and CEO of The Children's Institute, which is based in Squirrel Hill ( www.amazingkids.org ).


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