Medical Exams for Abused Children Cut Despite Available Funding

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(Sacramento, CA)
Thursday, November 19, 2009


The UC Davis Medical Center in Sacramento has sharply cut a decades-old program that provides medical exams to abused or neglected children because of a breakdown in the long relationship between the hospital and Sacramento County.  But the county actually has the money to pay for the program – and it’s going unused.

What kind of kids are we talking about here? Mary Anne Aikens would know.  Aikens is a foster parent who says she’s taken in more than 1200 children and adopted 10 since 1975.  One of the kids with her now arrived just two days after he was born, unable to keep any food in his stomach.
Aikens: “He was very, very frail. They told me he was six pounds. When I got him, he looked like he was about 2-3 pounds. His skin was very, very dry. It looked like sandpaper and he had these white corpuscles.”
So she took him to a special program at the UC Davis Medical Center, called the CAARE Center.  For 30 years, Sacramento County has paid the hospital to give kids who had just been removed from their homes basic checkups to make sure they’re okay.
Aikens: “The CAARE Center would make sure that the child got the referrals to this place or that place, and then from that, those doctors would do what they needed to do.”
And now? The boy is 17 months old. He looks healthy and well-fed as he wanders through the house.
Aikens: “He’s getting his needs met. He’s walking. He’s just progressing. And I’m just so happy that he was able to get that intervention right away.”
Philipps: “These are very vulnerable children in our society.”
Dr. Anthony Philipps is medical director of the UC Davis Children’s Hospital. He says the CAARE Center would treat anywhere from 50 to 150 kids a month, most of them infants and preschoolers.
Philipps: “They would be children who would be abused by parents or other care givers. That could be physical abuse; sometimes that was also sexual abuse; sometimes these were drug endangered children who were in homes where drugs were being used frequently.”
But as of November 1st, these medical clearance exams are no longer available because the UC Davis Medical Center said it couldn’t renew the contract with the county.  Since then, the county says, 33 children have gone without an exam.
UC Davis blames the county. Dr. Fred Meyers is one of the hospital’s top officials.  He’s frustrated with the county’s behavior over the last couple of years – specifically, its last-minute changes in plans and a pattern of paying its bills late.
Meyers: “It’s pretty clear given the erratic payment history and the failure to develop a good working partnership – particularly with the county’s erratic communication with us – that we didn’t feel comfortable going ahead and being their partner on an ongoing fashion.”
But Sacramento County officials say they’ve worked with UC Davis every step of the way. Supervisor Roger Dickinson called the situation “fractious” but declined to engage in a war of words because he hopes to rebuild the relationship. Still, he’s disappointed the exams aren’t being offered.
Dickinson: “It’s something that was important enough for the board to find funding for, even in our very difficult budget circumstances. And we believe – as does the District Attorney – that these exams are of enormous value.”
According to numbers provided by the county and the hospital, the county has enough money – between local and federal matching funds – to pay UC Davis for two months worth of exams. And county officials have their eyes on a long-term funding source after that. But the hospital won’t take the money,  saying the county is just too unreliable.

Foster parent Mary Anne Aikens isn’t happy the exams aren’t available.
Aikens: “I’m flabbergasted. I’m appalled, for real. If they have to go to a regular doctor’s appointment, they’re usually full and it takes months for them to get an appointment. And those months are crucial to a child.”
The county will find out if it wins new funds for the medical clearance exams in early December. If so, it’ll move forward with a newer, smaller program at the Sutter Health System. If not, children just removed from their homes might not get the specialized care they need.

Capital Public Radio's Steffi Broski contributed to this report.