Better Together - 2011 Community Benefit Report
In this report, you’ll learn about how we partner with the Philadelphia Zoo and the Please Touch Museum to give children new opportunities, and about the projects our medical residents are implementing in our communities. You’ll find out how we’re helping kids in South Jersey and the Dominican Republic, and how we’re dealing with major public health challenges like asthma and AIDS.
2011 COMMUNITY BENEFIT REPORT Dear Friends, The Children's Hospital of Philadelphia is world-renowned for providing the very best healthcare for children. We welcome patients from all over the world every year -- and care for many, many more from our local communities. It is the people in these communities -- our neighbors, friends and collaborators -- who make much of our work possible. We count on our community partners to provide insight and opportunities as we develop new programs and find new ways to deliver care. Once needs are identified, CHOP employees and clinicians take the initiative to step outside the walls of our buildings and collaborate with our partners to improve life for the children who live, play and go to school in the areas we serve. We are, truly, better together. In this report, you'll learn about how we partner with the Philadelphia Zoo and the Please Touch Museum to give children new opportunities, and about the projects our medical residents are implementing in our communities. You'll find out how we're helping kids in South Jersey and the Dominican Republic, and how we're dealing with major public health challenges like asthma and AIDS. And there's so much more. Whether we're introducing kids to the joy of reading or helping their parents keep them safe from common injuries, the work we do improves kids' lives as well as their health. We see the difference we make in the community every day. In this report, you'll have a chance to see it, too. Sincerely, Steven M. Altschuler, M.D. Chief Executive Officer The Children's Hospital of Philadelphia Table of Contents 2011 Community Benefit Report 4 Poison Control 1-800-LIVES SAVED Asthma Care Asthma Is Relentless and So Is CAPP Special Babies Clinic Special Trips for Special Babies Homeless Health Initiative Hands-on Care and Big-picture Assistance Global Health Caring for Kids the World Over CHOP Care Network CHOP's Presence in N.J. Expands � Power of the Positive PolicyLab A Voice for Children in Policy Decisions Reach Out and Read Still Reading, 15 Years Later Adolescent Initiative Fighting HIV, One Youth at a Time Youth Heart Watch Champions in Saving Lives Injury Prevention Leading the Way in Injury Prevention Community Nursing Advocacy Fellowship Nurses Address Greatest Needs Training and Education Pediatric Residents' Projects Boost Advocacy Skills Center for Childhood Communication CHOP Expands Hearing Loss Services in N.J., Pa. Community Benefit Impact CHOP Care Network Map 5 24 20 26 6 8 10 12 16 18 14 5 19 20 22 24 10 25 26 27 28 Poison Control Poison Control Center at CHOP Keeps Communities Safer Lives saved Every day in our communities, a curious child eats something he shouldn't. An elderly person takes the wrong dose of medicine. A worker splashes something harmful on her skin. Help is a phone call away, at 1-800-222-1222, the Poison Control Hotline. For 23 counties in Pennsylvania and all of Delaware, the 24/7 hotline is staffed by specially trained pharmacists, nurses and doctors at The Children's Hospital of Philadelphia. The Poison Control Center at CHOP responds to more than 80,000 calls per year, from homes, workplaces and hospitals. The center, with a staff of 17 working around the clock, is certified by the American Association of Poison Control Centers, and is supported by state and federal funds. CHOP also helps with funding, with in-kind support as well as direct support totaling $1.1 million. For 25 years, the center has helped people of all ages, in every community. With every call to the hotline, a nurse or other staff person takes information about the potential poison and the person's symptoms, and helps calm the caller. In many cases, the incident can be handled over the phone. After giving instructions, the nurse calls back over the next few hours to be sure the situation is under control. Hotline advice often prevents an unnecessary trip to the emergency room, saving many dollars in healthcare spending. The Poison Control Center helps hospitals manage perplexing cases related to medication overdoses and other types of poisonings. Hospitals get poisoning advice from hotline staff and also have access to board-certified on-call toxicologists. In one example, the emergency room at a local hospital called the Poison Control Center at CHOP after more than an hour attempting to resuscitate a girl who had overdosed on medication. The toxicologist on call suggested an antidote, and the girl's pulse was restored. The life of a 17-year-old was saved. The Poison Control Center also serves the public by monitoring new trends in types of poisonings (for example, children drinking lamp oil). The center sends email alerts to a large list of physicians and hospitals, with information about the potential new threat and treatment recommendations. The center reaches out to the public about recent poisoning trends and is a trusted source of information for government and industry. n Learn more about the Poison Control Center at www.chop.edu/poisoncontrol or by calling 215-590-2003. Prevention The Poison Control Center staff believe that the best way to save lives is to prevent poisonings from happening at all. The center developed an extensive set of materials to help educate the community, including: u Preschool and elementary school teacher handbook Toddlers and children in the early grades are especially vulnerable to accidental poisonings. These lessons, games and puzzles are targeted to this age group and teach about potential hazards in homes and yards. u Recipes for "green" cleaning Because household cleaners result in many poisonings, the center developed materials about making cleaners with safer ingredients, such as vinegar. In addition to recipes, the booklets include tips for keeping homes, yards and garages safer. u A puzzle and game booklet for children Children don't understand what is and isn't harmful. This booklet teaches them never to eat or drink anything unless an adult says it's OK, and helps them understand what types of common items can hurt them. Staff members visit local businesses to give talks and distribute the materials. They send order forms to local schools and day care centers. Materials are also available to download at www.chop.edu/poisoncontrol. 