Many families in Ohio struggle to find affordable child care. The Ohio Chamber of Commerce says a lack of child care options costs nearly $5.5 billion in lost economic activity in Ohio each year. But for families who have children with complex medical needs, childcare centers are often not an option at all.
A bipartisan bill could change that by allowing for prescribed pediatric extended care or PPEC centers, which can be paid for by Medicaid. They’re available in Kentucky now.
In some ways, the playroom at the Easter Seals Redwood Childcare Center in Ft Mitchell, Ky., looks like others. It features a jungle gym, balls, and soft mats on the floor. You hear squeals of joy as a child rides a trike down the hallway for the first time, being encouraged by staff at the center. Four-year-old son Boone Studer is sitting in the library while his Dad, Ben Studer, explains the challenges his son faces.
“He’s got a rare genetic skin disorder called epidermolysis bullosa. He doesn’t produce enough protein in the skin called collagen VII," said his father Ben. "His skin is extremely fragile. It scars or blisters with any type of hard contact or friction. And it also affect the inside of his body, his mouth, his esophagus, his GI tract. And yeah, he’s a warrior."
Gabby Buechel of Hebron is the mother of four-year-old Bradley, another child at the facility.
“He has Down syndrome. He has a feeding tube," Buechel said. "But he gets therapies. He gets speech.”
Chevonne Magnuson of Cleves said she’s lucky that her two-year-old son, George, has one of three slots available to Ohio kids in this childcare. He was getting care at Cincinnati Children’s Hospital Medical Center before coming here.
“He doesn’t have a corpus callosum, which is the part of the brain that communicates the two lobes together. He also has cerebral palsy and some hormone things and a lot of developmental issues," Magnuson said. "Right now, he’s learning how to sit up and walk in his gait trainer."
The parents said their children learn a lot in this place, especially since the center also accepts a certain number of typical, healthy children. Katrina Proud, Director of Children’s Services at Easter Seals Redwood, said mixing the two populations is a win-win.
“There’s not a great motivator for a child who is unable to walk to be in a classroom with five, six, seven other kids their age walking and climbing," Proud said, noting how bringing in other kids can help. "A child is not able to use a spoon, and they’re sitting around a table while their friends are using a spoon. Man, they’re ready to try that spoon now."
Options for medically fragile kids in Ohio are limited
In Ohio, most medically fragile kids don’t get that experience. Rep. Cindy Abrams (R-Harrison) said many of these kids spend a lot of time in hospitals because there isn’t an option for specialized care outside of that setting.
“Who on Earth would say 'no' to granting a child to go to a place during the day to be educated, get all of their medical needs met, and then go back home to sleep in their own bed? Who would say 'no' to that?” Abrams said in an interview.
House Bill 141, which Abrams joint sponsored with Rep. Rachel Baker (D-Cincinnati), would create licenses for these provider-prescribed extended care (PPEC) centers. Like the Kentucky facility, the Ohio facilities would feature nurses and medical facilities on site to provide daycare for medically fragile children until they attend school. They would also provide before- and after-school care. The bill passed the House unanimously in June and is awaiting action in the Senate.
“These centers have been funded and exist in many other states and most states have found a cost savings. And the reason is that most of these kids are eligible and get Medicaid waivers to pay for one-on-one nursing at home," Baker said in an interview. "So if we look at the cost of having a one-on-one nurse all day and all night at your house for all of these kids, versus kids being able to come to a center where multiple nurses work and can take care of kids, that’s a savings."
Supporters said passage of the bill would boost the economy by allowing a parent to work, something they say is often not possible otherwise.
Bill to create PPEC centers has support, but cost is a question
“There’s no question about the need," said Ohio Medicaid Director Maureen Corcoran in an interview. She added there’s a lot happening with Medicaid at the local and state levels. But Corcoran said Medicaid is flexible and vouchers can be used for different services.
"There is concern about the cost. And certainly the General Assembly wants to be sure that we’re going to save money in the process right away," Corcoran said.
Ben Studer said there’s another savings to consider. Being able to put Boone in childcare has given his wife a break and it has allowed her to work a part-time job.
“It saved our family and it gave my child a chance to be a kid," Studer said.
