What is the single greatest threat today to your child’s ability to thrive as a cystic fibrosis patient?In my respectful though emphatic opinion, it is the plan unveiled last week in the New Hampshire Senate to zero out the state’s special funding of CHaD, the Children’s Hospital at Dartmouth, from the two pending budget bills (HB1 and HB2). That’s right – ZERO!
Many CF families that use DHMC are fortunate enough to have health insurance. If yours is one of those families, you might be tempted to think this doesn’t affect you because your kid’s healthcare is covered. Absolutely, positively wrong!
Every CF child who seeks treatment for this life-shortening disease at CHaD gets care, regardless of the family’s ability to pay. The hospital turns no CF child away, ever. Thus, rich or poor, insurance or no insurance, every CF kid who shows up at DHMC’s Lebanon or Manchester facility gets something remarkable: some of the best CF care in the nation, as documented by the national patient registry maintained by the CF Foundation.
So we rise and fall together. If CHaD cannot afford to provide the same level of excellent care we take for granted, given the income it receives from our insurance carriers and the federal/state Medicaid program, then the care every CF kid receives will suffer.
Though this irrefutable math affects every kid who uses CHaD, it looms especially large for CF patients because their care is so expensive and so dependent on inpatient stays. That’s why two familiar names were among the people DHMC asked to testify recently before the Senate Finance Committee in Concord.
Dartmouth-Hitchcock supports the sections of HB 1 and HB 2 that create special Medicaid funding for the Children's Hospital at Dartmouth-Hitchcock. This funding is critical to CHaD,” testified Dr. Pam Hofley, the pediatric gastroenterologist who helps take care of our children. “Without it, we may not be able to continue to offer the over 30 pediatric specialties we currently provide. There is no other institution in New Hampshire that will be able to step in and offer these services, because you need dedicated pediatric inpatient facilities where these specialists can care for children.
“NH Medicaid pays Dartmouth-Hitchcock just 40 percent of the cost of providing care,” Pam added. “HB 1 and HB 2, as amended by the House, reverse hospital Medicaid cuts as they apply to pediatric services. This will not come close to covering our costs, but it's a step in the right direction and will help us preserve access to pediatric specialty care.”
Sue Richardson – long a heroically outspoken New Hampshire CF parent – also testified.
“My daughter Meghan has Cystic Fibrosis and has been a ChaD kid for 11 years,” Sue told the Senate panel. “During these years they not only saved her life, but they have and continue to go above and beyond by treating not only her, but also the whole family, which has improved her health and quality of life immensely.
“I'm concerned that Medicaid payments are so low that CHaD won't be able to continue to offer the services that are so important to my family,” Sue added. “If these services — which are the only ones offered in this state — are not offered, we would have to go out of state, which may cause her to go backwards in her health and put more stress and expenses on our family and other families in New Hampshire.”
“Go out of state” is exactly the message the Senate Finance Committee is sending CF families who use CHaD. For one thing, as they have lopped off special funding for CHaD, they have agreed to increase New Hampshire’s payments to Children’s Hospital Boston by between 4 and 500 percent, depending on the type of care involved.
CHaD is vulnerable because it is so dependent on the Medicaid program. In fiscal 2008, Medicaid accounted for 39 percent of the money CHaD received for patient care. According to figures provided by the hospital, CHaD was in the black by $11.7 last year when it came to non-Medicaid patients, but CHaD lost $21.5 million during the same period caring for children covered by Medicaid. That’s a net loss of nearly ten million dollars – unsustainable!!
This is especially dispiriting if your family, like mine, lives in Vermont and thus has no direct influence on the budget deliberations of the New Hampshire Senate. We CF families are all in this together – New Hampshire and Vermont, privately insured and those who are part of the Medicaid program. If you care about the quality of CF care your family receives from CHaD, please contact your state senator immediately. To find out who that person is and how to get in touch with her/him, follow this link:
http://www.gencourt.state.nh.us/house/members/wml.aspx
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