4 � CHOP 2011 Community Benefit Report Asthma Care (A) Asthma Is Relentless and So Is CAPP When a child with asthma struggles to breathe, parents tend to panic and rush their child to the emergency room. While there are rare times when an asthma attack requires immediate medical care, the key to keeping children breathing freely is prevention, and prevention requires knowledge. The Community Asthma Prevention Program (CAPP) at Children's Hospital fills the bill perfectly. CAPP provides a community-driven asthma management program that is comprehensive and sustainable. Staff spend their time in the community because that is where they can best help families control their kids' asthma and partner with neighborhood schools and doctors' offices to keep asthma care a priority for families. Over the last year, more emphasis has been placed on connecting families with primary care physicians who will work with families to create an asthma care plan, reinforce the need to continue medicines -- even when their child is symptom-free -- and recognize, and avoid, triggers. "Asthma doesn't go away," says CAPP Medical Director Tyra Bryant-Stephens, M.D. "It only goes into hiding, waiting for a family to let down its guard, and then it'll come roaring back. Once families really understand that and know how to control their child's disease, we've accomplished our mission." n Learn more about CAPP at www.chop.edu/capp or by calling 215-590-5261. Key elements of the program are: u Community asthma education classes In schools, churches, daycare centers and other locations throughout the city. u Home visitor program In West Philadelphia, where home visitors work one-on-one with parents to address the home environment and get rid of asthma triggers such as dust, pet dander, cockroaches and mice allergens. Ninety families were helped by home visitors last year. u Asthma education workshops For school nurses, coaches and teachers in Philadelphia so they better understand asthma care and how to respond if a student with asthma begins to struggle; Continuing asthma education for primary care practitioners and their staff. CAPP presented a total of five professional education sessions last year. (B) Learning to Breathe (A) Sisters Melay-ana, 7, and Shaynna, 5, better controlled their asthma after a CAPP home visitor worked with their parents. (B) Naima, 6, practices how to use a spacer with her asthma inhaler. Proper use of medication can keep asthma at bay. CHOP 2011 Community Benefit Report � 5 Special Babies Clinic Special Trips for Special Babies Exotic animals, a hot-air balloon, a chance to build your "dream" car -- a trip to the Philadelphia Zoo or the Please Touch Museum helps kids get to know a whole new world. And that, in turn, helps them grow: "Research shows that enlarging a child's universe is important to development," says Hallam Hurt, M.D., director of the Special Babies Clinic (SBC), a follow-up program for high-risk and preterm infants treated at CHOP Newborn Care at the Hospital of the University of Pennsylvania. The families also want to foster their children's development. In a survey conducted in 2011, 96 percent of the 79 families surveyed felt that reading was important to their child's development, with 41 percent having been to the library in the past six months. Ninety-six percent also felt that taking the time to do a new activity was important to their child's development, but only 27 percent had taken their child to a zoo, museum, aquarium or theme park in the past six months. And only 22 percent had taken their child on a trip 50 miles outside the city in the past six months. The barrier many SBC families face, Hurt says, is cost. For some activities, adult tickets can range from $18 � $50, while child tickets cost $15 � $40 -- well beyond the reach of families facing economic challenges. To make these important experiences more accessible for SBC families, Hurt and her colleagues worked with Philadelphia Zoo President and CEO Vikram Dewan to arrange for SBC families to spend a day at the Zoo free of charge; Laura Foster, president and CEO of Please Touch Museum, also helped arrange free museum visits for the families. Since the Special Trips for Special Babies program began in summer 2010, there have been nine trips to the Zoo and two trips to the Please Touch Museum, with a total of 231 visitors in 2010 and 321 visitors in 2011. Of the 2011 visitors, 99 percent had Medicaid-type insurance, 99 percent of the biological mothers were single, and 1 percent of the mothers had a college degree. In a post-visit survey, 100 percent of families said they were enthusiastic about their experience, and 100 percent wished to return. Both the Zoo and the Please Touch Museum offered free admission, and CHOP covered transportation, snacks and the other incidentals that helped make the trips so special. "The kids were just enthralled," says Hurt, "and the families were so grateful." n Learn more about SBC by calling 215-426-7329. Visiting Please Touch Museum "We enjoyed everything: the cars, the bus -- and the kids loved Alice in Wonderland. They wanted to go back the next day ... they are talking about it nonstop. I didn't even know Please Touch Museum existed ... it let them see a whole new place." � SBC Grandmother 6 � CHOP 2011 Community Benefit Report Visiting the Philadelphia Zoo "The whole family had a blast at the Zoo! My kids loved all the animals, but especially riding the camel and will be talking about it for the next three months. It was the highlight of their summer! We are so thankful to the Zoo and to SBC." � SBC Mother CHOP 2011 Community Benefit Report � 7 Homeless Health Initiative Hands-on Care and Big-picture Assistance Children and families experiencing homelessness have also often experienced trauma -- emotional and/or physical. In an effort to ensure families are not unintentionally retraumatized through policies and services meant to help them, CHOP's Homeless Health Initiative (HHI) co-hosted a week-long Sanctuary Model� training last spring. Eighty of the city's homeless services providers received trauma training and learned how to effectively address healing from psychologically and socially traumatic experiences. The training is just one example of how the HHI of The Children's Hospital of Philadelphia worked even more closely with its partners and stakeholders last year to understand and meet the increased needs of families in emergency housing. As it has since 1988, HHI continued to provide free medical and dental services to children living in three West Philadelphia homeless shelters. HHI volunteer physicians, dentists, nurses and social workers conducted 24 shelter visits and saw 173 medical patients and 150 dental patients in the first 10 months of 2011. In addition to those core services, HHI has also worked at a system level over the last year to improve the future of families experiencing homelessness. Some other examples are: (A) (A) Karen Hudson, M.S.W., L.S.W., HHI program manager, at St. Barnabas Mission in West Philadelphia (B) Medical residents give children checkups during twice-amonth homeless shelter visits. HHI's Fivefold Mission high-quality, 1. Provide to children inculturally sensitive acute medical services shelters families 2. Connect care with insurance and primary and specialty knowledge of and 3. Enhance healthcare professionals'impact on children's exposure to homelessness and its lives and health education and residents in shelters, 4. Providecommunityto both staffan effort to empower themas well as groups, in local and 5. Collaborate withhealthcare national partners to effectively advocate for the of children in shelters and to assist others in replicating the HHI model Citywide Support HHI is an active participant in the Children's Working Group (CWG), a public-private partnership with a goal of unifying efforts to best serve children experiencing homelessness or housing insecurity. The HHI team is on the data and policy subcommittee, which helps make recommendations to improve the health and well-being of children living in emergency and transitional housing. HHI also participates on the early intervention subcommittee, which identified parenting training as high priority. Karen Hudson, M.S.W., L.S.W., HHI program manager, helped create a comprehensive new parenting curriculum that incorporates principles of the Center for the Improvement of Child Caring Program Effective Black Parenting, evidencebased practices, trauma-informed care and self-care practices. Family Care was piloted at the Salvation Army Red Shield 8 � CHOP 2011 Community Benefit Report HHI/Emergency Housing Partners HHI offered primary level support, including monthly medical and dental care visits, ongoing education and training for emergency housing staff and families, and fundraisers to three West Philadelphia emergency housing facilities: u People's Emergency Center (PEC): Approximately 220 women, children and teenage girls reside at PEC for stays averaging between six and 18 months. u Episcopal Community Services (ECS)/St. Barnabas Mission: St. Barnabas Mission provides emergency housing for up to 105 women and children every day. u Lutheran Settlement House/Jane Addams Place: Jane Addams Place is a comprehensive emergency housing facility for 95 women and children. (B) Family Residence with a group of about 12 mothers. The sixweek program was well received by the mothers, who said they wanted even more training. Philadelphia's Office of Supportive Housing funded the training of more than 80 emergency and transitional housing providers at more than 20 emergency and transitional sites across the city. Secondary support, including education sessions, training seminars and donation drives, was provided to Salvation Army Red Shield Family Residence, Red Cross House and Women Against Abuse. Sharing the Model HHI leadership continued its mission of sharing the HHI model and programming. In June 2011, Hudson and Berrios presented the workshop "Operation CHOICES: Promoting Healthy Food & Fitness for Families Living in Emergency Housing" at the sixth Young Children Without Homes National Conference in Washington, D.C. Hudson also participated in and shared information about the HHI model at the Public Service Leadership Diversity Summit in Atlanta. While there, she met with staff from Morehouse College and Emory University schools of medicine and Children's Healthcare of Atlanta to share the HHI model. Hudson and Malkia Singleton of People's Energy Center (PEC) shared information about homelessness in the United States with exchange students from China's Beijing Normal University School of Social Development and Public Policy. The students toured CHOP and Gloria's Place at the PEC during their summer study program at the University of Pennsylvania School of Social Policy & Practice. Providing Choices Through HHI's Operation CHOICES, more than 100 CHOP and University of Pennsylvania employees and students volunteer their time and energy to help children get active and learn about health topics. Volunteers teach moms and their children living in shelters about flexibility, strength, endurance, balance, coordination and agility. Volunteers also teach moms and children about nutrition, empowering them to make healthy choices for themselves and their families -- lessons that extend beyond their time in shelters. Teen Group Thanks to generous funding from the Lomax Family Foundation, HHI's Melissa Berrios, M.S.W., continues to facilitate the teen group at People's Emergency Center. The group is a place where teenagers experiencing housing insecurity can explore their feelings and learn about ways to improve their health and wellbeing. Generous Volunteers HHI staff channeled the generosity of CHOP employees, other businesses' employees and individuals to support collections of school supplies and holiday gifts, service projects that resulted in special Mother's Day and holiday celebrations, and fresh paint and tile in Lutheran Settlement House/Jane Addams Place. n Learn more about CHOP's HHI program at www.chop.edu/hhi or by calling 215-590-7646. CHOP 2011 Community Benefit Report � 9 Safe Sitters Last fall, nurses from CHOP worked with adolescents staying in shelters, introducing them to the Safe Sitter� program, which prepares kids for the responsibilities of protecting and nurturing children. A dozen youth living at Jane Addams Place graduated from the Safe Sitter program, which may help them secure a babysitting job or help their mothers care for younger siblings. Global Health Caring for Kids the World Over 10 � CHOP 2011 Community Benefit Report Every day, nearly 25,000 children in developing countries die of curable sicknesses: malaria, diarrhea, tuberculosis, malnutrition. "That's our call to action," says Rodney Finalle, M.D., director of the Global Health Program at The Children's Hospital of Philadelphia (pictured at right). "So many children dying every day from preventable diseases is what propels our programs." Since 2004, more than 100 Children's Hospital staff have participated in a CHOP Global Health activity, primarily outside the borders of the United States. And more than 4,000 children have received care in another country from a Children's Hospital clinical professional through one of our established programs. The Global Health Program has four signature initiatives: primary healthcare and targeted programs to approximately 400 children; approximately 14 in-country nationals are directly involved with the program. David N. Pincus Global Health Fellowship This fellowship was established in 2008 with the goal of attracting the best and brightest pediatricians at the beginning of their careers. Fellows complete an intense two-year academic fellowship working at The Children's Hospital of Philadelphia and in our partner countries: the Dominican Republic and Botswana/South Africa. The fellows work alongside local health providers, treating children, training health "promoters," doing research and building relationships that will have a lasting impact in those countries -- and beyond. The goal is to create sustainable models that can be replicated in other countries. The fellowship actively collaborates with the Columbia University International Family AIDS Program, Sparrow Rainbow Village, the Botswana-UPenn Partnership and the Centro de Salud Divina Providencia. Finalle and his team believe that one of the best ways to improve children's health is to build strong, sustainable community partnerships -- both here in the United States and in other countries. "With our partners, we bring science to the real world and make it meaningful in a culturally effective way," says Finalle. "At the end of the day, it's about how you deliver care and build capacity to help the children." n Learn more about CHOP's Global Health Program at www.chop.edu/globalhealth or by calling 267-426-9666. Annual Global Health Symposium Held each year in Philadelphia, this gathering spotlights global health issues and offers an opportunity to share ideas and innovative solutions to the health challenges facing children around the globe. Global Health Allies This program, which operates primarily in the Dominican Republic, provides opportunities for CHOP staff to share their expertise at one of our partner sites for a designated period of time. In fiscal year 2011, 11 CHOP employees participated in a Global Health Allies experience in the Dominican Republic. Ni�os Primeros en Salud In 2009, building on years of collaboration with the community of Consuelo in the Dominican Republic, CHOP Global Health opened its first pediatric clinic, Ni�os Primeros en Salud ("Kids First in Health"). The program focuses on improving access to primary care, deworming, immunization coverage, breastfeeding education and nutrition. All programs were developed at the request of and in conjunction with the community of Consuelo, working to target needs that were felt to be most significant in the under-5 population. The clinic currently provides CHOP 2011 Community Benefit Report � 11 CHOP Care Network CHOP's Presence in New Jersey Expands (A) (B) (A)The CHOP-Virtua partnership gives even more New Jersey families access to Children's Hospital-trained specialists in locations close to home. This shows the new CHOP Care Network Specialty Care Center at Virtua in Voorhees, which opened in May. (B) Patients like Justin can see their specialists in New Jersey, which is convenient for their families. 