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Shriners renewing cleft lip, palate care

Hospital offers to take over health district program

Shriners Hospital for Children in Spokane is restarting its cleft lip and palate program next year and seeks to take over a successful Spokane County program that’s threatened by budget cuts.

Yet Shriners’ efforts have met stiff resistance from some health district employees and so far, no deal has been struck to transfer that care from the publicly funded health district to the mostly privately funded Shriners.

Shriners officials met with a health district coordinator and public health nurse over the summer about the hospital’s interest in treating children with cleft lip and palate.

The Shriners offer was met with indifference, said Shriners CEO Gene Raynaud in a letter to the health district last week. A second effort to engage the health district in September was ignored, he said.

Dr. Joel McCullough, who runs the district, said his staff hadn’t informed him of the meetings and that he learned of the results last week in an email that was widely circulated to his board members, public officials and several business leaders.

McCullough said this “communication breakdown” is being addressed and that he remains committed to finding a home for the cleft lip and palate program that’s run by a group within the health district called the maxillofacial team. The district, he said, can no longer afford to fund the work. The maxillofacial team doesn’t provide treatment, but instead coordinates the care of between 30 and 40 new cases of cleft lip and palate each year in 11 Eastern Washington counties at a cost of about $170,000.

The health district faces an 8.7 percent budget cut next year. And that’s based on the most optimistic revenue projections, Spokane County Commissioner Todd Mielke said.

Cutting the maxillofacial team is a relatively minor reduction, but the emotions surrounding cuts to programs serving babies in need of specialized care has made it especially difficult.

The health board will meet again this month in hopes of finding a way to save the program.

If Shriners is able to arrange the coordination and care of cleft lip and palate surgeries, therapy and ongoing care, Providence Sacred Heart Medical Center and Children’s Hospital would support that change, according to Sacred Heart spokesman Joe Robb.

Most cleft lip and palate surgeries are performed at Sacred Heart. If Shriners takes over the effort, the surgeries would most likely be performed there.

This is worrisome to some in the maxillofacial team who contend Sacred Heart offers superior care, members of the team told the health board in recent testimony. Some supporters have suggested that the health district cut programs for drug addicts rather than care-coordination programs for children.

McCullough dismissed such talk.

He noted that the health district’s methadone clinic, which treats heroin and prescription painkiller addicts, is not funded by the county. Rather, he said, the program is funded by patients with private insurance and through the Medicaid program.

“People who make such arguments don’t understand our budget,” he said. The health district board intends to hold a special November meeting to pass the budget. A time and date has not yet been set.