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Macomb County Health Department helps families with special needs navigate health care, insurance industries

-Posted on July 21, 2020

 

Welcoming a child into the world can be an exciting experience. Watching them grow, learn and become independent individuals can be even more joyful. But for some families, this can be complicated. Especially when they have children with a serious illness or disability.  

 

Fortunately, programs like the Macomb County Health Department’s Children’s Special Health Care Services (CSHCS) can provide relief for those dealing with a challenging diagnosis. 

 

“It can be hard to maneuver through the health care and insurance systems,” said Karla Anderson, program manager for the Health Department’s CSHCS program. “It’s our job to provide support and services so families can keep children out of extended care facilities. We help them manage care at home.”

 

CSHCS is part of Title V of the Federal Social Security Act, which provides grants to states for maternal and child welfare. It’s goal is to enable individuals with special health care needs to have improved health outcomes and an enhanced quality of life.

 

 

“Our program reaches out to over 2,900 families that have children with over 2,700 different diagnoses from birth to 21 years of age,” she said. “This includes clients over the age of 21 with Cystic Fibrosis, Hemophilia and related coagulation disorders. Conditions must be severe and chronic and must involve medications with intensive treatments.”

 

Anderson’s background as a public health nurse gives her the knowledge and expertise to counsel families and guide them through complex medical institutions. Her team of seven staff members, five of which are also public health nurses, work together to provide service for Macomb County families in need. 

 

“Our training ranges from customer service to problem solving and database management,” she said. “We are also well-versed in developing plans of care for our clients.” 

 

For example, Anderson and her team can help participants receive medication and medical supplies or assist them with billing and financial issues. They can even help families find suitable respite care, a service that provides temporary relief for primary caregivers.

 

“For families, this aspect of care can be frustrating, so it is extremely rewarding when we can help them find what they need,” she said. “Just giving a mom or a dad an afternoon to go to the grocery store or run errands while someone watches over their child….it can be a huge relief.”

 

Under Anderson’s direction, the CSHCS program also provides classes for young people transitioning into adult health care and aging out of the program.

 

“We sit down with these participants and educate them about what will change for them as they become adults,” she said. “We talk to them about HIPAA and guardianship, secondary school and insurance. They aren’t easy conversations to have, but they are important.”

 

Connection is also important for Anderson and her team. They want to help families in the program build relationships and support groups with one another. This goal inspired the creation of the Children’s Special Family Fun and Information Night in 2019. The event featured educational resources and vendors, but also face-painting and games that could foster a rapport among attendees.  

 

 
 
 

 

This year, the spread of COVID-19 prevented a second event from being held. In lieu of a gathering, Anderson and her team kept in contact with participants through phone calls, emails and other virtual means. 

 

“Everyone learned something new every day during these last few months,” she said. “We’re not always a clear cut program and we have to be creative. So we made sure to work with each other and share knowledge as much as possible.”

 

Program staff made sure to share insights with participants as well.

 

“We were quick to inform our families about the state’s extension of medical enrollment for the year due to COVID,” Anderson said. “This was a huge relief for participants because many couldn’t schedule an appointment with their specialist during a pandemic.”

 

“Supporting families with special health care needs has been a long-standing service of local public health departments,” said William Ridella, director/health officer of the Macomb County Health Department. “Our CSHCS program staff are genuinely committed to the families they serve, and are passionate about providing much needed assistance.”

 

Anderson continued: “At the end of the day, our biggest goal is to try to make sure that families can keep kids at home and that they get the care they need knowing they have special needs.”

 

It’s this mission that makes CSHCS an essential program - one that ensures parents with sick or disabled children are never alone when navigating the complex world of health care and insurance. 

 

“Our jobs are challenging yet joyful,” Anderson said. “I am proud of what we do.”

 

For more information on Macomb County’s Children’s Special Health Care Services, click here or call (586)-466-6855. Program specialists can help you determine eligibility and discuss applications, insurance and fees.  

 

Megan Ochmanek is a communications specialist for Macomb County Planning and Economic Development.