12 � CHOP 2011 Community Benefit Report CHOP's Main Campus is Philadelphia, but its reach across the Delaware River into New Jersey has grown to 13 locations and will continue to strengthen. Starting Feb. 1, 2011, doctors from The Children's Hospital of Philadelphia began to care for pediatric patients at two Virtua hospitals, Virtua Memorial in Mount Holly and Virtua Voorhees, as part of a new partnership. Virtua is South Jersey's largest healthcare provider. "This partnership adds a rich new dimension to pediatric care in South Jersey," said CHOP CEO Steven M. Altschuler, M.D., when the collaboration was announced. "CHOP brings added specialties to an already well-established pediatric program at Virtua." In the first five months of the partnership, CHOP doctors cared for 10,018 patients in Virtua's facilities. That number will grow in 2012 when the Virtua Voorhees location completes a new outpatient building, where patients needing certain specialty care will be seen by CHOP specialists. The Virtua partnership builds upon earlier community hospital relationships: University Medical Center at Princeton (2009) and Shore Memorial (1999). The CHOP Care Network also operates four Specialty Care Centers and five Primary Care practices in New Jersey. All further CHOP's goal of bringing the best pediatric care to families in locations convenient to where they live. n To learn more about CHOP at Virtua and see a complete list of locations, go to www.chop.edu/network. Patients Treated by CHOP at Virtua Doctors* *First five months of partnership Location Memorial Hospital, Mount Holly Department Cardiac General Pediatrics Neurology Cardiac Emergency General Pediatrics Neurology Total Patients: Patients 191 2,682 14 196 6,549 355 31 10,018 CHOP Care Network Primary and Specialty Care visits in N.J. 2011 Patient Visits Specialty Care Location Patients Voorhees Atlantic County Princeton St. Peters Total Patients 32,458 5,502 10,234 2,623 50,817 Primary Care Location Patients Haborview includes Cape May Smithville Somers Point Mount Laurel Salem Road Total Patients 42,468 10,899 9,885 21,684 31,234 30,294 103,719 Virtua Voorhees Total visits for Primary Care and Specialty Care 154,813 CHOP locations in New Jersey Primary Care practice Specialty Care Center Specialty Care Center/ Surgery Center CHOP Newborn & Pediatric Care MERCER One Person, Many Roles Officially, Donna Wasik, M.S.W., is the Hematology/Oncology social worker in the CHOP Care Network Voorhees Specialty Care Center. Unofficially, she is also a bus chaperone, camp infirmary volunteer, donation coordinator and event planner. "This Specialty Care Center has an altruistic mind-set," Wasik says. "Of course we care for the children who need our services, but we also look out for the whole family so the child's overall experience is better." The office puts together Thanksgiving food baskets to give to financially challenged families. Nineteen families received baskets last year. All winter, a tree in the vestibule is "decorated" with new scarves, mittens and hats, and families are encouraged to take what they need to keep their children warm. Gently used coats and boots are also given to needy families. There's a closet loaded with baby socks that staff can give to infants. "People in the community often call us, wanting to know how they can help," Wasik says. "I'm happy to be the go-between to help others help our patient families." n MIDDLESEX MONMOUTH OCEAN BURLINGTON GLOUCESTER CAMDEN * SALEM ATLANTIC diatric Care* CUMBERLAND CAPE MAY CHOP 2011 Community Benefit Report � 13 CHOP Care Network Power of the Positive CHOP's Intensive Program Helps Kids Change Their Behavior There was the Tyler of August: impulsive, defiant, destructive, aggressive, threatening, unapologetic and generally out of control. He was 10 years old. Then there is the Tyler of January: hard-working, respectful, in control of his emotions (most of the time), fun, and, if he messses up, genuinely remorseful. For the six months in between, he was a patient at the Children's Intensive Emotional and Behavioral Program (CIEBP) of Children's Hospital, a psychiatric day hospital for children between the ages of 5 and 12. "When Tyler graduated, he was a different child," says his mother, Michele Kitzler. "He still has a way to go, but the change is amazing and CHOP is the reason." CIEBP serves children with significant behavioral, emotional and social needs from throughout the South Jersey region, including Atlantic, Cape May, Cumberland and Ocean counties. Children attend the program, located in the CHOP Care Network Specialty Care Center Mays Landing, for six hours a day, five days a week. Each therapeutic classroom is staffed with a certified teacher, a behavioral therapist and a clinical assistant. An attending psychiatrist is always on staff. The focus is learning what supports a child's maladaptive behavior and then teaching appropriate replacement behaviors and building social skills. "Our goal is to access the child's true potential to learn," says Operations Manager Carl Wolfarth. "Children come to us with a wide variety of psychiatric diagnoses, psychiatric medications and medical needs. Because we're part of CHOP, we are able to take a holistic view of the patients' needs to provide the best possible patient care." Including parents and caregivers is a key element of treatment. For the Kitzlers, of Manahawkin, N.J., the weekly parents' nights were a lifeline. "Everyone going through this needs the support," Michele says. "It made a huge difference in helping my husband and me learn how to handle Tyler's special needs, how not to get drawn into his episodes. Never once did I feel judged or looked down upon. I wasn't afraid to say what really went on in my home because I knew they had gone through it, too." There are parallels between what goes on in the children's classroom and in the parents' group. There's a deliberate, constant focus on the positive, on what they did right. And just as kids who have been in CIEBP longer support newer students through peer leadership, parents whose children have graduated help newer parents and give them hope that, over time, things will indeed get better. "I'll never forget how proud Tyler was of himself the week he was peer leader president," says Michele. "He was never proud before. He was always so down on himself. At CHOP, he wanted to work toward things; he wanted to reach higher levels." Before Tyler entered CIEBP, he had been in counseling for five years. He had been hospitalized three times in psychiatric wards after threatening to commit suicide. He had been diagnosed with depression, anxiety, attention deficit hyperactivity disorder, visual processing disorder, auditory processing disorder and, after one hospitalization, pervasive developmental disorder-not otherwise specified. "He had been given so many different medications, we didn't really know who the real Tyler was," says Michele, who weaned him off all drugs before he started CIEBP. "Through all those years, all those counselors, all those diagnoses -- no one else did what CHOP did: Save my son." n For more information about CIEBP, go to www.chop.edu/ciebp or call 609-677-7850. 