Boulder Community Health is closing its last unit primarily serving children in early December, and families are wondering how they’ll find therapists to meet their children’s sometimes-unique needs by then.
The pediatric rehabilitation unit in Erie, which offers physical therapy, speech therapy and similar services, will close on Dec. 9. BCH hasn’t had inpatient care for children in years, though it does employ pediatricians offering primary care.
Jackie Stone, of Lafayette, said she called a provider in Louisville on the day she learned the BCH unit was closing, but that provider doesn’t take her insurance and didn’t have any initial appointments available for six months.
Stone has two children who receive services at the BCH pediatric rehab unit. Nora, 5 months, gets therapy for difficulty eating, which mostly involves training 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 cope with frustration when he’s overwhelmed, she said.
“We got him in, and now it’s closing,” she said.
She said she might pay out-of-pocket for Jackson to see his current therapist privately — an option many families don’t have — but that still could mean going longer between sessions than they would if insurance was covering part of the bill.
“These are not like machines. These are children. They have relationships with providers,” she said.
Larry Novissimo, vice president of ambulatory services at BCH, said that like other providers, the health system has struggled with increased costs for supplies and labor. They previously reduced their urgent care locations and closed their home care business to try to preserve core services, he said.
The facility in Erie has 11 full-time employees and 16 who are either part-time or brought in as needed. Some employees may be able to transfer to other positions, while those who are laid off will get severance packages, Novissimo said.
“It’s become very difficult to operate our health system,” he said. “The cost of everything has just skyrocketed.”
Novissimo declined to discuss finances in detail, but said the pediatric rehab unit had been losing money for some time. They tried increasing the number of patients to spread the overhead costs out and at least break even on each patient, but it didn’t work out, he said.
“We want to provide high-quality service, but you also need to be sustainable,” he said.
The closing at BCH is part of a pattern around the country. Hospitals in Virginia, Oklahoma, Massachusetts, North Carolina and Pennsylvania have all closed children’s inpatient units in the past year, according to The New York Times.
Nationwide, the number of designated pediatric hospital units decreased by about 19% from 2008 to 2018, according to the American Academy of Pediatrics. Children’s services typically aren’t moneymakers, especially since so many kids are covered by Medicaid, which pays less than Medicare and private insurance.
Julie Marshall, of Lafayette, said her daughter Sarah started receiving occupational therapy at BCH as a baby, with speech therapy and physical therapy added later. One gene got deleted while Sarah, now 18, was developing, and Marshall estimated she’s worked with more than 30 different therapists to treat her symptoms over the years. Marshall used to be the opinion editor at the Boulder Daily Camera.
While Sarah would graduate from the pediatric program soon anyway, it’s disheartening to see families lose an option for their children’s therapy, Marshall said. It’s a “full-time job” coordinating care for a child with complex needs, so once parents find a therapist who takes their insurance, works within a reasonable driving distance and connects with their kid, they don’t want to have to start the process over again, she said.
“I don’t understand why children with disabilities are on the chopping block,” she said.
Amy Brissette, of Broomfield, is concerned about how her son will handle a transition. Theo, 3, has trouble swallowing and has to drink thickened liquids so that fluid won’t go into his lungs, where it could contribute to pneumonia. It’s taken a month or two for him to get comfortable enough to let his current therapist touch his mouth, and she’s worried he’ll lose the gains he’s made if they have to switch therapists, particularly if there’s an extended wait.
“It’s not like I have an allegiance to BCH. He has a rapport with these specific therapists,” she said.
Brissette said that she wishes families like hers had gotten more notice and more guidance in finding new therapists, if the unit must close. The timing is particularly challenging because the holidays throw off people’s schedules, making it harder to get an appointment, she said.
“I think people don’t realize how much 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 Therapy Care location in Broomfield as well as more limited services at its north campus. Suzy Jaeger, chief patient experience and access officer at Children’s, said in a statement that some appointments are available in January, though if a family wants an after-school time slot, it could be a longer wait.
Children’s is talking to BCH to determine how many patients may want to transfer, and how to serve them in person or via telehealth, Jaeger said. Some therapists at BCH have shown interest in applying at Children’s, she said, though they haven’t committed to hiring a specific number of people.
A “large group” of patients will finish their course of therapy by early December, and the unit’s manager is working to help those who are in the middle of therapy to make a transition, Novissimo said.
“We tried to give as much advance notice as we could,” he said. “We know how challenging this is. This is not a decision that was made quickly or flippantly.”
Jessica Sibley, of Longmont, said her son Isaac previously received speech therapy at BCH, though in late 2020 he transferred to Inspiring Talkers, a speech pathology practice that would help him use an electronic device to communicate.
They were planning to transfer back to BCH to work on different aspects of his speech, but since the unit’s closing, will have to find help elsewhere, she said.
Sibley said driving to Broomfield on a regular basis wouldn’t be feasible with her work schedule, school and other types of therapy Isaac, 8, receives. Private providers in Longmont told her it would take three to six months to get an appointment, and she’s worried he could lose some of the skills he’s gained in that time.
“It’s been me through this whole journey, so I’ve learned a lot, but I’m not trained” as a speech therapist, she said. “It’s my son’s life. It’s his future.”