2011 Community Service Plan Update
Blythedale Children's Hospital is a specialty children’s hospital located in Westchester County and dedicated to the diagnosis, care and treatment of children and adolescents with complex medical and rehabilitative needs. Blythedale is a leader in developing innovative, multi-disciplinary inpatient and ambulatory programs.
This Community Service Plan Update was prepared to meet the requirements of Section 2803 of the NYS Public Health Law, and in accordance with updated guidance provided by the NYS Department of Health in March 2010. As directed by the State Health Department, Blythedale’s 2009 Community Service Plan addressed local health improvement priorities selected from the State’s Prevention Agenda Toward the Healthiest State by a coalition of local community hospitals convened by the Westchester County Department of Health. This report updates the information reported in 2010 with information on the Hospital’s activities in the past year.
As a specialty hospital serving children and adolescents, several of the community health initiatives identified by the Westchester County Department of Health were not within Blythedale’s mission and scope. Thus our report on Blythedale’s efforts to address these priorities is more focused than that of the typical community hospital. Nonetheless, as highlighted below, Blythedale has made a significant contribution toward addressing one of the County Health Department’s priorities (healthy eating) and also provides a diverse array of other community programs.
Blythedale Children’s Hospital is dedicated to improving the health and quality of life of children. We change the lives of children with complex medical illnesses and disabling conditions through superb multi-disciplinary care, teaching, research and advocacy programs.
We are the only specialty children’s hospital in New York State that provides the highest level of multi-disciplinary medical care and rehabilitation for children with complex medical illnesses and conditions. Working collaboratively in an environment that fosters excellence, our goal is to improve each patient’s overall health, independence and quality of life, as well as provide hope to patients and families through superior outcomes—without regard to religion, race or ability to pay.
HOSPITAL SERVICE AREA
There have been no changes to Blythedale’s service area in the past year. As a specialty children’s hospital, Blythedale’s service area is widespread, with patients coming from the entire southern portion of New York State, as well as adjacent areas of New Jersey and Connecticut. Since the vast majority of admissions to Blythedale come by referral from other hospitals, particularly the large medical centers in the metropolitan New York and Hudson Valley area, Blythedale’s sense of need for services largely emanates from referring hospitals and their physicians.
PARTICIPANTS AND HOSPITAL ROLE
In addition to its referral hospitals, Blythedale also works closely with a variety of local agencies, notably the Westchester, Rockland and Putnam County Departments of Health, the Westchester Child Health Advocacy Network and the Westchester Safe Kids Coalition, to identify community health priorities relevant to Blythedale’s mission and services. Participants in these coalitions include the major child and adolescent health-focused community-based organizations in Westchester. Blythedale also has close working relationships with many of the school districts in Westchester County, through the nutrition education and prevention activities outlined in this report and through arrangements whereby Blythedale staff are contracted to provide physical, occupational and speech therapy services to children in the schools.
IDENTIFICATION OF PUBLIC HEALTH PRIORITIES
In 2009, the Westchester County Department of Health convened a workgroup of local hospitals to select two local priorities from the State’s Prevention Agenda and develop a plan to address these priorities as part of the County Health Department’s Community Health Assessment and the hospitals’ Community Service Plans.
Based on an analysis of data on the health of Westchester County’s population relative to the State’s Prevention Agenda priorities, and a discussion of the prevention initiatives currently being undertaken by the County Department of Health, the work group identified increasing physical activity (Physical Activity/Nutrition priority area) and reducing sodium intake (Chronic Disease priority area) as its community priorities.
UPDATE ON PLAN OF ACTION
As noted above, some of the priority community health initiatives identified by the Westchester County Department of Health, particularly those related to chronic disease in the adult population, are not within Blythedale’s mission and scope. Nonetheless, as detailed below, Blythedale has a very significant commitment in the area of nutrition education for children in the Westchester community. This program has the potential to make an important contribution to the goal of reducing obesity in children, and providing the building blocks for healthy lifestyles which will ultimately reduce the incidence of chronic conditions.