14 � CHOP 2011 Community Benefit Report Tyler (below, right) and his whole family benefited from therapy he received in the Children's Intensive Emotional and Behavioral Program in Mays Landing. Tyler, 10, traveled an hour each way from his home in Manahawkin, N.J., every weekday for six months to participate in the program. Classrooms Like No Other (A) Teacher-psychologist Ivette Merrick, M.Ed., program director Carl Wolfarth, and behavioral specialist Frank Lecklikner, B.A., C.S.II, help children that schools have given up on. (B) Treatment rooms are set up as classrooms where the main subject for the children is to learn how to control their behavior. (A) (B) (C) (C) "Mr. Carl" works with the children, like Tyler, and also with parents so the skills the kids are learning in the program are reinforced by parents at home. Parents and guardians attend a weekly parents' group to learn from and support each other. (D) The walls of the three classrooms reflect the social and emotional skills the children are learning. (D) CHOP 2011 Community Benefit Report � 15 Education and Advocacy PolicyLab A Voice for Children in Policy Decisions Who speaks for children and families when policies about their health and well-being are developed? One of the strongest voices is the PolicyLab at The Children's Hospital of Philadelphia. PolicyLab is a team of researchers, including physicians and psychologists with decades of experience in children's health, who conduct studies to inform policy decisions on tough, important topics such as access to behavioral health services, the child welfare system, complex chronic conditions, family and parenting supports, sexually transmitted diseases, and teen pregnancy. PolicyLab aims to bridge the gap between academic communities and the real world by engaging in research that is responsive to community needs and relevant to policy priorities. And PolicyLab doesn't stop with research. Working with families, government and community agencies, the team also puts in place interventions to truly make a difference in the lives of children and families. n Current PolicyLab initiatives include: u Cross-system Collaboration for Child Well-being When children in the foster care system need mental health and behavioral health services, they often don't receive services in a timely fashion due to system-level barriers. This project aims to identify and address policy barriers surrounding access to such services in the child welfare system, and to foster partnerships across various agencies in Philadelphia to improve quality and access. u Foster Parent and Child Interventions �Parent Child Interaction Therapy (PCIT) � an intensive mental health intervention for caregiver-child (ages 2 to 8) pairs at risk for placement disruption related to child behavior problems and/or associated caregiver stress u Enhancing Parenting for Depressed Caregivers This pilot program co-locates behavioral health services in select Philadelphia foster care agencies. Two interventions are provided: � Child Adult Relationship Enhancement (CARE) � a six-hour group training module for kinship and foster caregivers of children, as well as foster care agency social workers and staff This program addresses stress and depression in low-income families with young children. Parents who screen positive for depressive symptoms at seven Philadelphia primary care centers are invited to participate. They attend a 12-week parenting program with topics such as praising and encouraging children and positive discipline. The program includes materials on depression and stress designed to empower parents to seek treatment and better manage depression. Learn more about PolicyLab initiatives at policylab.us or by calling 267-426-5300. 16 � CHOP 2011 Community Benefit Report A Tool to Help Pediatricians Identify Problems, Find Help CHOP a Leader in Ambitious Federal Grant Children's Hospital is helping to lead work on a $9.7 million grant to develop innovative uses of technology to improve the quality of care and reduce the cost of services for approximately 1.3 million children enrolled in Medicaid and CHIP in Pennsylvania. CHOP's team is charged with using the electronic health record to improve early identification of children with developmental delay, behavioral health issues and complex medical conditions so the primary care pediatricians can quickly and efficiently connect them with available services. The electronic screening tool is currently being tested at select CHOP primary care centers. n For more information, call 267-426-9941. Donekia and her 19-month-old son Marcus, who is a patient at the CHOP Care Network Market Street Primary Care Center, are participants in a five-year federal research project. As they wait for Marcus' well-child visit, Donekia uses a CHOP laptop computer to answer a series of questions about her and Marcus. The answers are used to screen for a variety of potential maternal/child health issues. The information in this article was developed under grant CFDA 93.767 from the U.S Department of Health & Human Services, Centers for Medicare and Medicaid Services. The contents, however, do not necessarily represent the policy of the U.S. Department of Health & Human Services, and you should not assume endorsement by the Federal Government. Kids Come First Summit Healthcare reform and the new economic realities of our time pose daunting challenges for children's hospitals. The Kids Come First Summit was organized by CHOP and brought together pediatric leaders from across the country to share ideas and innovative strategies to ensure children receive the high-quality care they deserve now -- and in the future. In October 2010, the Kids Come First Summit convened leaders from more than 20 children's hospitals around the country who, together, explored what healthcare reform means to children's hospitals and pediatric healthcare in the future. Panel discussions ranged from Creating the Children's Hospital of the Future the growing deficit to Medicaid reform, and panelists shared best practices in safety and quality, research, care coordination, facility design, consolidation, payment redesign and advocacy. A spinoff of the summit was the development of a coalition of freestanding children's hospitals charged with making care better and more efficient. Children's hospitals, which provide significant care through the Medicaid program, are at great risk in the current fiscal environment. Given this, it is vitally important to ensure that resources are available so children will continue to receive care, regardless of their coverage. n Speaking Out for Healthcare Keynote speaker Bill Frist, M.D., nationally recognized surgeon and former U.S. Senate Majority Leader, shared his thoughts on the future of healthcare reform. CHOP 2011 Community Benefit Report � 17 Reach Out and Read Still Reading, 15 Years Later Fifteen years, 278,000 brand-new books, 297,000 gently used books and more than half a million opportunities to promote reading aloud to young children. Those are the statistical accomplishments of the Reach Out and Read Program at Children's Hospital since CHOP embraced the evidence-based school readiness initiative in 1996. Research has proven what anecdotes suggest: Children whose parents read aloud to them enter kindergarten more prepared to succeed, and that edge sets them on a path to success in other aspects of their lives, too. Trude Haecker, M.D., was an early believer in Reach Out and Read's purpose: preparing America's youngest children to succeed in school by partnering with doctors to prescribe books and encourage families to read together. Reach Out and Read helps families and communities encourage early literacy skills. Haecker and her colleagues in six primary care practices in the CHOP Care Network continue to spread the word that reading aloud to young children is one of the best activities to stimulate language and cognitive skills, and it builds motivation, curiosity and memory. Two of Dr. Haecker's patients, Tamairra and Tiairra, born three months early in 1996, were among the first CHOP patients to receive new books through Reach Out and Read. Now 15, the twins had been accepted into their chosen competitive charter high school. Their mother, Tamia, attributed the girls' school success to the books and advice they received during doctor visits. "Patients like Tamairra and Tiairra fuel my passion for Reach Out and Read," says Haecker. "I know that small gestures do matter. Spending a few minutes to share a book and encourage reading aloud changes lives." Each year, CHOP's Reach Out and Read Program