When Pat Bergstrom learned last year that St. Luke’s Rehabilitation Institute was going to close its children’s outpatient program, her options were limited.
Bergstrom’s 5-year-old son, Hayden, has autism and was taught to talk at St. Luke’s. Her daughter, Avery, who is almost 2 years old, has a motor skill disability. They needed a facility that offered physical and occupational therapy, the services of social workers and inpatient and outpatient care. They needed a place like St. Luke’s.
“We were thinking we were going to have to relocate to Oregon,” the 34-year-old Spokane native said.
So Bergstrom was relieved this spring when decisions made in Olympia saved the program that otherwise would have closed this week. The single mom joined about 300 other family members, politicians and medical professionals to thank Gov. Christine Gregoire and Senate Majority Leader Lisa Brown, D-Spokane, at a ceremony Tuesday.
“It is a proud day to come here and see all of you and realize what that means,” Gregoire said of the effort made to preserve care for children.
St. Luke’s also unveiled a new name for the program Tuesday: the Northwest Center for Children’s Rehabilitation at St. Luke’s.
In one of her first moves as governor, Gregoire ordered a change that returned Medicaid-paid health coverage to about 23,000 children. Later in the spring, the Legislature approved a 1.3 percent increase in state Medicaid reimbursements for the next two years. That amounts to a $37 million bump for hospitals statewide.
The decisions didn’t come without a price, however. The Legislature and the governor agreed to a tax hike on cigarettes and alcohol and the imposition of an estate tax, a revenue package expected to raise $480 million.
Another factor that helped save St. Luke’s program was a decision to revive an old formula the state used to reimburse the rehabilitation center for services.
More than half of the 600 children treated at St. Luke’s are covered by state Medicaid programs. Until Jan. 1, 2004, St. Luke’s received more state money than other facilities that provide the same services. After the Medical Assistance Administration put an end to that disparity, St. Luke’s lost $250,000 in the first six months of last year.
That shortfall led St. Luke’s to announce the pediatric program closure.
There had been good reason for St. Luke’s to receive more money than other facilities, though, said the center’s spokesman, Steve Becker.
While rehabilitation care is provided at some hospitals, St. Luke’s is the only freestanding rehabilitation center in the state. When costly rehabilitation services – such as pediatric therapy – put a drain on a hospital’s overall budget, hospitals can usually shift funds from money-making procedures to make up for the loss. St. Luke’s, with its narrower focus, doesn’t have that flexibility.
“Any kind of pediatric rehabilitation services are more costly because children have to be more closely supervised,” Becker said. “With an adult, you can say I need you to go work out on a machine for a while. With children, it’s much more labor intensive.”
Doug Porter, assistant secretary for the Medical Assistance Administration, told The Spokesman-Review last fall that the old payment agreement was one of the sloppy business practices he was asked to clean up when former DSHS Secretary Dennis Braddock was hired.
But at the urging of Brown, former Gov. Gary Locke and Gregoire, the administration reversed its rate structure to the pre-2004 level.
Neither Porter nor other officials from the administration could be reached for comment Tuesday.
At the ceremony, one speaker introduced the dignitaries in the room and then asked anyone of importance to raise their hands if she missed them. Several children in the audience automatically put their hands in the air.
How appropriate, Brown later remarked.
“They know they’re somebody,” she said.
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