Unique Medical Needs Fund Helps Children and Families
June 15, 2017
Few people know that Family & Children Services administers a unique Children’s Medical Needs Fund that covers the cost of medical necessities that parents or legal guardians cannot afford to pay and that Medicaid, private insurance, and other sources do not cover.
The fund was established by a generous donor through the Kalamazoo Community Foundation and provides significant dollars of support each year. Dale Hein administers the fund for Family & Children Services.
“When I first started this, I thought we would have to turn people away,” he said. “That has not been the case. Our biggest challenge is letting people know that this resource exists.”
According to Hein, the fund has helped to provide for equipment such as wheelchairs, ramps, lifts, beds, and strollers for kids with special needs, cochlear implants, and special car seats and other devices for autos so that children and caregivers can travel safely.
The fund has provided for physical therapy and for urgently needed medication when a supply has been interrupted. It’s covered hotel and transportation costs for families when their child has required a visit to an out-of-town hospital or specialist.
The process to receive funds typically begins with a referral from a medical office or social service agency. Nurses, dental office managers, home caregivers, and case managers help families fill out an application that states the child’s medical condition, the intervention that they seek, its cost, and a letter from the doctor or dentist stating that it’s medically necessary.
“That letter of medical necessity is critical,” he said. “It must clearly state that the procedure, product, or service will lead to an improved medical outcome and it must be signed by a doctor or dentist.”
The application must also include information on the family’s finances in order to determine whether they can afford this service or product on their own. The amount of support provided by the fund is based on the family’s financial situation.
“We ask families to investigate other sources of revenue that could assist with payment. And we need evidence that Medicaid or the family’s private insurance carrier has denied coverage for the intervention. If so, then we will be amenable to help.”
The fund serves children from newborns up to age 18, primarily in Kalamazoo County. Many are children in foster care with special needs. The minimum expenditure is $200, with an average expenditure of about $1,500.
According to Hein, insurance policies and Medicaid cover most expenses for newborns and infants. They also cover expensive surgeries, hospital stays, and out-patient treatments for older children.
“But children with chronic medical issues often have needs that insurance will not cover and that families with low financial means cannot afford. That’s where this fund can have a huge effect on children and their families.”
Hein cites the case of one autistic child who often fell or jumped out of bed and suffered injuries. The fund was able to help the family purchase a bed designed for children that keeps them safe at night.
There was also the case of a learning-disabled child who needed outdoor exercise, but would run into the street even when closely supervised. The fund helped pay for a safety fence around the family’s backyard so the child was kept safe.
Neither Hein nor the anonymous donor meets the children or families who benefit from the fund. But they see the thank you notes and photos.
“Needless to say, it can be very emotional,” he said. “Children and families are very thankful.”
Hein said he is very grateful to the nurses, dental hygienists, social workers, in-home caregivers, and others who tell families and legal guardians about the fund, help them fill out the application, and procure the letters of medical necessity from physicians and dentists.
He’s also grateful to community partners that refer families to the fund. These include partners such as Communities in Schools /Kalamazoo, KRESA, (Head Start, Woods Edge), Children’s Special Health Care Services (a state program administered by Kalamazoo County), Borgess Pro-Med Pediatrics and Rambling Road Pediatrics, Bethany Christian Services, The Michigan Department of Health and Human Services, and Family & Children Services.
Hein encourages parents and caregivers to contact their pediatrician’s office or Medicaid case manager to start the application process.
“Helping more kids is the goal,” he said. “Accomplishing that is a matter of getting medical professionals to stay alert for patients and families that we can serve.”
Medical and dental offices, caseworkers, and caregivers who’d like to help patients apply to the medical needs fund administered by Family & Children Services may contact Dale Hein at Dale.Hein@fcsource.org.