touches the lives of 22,000 infants, toddlers and preschoolers in need and their families each year. Families served by Reach Out and Read read together more often, and their children enter kindergarten with larger vocabularies, stronger language skills and a six-month developmental edge. n Learn more about CHOP's Reach Out and Read Program at www.chop.edu/reachoutandread or by calling 215-590-5989. CHOP's Reach Out and Read Program relies on donations and support from schools, community groups, corporations, foundations, government, families and individuals. Through fundraisers and book drives, these supporters help CHOP maintain this valuable program. How Reach Out and Read works: Children of all ages being seen for well and sick visits are offered a book to take home and keep. � In the exam room at a Reach Out and Read practice, the pediatrician or nurse practitioner encourages parents to read aloud to their young children and offers age-appropriate tips. � At well visits, the pediatrician or nurse practitioner gives every child 6 months through 5 years of age a brand-new, culturally and age-appropriate book to take home and keep. Children in for a sick visit receive a gently used book. � In the waiting room, displays, information and gently used books create a literacy-rich environment. Where possible, volunteer readers engage the children with books and reading aloud, modeling for parents the pleasures and techniques of reading aloud. Head of the Class During the 15-year celebration, from left: CHOP CEO Steven M. Altschuler, M.D., Philadelphia Councilwoman Jannie Blackwell, Reach Out and Read graduates Tamairra and Tiairra, donors David and Marjorie Rosenberg, Reach Out and Read Medical Director Trude Haecker, M.D., and Director of Community Outreach for U.S. Congressman Chaka Fattah, Solomon Jones 18 � CHOP 2011 Community Benefit Report Adolecent Initiative One Youth at a Time CHOP's Adolescent Initiative Leads Philadelphia's Battle Against HIV. Fighting HIV, "This is about prevention at its finest. With the proper education oriented toward changing behaviors, it really might make a difference. It might ultimately save lives." � Kenneth Ginsburg, M.D., attending physician, Craig-Dalsimer Division of Adolescent Medicine According to the Centers for Disease Control and Prevention, 63 percent of Philadelphia high school students are sexually active; some younger than age 13. This statistic underscores the tremendous need for adolescent-specific HIV medical care and sexual health prevention services in our city. CHOP's Adolescent Initiative Program answers this need. One of the first clinical programs dedicated to the prevention, care and research of HIV in adolescents, it is recognized nationally by the Health Resource Services Administration as a model for "Best Practices" for linking and retaining HIVinfected youth in care. A multidisciplinary team has developed numerous innovative approaches for prevention, outreach, identification and comprehensive care for HIV-infected youth, providing the framework for successful clinical research and prevention programming. comprehensive risk counseling services and 382 were assessed. Services included referral to early intervention counseling, testing and linkage to community-based services to promote positive health behaviors. HIV counseling and testing services were also made available at several community settings, including CHOP's Pediatric and Adolescent Care Network sites in West Philadelphia and Cobbs Creek, Covenant House (a homeless shelter for high risk youth), the Youth Study Center, and other sites, including two high schools. More than 1,500 youth have been reached through this program; 1,328 have been tested and 191 have received counseling and education. Advancing Understanding CHOP's Adolescent Initiative works hand-in-hand with area agencies through its involvement with the Adolescent Trials Network (ATN) -- a 15-site research network that conducts therapeutic, behavioral and community prevention research in HIV-infected and HIV-at-risk youth populations -- and SMILE (Strategic Multisite Initiative for the Identification, Linkage and Engagement in Care of Youth with Undiagnosed HIV Infection), a joint venture of the CDC and the National Institutes of Health. The economic crisis, unstable government budgets and other factors indicate an uncertain future when it comes to HIV and AIDS. Despite these obstacles, the Adolescent Initiative hopes to continue its efforts to reduce new infections; increase access; improve health outcomes; and reduce HIV-related health disparities for our city's populations. n Learn more about CHOP's Adolescent Initiative Program by calling 215-590-4943. Helping Youth Last year, CHOP's Adolescent Initiative continued to lead the field and actively collaborate in efforts to increase the services provided to youth throughout the area and the nation. The program served 155 HIV-infected youth and more than 3,000 high-risk HIV-negative youth, providing an array of services including outreach case management to link infected youth to care; comprehensive HIV care and primary care; family planning services; intensive case management; onsite mental health screening and individual counseling; on-site psychiatric consultation; life skills support groups; communitybased nursing adherence; and wellness counseling. Community Collaboration The program continued to oversee a Centers for Disease Control and Prevention proven risk reduction intervention program at the Youth Study Center, a juvenile detention facility in Philadelphia. In 2010, 77 youths received intensive CHOP 2011 Community Benefit Report � 19 Youth Heart Watch Champions in Saving Lives Local Teenagers Star in CPR/AED Olympics Suppose a friend collapses and has no pulse. How quickly can you find a defibrillator? How many chest compressions can you do per minute? Hundreds of students from 13 Philadelphia high schools showed off their lifesaving skills during the first CPR/AED Olympics, organized by Youth Heart Watch at The Children's Hospital of Philadelphia. Held last May at the University of Pennsylvania's Franklin Field, with nearly 100 volunteers from CHOP, the Olympics were the culmination of a Youth Heart Watch study examining how to help young people become interested in and adept at cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AEDs). More than 500 Philadelphia students were involved in the study, called the Student Program for Olympic Resuscitation Training in Schools (SPORTS). They developed their own CPR/AED curriculum to be used during high school health classes. Youth Heart Watch was one of four institutions in the United States to be awarded a CPR in Schools grant from the American Heart Association and the Laerdal Foundation for Acute Medicine. Training a new generation to spring into action to help people who experience sudden cardiac arrest from a variety of heart conditions, including heart attacks, is part of the mission of Youth Heart Watch. Led by pediatric cardiologist Victoria Vetter, M.D., M.P.H., the program seeks to eradicate sudden cardiac death through research, education, prevention and advocacy. Youth Heart Watch is an affiliate of Project ADAM�, a Wisconsin-based nonprofit founded in memory of a 17-yearold who died while playing basketball. Athletes and other young people can die of sudden cardiac arrest as a result of undiagnosed heart defects, including abnormalities in the heart's electrical system. A sudden blow to the chest, such as from a baseball, and recreational drugs can also cause sudden cardiac arrest. When a young person (A) (B) (C) Life and Death Matters (A) CHOP cardiologist Victoria Vetter, M.D., with Bo Kimble, whose friend Hank Gathers died on a college basketball court in 1990 because of a heart condition. (B, C) Students participate in competitions testing skill and speed in CPR and in AED use. (D) Students from Jules Mastbaun Vocational/Technical School await presentation of results and prizes. 