By Kalisha Crossland
San Juan Basin Public Health
One of the fundamental visions of San Juan Basin Public Health (SJBPH) is to ensure that health care services are equitable throughout the communities we serve. One way the agency addresses this is by working to reduce barriers to care and unifying our forces with other programs like the out of home care Melbourne program.
The Children and Youth with Special Health Care Needs, or HCP Program, has had great success in working toward this goal.
When Valerie was 4 months old, she was referred by her pediatrician to see a neurologist. For her Durango-based, first-time parents, this meant a two- or three-day trip to Denver with an infant with complex medical needs. Scheduling the appointment, taking time off from work, making lodging arrangements and navigating the city were just a few of the challenges her parents faced.
With the unknowns of rush-hour traffic and finding parking at the hospital, the family started their day at the crack of dawn to make sure they didn’t miss their first appointment. Exhausted and overwhelmed on the drive back to Durango, the reality sank in that they would be faced with this challenging trip every four months. Questions raced through their heads: What were the next steps? How would follow-up work? Who would send neurology test results? How were they going to afford this amount of travel and time off from work?
After several challenging years of commuting to Denver for Valerie’s health care, her parents got the welcome news that a pediatric neurologist from Children’s Hospital of Colorado (CHCO) and Colorado School of Medicine (CU) would be traveling to Durango to provide clinics hosted by SJBPH.
“Specialty Outreach Clinics” provided the opportunity for physicians from CHCO/CU to travel to rural parts of the state so families like Valerie’s could access care for their children within their own communities. This was truly a life-changing impact for Valerie’s family and other families with their children who needed care not available to them locally. This included families who had not been able to make the repeated trips to Denver and so their children had gone without the care they needed.
Valerie, now 28 years old, met with the pediatric neurologist through the HCP clinics at SJBPH, sometimes up to four times per year until she was 21 years old. The HCP clinics hosted by SJBPH for pediatric neurology and pediatric orthopedics provided a registered nurse and family advocate who scheduled appointments, assisted with preparation including travel, advocated for and connected the families to additional resources, and coordinated communication between providers.
Pediatric specialty outreach clinics have since expanded, with a variety of specialty types available. Services are available through “host sites” within each community and are offered in a variety of ways: in-person and through telehealth platforms through SJBPH, Pediatric Partners of the Southwest and most recently, Pagosa Medical Group.
Telehealth services are a particularly invaluable resource right now, as everyone is forced to adapt to the constraints of the current pandemic. Many of the children who are utilizing specialty outreach clinics are immune-compromised or have high-risk medical conditions that make it difficult to travel long distances. Limiting the amount of potential exposure to COVID-19 these children receive by being able to provide specialty services closer to home is a welcome relief for families.
Through funding provided by the Colorado Department of Public Health and Environment, the HCP program provides care coordination for children and youth with specialty health care needs from birth to age 21. At SJBPH, the success of these clinics has relied heavily on partnerships with area providers and CHCO.
SJBPH continues its dedication to increase the services available in the communities we serve and strives to improve the health outcomes of local children who face barriers to health care. Programs such as HCP reflect the foundational belief of SJBPH that everyone deserves to reach their highest potential for health.
Kalisha Crossland is the director of prevention and population health at SJBPH.