Eat Well, Be Well
In a major initiative to help reduce the prevalence of childhood obesity and prevent its long-term negative health effects, Blythedale Children’s Hospital continues to serve school districts throughout Westchester, Rockland and Putnam Counties with its Eat Well, Be Well school-based nutrition education program.
The Eat Well, Be Well program, with funding support from Kohl’s Department Stores, is designed to provide school staff and students with the tools necessary to help children develop healthy eating habits through a comprehensive curriculum developed by Blythedale’s registered dietitians. To date this program has reached more than 70,000 students, as well as parents and school staff, with information on how to make food and lifestyle choices that will promote healthy living for a lifetime. The "Eat Well Be Well Program” offers a variety of nutrition education opportunities:
- Faculty Nutrition Education: Blythedale’s registered dietitian provides faculty and staff members with a presentation aimed at fostering consistent health messages in the school environment. Lecture topics include: an overview of the Eat Well, Be Well program and its nutrition-related concepts, evidence-based nutritional guidelines for children and families, appropriate actions schools can take to help improve the overall health and weight issues of children, and important nutrition messages that can be incorporated into the classroom.
- Classroom Education for Students: Registered dietitians provide fun, interactive and informative nutrition lessons to students on a variety of nutrition topics. The curriculum contains three lesson plans for each grade level, which are adapted to the individual grade’s skill levels. Topics include: the food guide pyramid and the food groups, healthy snacking, the importance of breakfast, balanced eating, major nutrients, fruits and vegetables, serving sizes, fiber facts, reading food labels, vitamins and minerals, calcium and healthy bones, sugar content of foods and drinks, distinguishing between the fats, and physical activity.
- Parent Education and Handouts: This presentation is designed to provide parents with nutritional guidelines and practical tips that help enable them to plan a more balanced way of eating for their families in their hectic, rushed 21st century lives. For those parents who do not make it out to the presentation, all students participating in the program receive a parent handout that provides the key messages and guidelines for each topic presented in the curriculum, with the hopes of creating dialogue and change in the home environment.
Other Blythedale initiatives to promote healthy eating practices in the community include participation in community-based and corporate health fairs and presentations. With support from the Dannon Corporation, Blythedale continued to offer a Community Lecture Series focusing on nutrition and healthy lifestyles.
Finally, to address the nutritional needs of its staff and visitors, Blythedale has implemented the Westchester County Department of Health’s recommendations to increase the number of healthier food and drink options available in Hospital vending machines, and the menu in the Hospital’s cafeteria features a variety of healthy choices with information on calorie count and fat and salt content.
OTHER BLYTHEDALE COMMUNITY SERVICE HIGHLIGHTS
In addition to those described above, Blythedale provides a significant amount of community benefit programs, as evidenced through a variety of programs and services, including:
In response to a growing need in Westchester, Blythedale continues to work with the Westchester County Department of Health to expand the Hospital’s center-based Early Intervention program for children up to age three to include a special program for children on the autism spectrum. This program was developed in conjunction with experts from Columbia University’s Teachers College and draws upon Blythedale’s strong multi-disciplinary staff to provide a comprehensive program of developmental and therapy services.
For more than 20 years, Blythedale has coordinated the Westchester Safe Kids Coalition, the local affiliate of the National Safe Kids Campaign. Safe Kids is dedicated to preventing unintentional childhood injury from accidents such as motor vehicle crashes, fires, drowning, poisoning, falls and bicycle accidents, by promoting change in behaviors, laws and the environment. As part of its Safe Kids activities, Blythedale sponsors fitting and installation checks for both regular and special-needs car seats on site at the Hospital, and Hospital staff serve as instructors in car seat technologist training courses in the lower Hudson Valley.
Over the past year, Blythedale has provided instruction in fitting and installation to more than 200 families, including special needs cars seats. The Hospital has offered three 32-hour certification classes at which new Child Passenger Safety technicians were trained, as well as three recertification classes and four continuing education unit classes for CPS technicians, which are required for technicians to maintain their certification. The Safe Kids program also again participated in the WHUD Health Fair, and at a similar event at Home Depot where family and home safety education was distributed and car seat fitting and installation demonstrated.