20 � CHOP 2011 Community Benefit Report (D) collapses, having an AED close by, and people who know how to use it and how to do CPR, can mean the difference between life and death. Over the past year, Youth Heart Watch has been extremely busy in the community. The program's coordinator Danielle Main Haley, M.P.H., met with staff at 42 schools in Pennsylvania, New Jersey and Delaware to help them start and sustain their own public access defibrillation programs, fielded over 200 calls regarding AEDs and sudden cardiac arrest, and provided 25 training grants to schools. In 2011, grants were used to train 74 staff and students, 21 CPR/AED instructors, and to help schools purchase training materials. In addition to its efforts to promote the use of CPR and AEDs in schools, Youth Heart Watch includes the Heart Health Screening Study (HHSS). The goal of the HHSS is to find young people with potentially serious heart conditions who have not been recognized previously, and to determine the best way to identify these problems on a larger scale. Free screenings are held at schools and other community locations in the region and draw hundreds of people. For example, at an October 2010 screening at Norristown Area High School, 227 children were screened. All families of children at the screenings fill out a questionnaire that provides information on cardiac symptoms and cardiacrelated family history. Additionally, they receive an electrocardiogram (ECG), a test that measures the electrical activity and characteristics of the heart to help identify cardiac conditions. If the ECG is abnormal, the children have an echocardiogram and receive a cardiac examination from a CHOP pediatric cardiologist. Approximately 1 percent of the children who are screened are identified with previously undiagnosed cardiac abnormalities that require treatment or intervention. n Learn more about Youth Heart Watch at www.chop.edu/youthheartwatch or by calling 267-426-7389. (E) (F) (G) (H) Champions All! (E) Nearly 100 CHOP employees volunteered to help with the event. Winners included: (F) first place, Philadelphia High School for Girls (G) second place, Stephen A. Douglas High School, (H) third place, Kensington Culinary Arts High School. CHOP 2011 Community Benefit Report � 21 Injury Prevention Leading the Way in Injury Prevention Every year, one out of four kids is involved in an accident that requires medical attention, making injuries the leading cause of childhood death and disability in the United States. Part of CHOP's mission as a Level I Pediatric Trauma Center is prevention -- and our Kohl's Injury Prevention Program helps support that mission. The multifaceted program, funded by Kohl's Cares for Kids, provides community education along with access to lowcost safety products. It includes Kohl's Safety Center, Kohl's Mobile Safety Center, child safety seat inspection stations and numerous community events. Through this program, we donated 153 carbon monoxide alarms, 85 bicycle helmets, 1,608 child safety seats and many other safety devices. In total, more than 3,000 safety items were given away in the community. The Kohl's Safety Center is the only store in Philadelphia dedicated to child safety, offering low-cost safety products combined with one-on-one education on how to minimize injuries. The center is located on the first floor of the Hospital, within the Shops at CHOP, and is open Monday through Friday, 10 a.m. to 4 p.m. It offers a broad range of equipment at cost, from bicycle helmets, stove knob covers and baby gates to specialty items like visual smoke alarms for the hearing impaired. But the center is much more than a retail outlet. "The whole idea is to have a place where people can talk to health educators," explains Marla Vanore, R.N., B.S.N., M.H.A., manager of the Trauma and Injury Prevention programs. Visitors can view videos that illustrate the danger of an incorrectly installed car seat; then instructors show them how to install a seat, using the rear section from an actual automobile as a model. The Kohl's Mobile Safety Center, the first of its kind in the region, takes CHOP's Safety Center on the road, bringing affordable resources into the community. The purpose of the Kohl's Mobile Safety Center is to increase awareness of safety and injury prevention within the community and offer low-cost safety products by exhibiting at health fairs, child health and wellness expos, pediatric offices, and special events. CHOP's safety experts teach families how to keep their children safe and help prevent injury, and parents and caregivers learn how to baby-proof homes and select appropriate child safety seats. As a result, they feel empowered, and they know how to save lives. Another highlight of the program is nine community child safety seat inspection stations, where families learn how to install their child's safety seat correctly. Many CHOP nurses have become certified as child passenger safety technicians and travel to these community sites to teach parents how to use their child safety seats. Last year, this program checked the quality of 1,235 safety seats while providing education to each parent. n Learn more about CHOP's Trama and Injury Prevention programs at www.chop.edu/safekids or by calling 215-590-5437. Kohl's Safety Center Located on the first floor of the Hospital, Kohl's Safety Center offers safety products like bicycle helmets, smoke alarms and child safety seats at affordable prices. The center is staffed by health educators who can answer families' questions about injury prevention. 22 � CHOP 2011 Community Benefit Report Kohl's Mobile Safety Center (A�C) This colorful van takes the Kohl's Safety Center on the road, making affordable safety products -- including many for families of children with special needs -- available in local communities. (A) (B) Safety Seat Inspections (D, E) The Kohl's Injury Prevention Program partners with the Safe Kids Buckle Up program and Safe Kids Southeastern Pennsylvania Coalition to provide car seat inspections at many locations in the community. (C) (D) (E) CHOP 2011 Community Benefit Report � 23 Community Nursing Advocacy Fellowship Nurses Address Greatest Needs The Community Nursing Advocacy Fellowship (CNAF), the only fellowship of its kind in the nation, gives CHOP nurses the opportunity to step outside the Hospital's buildings and serve in the community. Nurse fellows give of themselves and gain a better understanding of the community. The nurses initially spend their allotted 12 hours a month visiting nonprofits, shelters, schools and family court. Then they develop a project drawn from that experience. Here are highlights from last year's projects: MRI and Me Children with autism, who often find new situations a challenge, prepare for upcoming MRI tests by reading a specially written story book: MRI and Me. CNAF fellows created a "social story," with photographs and text that describes what to expect when children go for an MRI and the behavior they should use in this new situation. The nurses surveyed parents and MRI staff to see if the books lowered the patient's anxiety about the procedure. Health Education Workshops at Episcopal Community Services/ St. Barnabas Mission The fellow conducted focus groups with the mothers in residence at St. Barnabas Mission to determine their health questions and interviewed shelter staff. Then she created a schedule of monthly health education workshops addressing their concerns. These hour-long meetings devote 30 minutes to childhood health issues and 30 minutes to women's health. CHOP midwives and maternal health nurses