Over the past year Blythedale’s Injury Prevention Program reached over 6,100 students and nearly 400 teachers, aides, administrators and parents. Professional qualified educators provided engaging, informative and successful programs to Pre K – 8th grade students covering such topics as Helmet Safety, Water Safety, and Fire Prevention and Safety. Programs are presented in classrooms, at assemblies, and at school and community fairs and events. Review curriculum is left with teachers for follow-up lessons throughout the year.
Services to the Professional Community
Blythedale provides a unique opportunity for Graduate Medical Education in caring for children with special health care needs for residents and fellows in Physical Medicine and Rehabilitation, Orthopedics, Pulmonology and Psychiatry from New York Presbyterian, Montefiore and New York Medical College/Westchester Medical Centers.
Each year Blythedale also provides clinical training for several hundred professional students in a wide range of other health care fields, including nursing, respiratory therapy, physical therapy, occupational therapy, speech therapy, social work and child life. Blythedale also sponsors specialized courses on pediatric issues for area nurses, and physical, occupational and speech therapists.
Blythedale is the sponsor of the New York Regional Chapter of the Society for Pediatric Nursing (SPN) which promotes excellence in nursing care of children and their families through support of its members’ clinical practice, education, research and advocacy. SPN hosts annual conferences which have covered topics ranging from preventing the spread of infection to children’s health problems caused by environmental exposures.
CPR Training Center
Blythedale is a Community Training Center for the American Heart Association, providing training in Heartsaver CPR (cardio-pulmonary resuscitation), Heartsaver AED (automated external defibrillator) and Heartsaver First Aid. In addition to Blythedale staff, those trained include health care professionals, members of local police and fire departments, students at area schools and staff from various community agencies. Blythedale also offers Pediatric CPR training for the community and health care professionals, and is a certified Pediatric Advanced Life Support (PALS) Training Center. Nearly 4,000 people received training through this program over the past year.
Blythedale has developed an agenda of clinical research in areas affecting children with disabling illness and their families, as well as studies of clinical outcomes in treating children with complex medical problems. Among the varied areas addressed by Blythedale’s research team are:
- Efficacy of robot-aided therapy in children with spasticity (in collaboration with the Massachusetts Institute of Technology)
- Exploring therapeutic feeding schedules
- Identifying new assessment methods for children recovering from acquired or traumatic brain injury
- Assessing a patient’s gait so as to improve his or her ability to perform every-day tasks
CHARITY CARE AND OTHER HOSPITAL FINANCIAL ASSISTANCE
Consistent with its mission and State requirements (Public Health Law 2807(k)(9-a)), Blythedale has developed guidelines that delineate the circumstances and procedures under which free or reduced cost care is available. These guidelines are made available to all families upon registration, and Hospital staff provide counseling as necessary. Patients are also notified of Blythedale’s Charity Care policies through notices in English and Spanish posted in the Hospital’s lobby and in patient registration and waiting areas. Interpretation services are available for patients needing information in languages other than English.
All patients having difficulty paying their bills are directed to Hospital staff who assist the family in completing a financial assessment and try to qualify the patient for assistance. Blythedale’s Patient Assistance Fund and other special funds are also used to help children with various items where family resources are limited and insurance does not cover. Blythedale provides van service from various locations in the Hospital’s service area, as well as taxi or railroad fare, for families who otherwise could not afford to visit their children.
Blythedale advocates for children with special health care needs at the federal, state and local level, with a particular focus on preserving the Medicaid and Child Health Plus programs, which are critical sources of funding for health care for children. As a major funder of services for children with special health care needs, Medicaid is a significant (over 65%) source of payment for the Hospital’s services. Thus, changes in Medicaid reimbursement can have significant impact on the Hospital’s ability to continue to provide services. While there have been no significant changes to the hospital’s operational or financial situation that have negatively impacted care of the community, financial assistance or access to health care, Blythedale continues to closely monitors federal and state activities affecting the Medicaid program.
DISSEMINATION OF THIS REPORT TO THE PUBLIC
Details on Blythedale’s community health programs and other hospital services are featured on the Hospital’s website, in the Hospital’s newsletter, in media advisories and in specialized mailings.