assist. Preschool and School-age Nutrition Education at Jane Addams Place To arm children who are experiencing homelessness with the knowledge to make healthy food choices, a CNAF nurse created a nutrition curriculum for homeless children. This curriculum complements a similar curriculum created for adults. Preschoolers learn about the food groups, exercise and are exposed to healthy foods. School-age kids learn the food pyramid, how to read food labels, the dangers of sugar and how to design a healthy plate. Asthma Explorer's Club at E.M. Stanton Elementary School To help the 150 students at E.M. Stanton Elementary, who reported they have asthma, live more fully and miss less school, a CNAF fellow launched an afterschool club to teach more about the condition and how to keep it well controlled. Safe Sitter Classes CNAF trained 59 youth in the Safe Sitter� program, which targets 11- to 13-yearolds to teach them parenting and first aid skills while instilling responsibility and independence. CNAF focused the training on children living in homeless shelters and children in economically challenged communities. Five nurse instructors were also trained. Upward Bound Math and Science Immersion into Healthcare CNAF participated in the Upward Bound Math and Science Summer Program, which helps prepare high school students in low income communities for college by creating six two-hour sessions to introduce students to a variety of career options in medicine. Selected students from Overbrook and University City high schools also experienced hands-on research and simulated clinical care. n For information, call 215-590-3936. CNAF nurses conduct healthcare screenings at local homeless shelters. 24 � CHOP 2011 Community Benefit Report Training and Education Pediatric Residents' Projects Boost Advocacy Skills Preparing residents to be great physicians isn't enough, in the eyes of Children's Hospital. Residents also need to garner an understanding of what it means to serve the community and to learn how to advocate on behalf of both individual patients and all children. That's the mission of the Community Pediatrics and Advocacy Program (CPAP), an integral part of each trainee's rotations each year. Through lectures on core advocacy skills and hands-on participation in community-based pediatric projects, CHOP residents are gaining the knowledge they need to be effective and ardent advocates for children. Residents Risa Small, M.D., and Tamara Miller, M.D., display a carbon monoxide detector outside the CHOP Care Network Cobbs Creek office. Establishment of a CHOP Refugee Health Clinic The CHOP Refugee Health Clinic opened in March 2011. The clinic project evolved from the work of residents interested in access to pediatric care for refugee families who resettled in Philadelphia. Refugee children are provided ready access to basic medical care, the required documentation that permits attendance in school and, when necessary, links to specialist care. Residents created order sets and other templates to facilitate rapid and comprehensive screening for infectious and developmental issues, psychosocial and nutritional needs, and clinical summaries for future healthcare providers. Carbon Monoxide Poisoning Awareness � Collaboration with the Philadelphia Injury Prevention Center Working with the CHOP Poison Control Center, residents facilitated a new partnership with the Philadelphia Department of Injury Prevention. Families were recruited from the CHOP Care Network Cobbs Creek practice for a free home safety inspection and installation of a carbon monoxide (CO) detector by the Philadelphia Department of Public Health. City inspectors were also trained to provide CO poisoning prevention education. Surveys collected information on the efficacy of the training for future projects. Physical Activity Opportunities in South Philadelphia: Where Can Families Go? A resident at the CHOP Care Network South Philadelphia practice researched organizations that provide youth exercise programs in South Philadelphia and compiled a list of longstanding, well-organized, inexpensive programs. The list was plugged into the electronic medical software used during all primary care visits, making it easy for care providers to share the resource with families. Ballroom Dance for L.I.F.E.: Partnering with Dancing Classrooms Philly In an ongoing partnership with Dancing Classrooms' program of weekly ballroom dance lessons for fifth-graders, CHOP residents taught five health lessons in West Philadelphia schools. The interactive teaching sessions reinforced the health benefits of dance and the impact of nutrition and exercise on a healthy lifestyle. CHOP/Henry House Collaboration The CHOP � Henry House Collaboration represents the continuation of a resident-initiated sexual health curriculum for the women of Henry House, a group of 15 to 20 young women who reside in this NorthEast Treatment Centers (NET) facility during their six to 12 months in Philadelphia's Department of Human Services custody. This year, residents revamped the core curriculum to create a series of more interactive "chalk talks" and an additional lecture on selfesteem. Residents connected the women to additional community resources, and acquired reproductive health literature and supplies from the Philadelphia Department of Public Health. Primary Care Provider Follow Up After CHOP Night at HHI Shelters The Homeless Health Initiative (HHI) provides medical care to children housed in the three West Philadelphia shelters (see related story on Page 8). This project is a two-year study of whether families follow-up after a doctor, during a CHOP shelter visit, has recommended their child see primary care physicians or specialists. The study seeks to understand ways in which case management, the shelter team and HHI can better support families as they seek additional care. n For information on CPAP, call 215-590-0661. CHOP 2011 Community Benefit Report � 25 Center for Childhood Communication CHOP Expands Hearing Loss Services in N.J., Pa. Suburbs The Children's Hospital of Philadelphia has become an even broader voice for babies and children with hearing loss. CHOP's comprehensive program of interdisciplinary family-centered advocacy and support services expanded last year into southern New Jersey and Bucks, Chester, Delaware and Montgomery counties in Pennsylvania. "The progress in New Jersey was remarkable," says Carol Knightly, Au.D., CCC-A, director of Clinical Operations for the Center for Childhood Communication. "In less than one year, we were able to facilitate change in policy. Now each child with hearing loss who receives services in southern New Jersey has a teacher of the deaf as part of his or her evaluation team. That was unheard of just a year ago." The focus on the four counties surrounding Philadelphia was also successful. CHOP partnered with the Hearing Support Programs of the four counties' Intermediate Units and with their Offices of Behavioral Health to prompt them to refer children with hearing loss to the appropriate behavioral health services. As a result, 41 students received referrals. CHOP provides training and monthly clinical consultation to behavioral health providers in the local area who can help the child, family and school make a healthy adjustment to the child's hearing loss. Due in part to CHOP's advocacy and educational efforts, a new residential treatment program for deaf and hard-of-hearing youth opened in Abington, Montgomery County, allowing area families to more easily support and participate in their child's treatment. Before it opened, the closest similar facility for children who needed this higher level of behavioral health support was in Pittsburgh, and many youth were sent to facilities in Florida or Massachusetts. The growth occurred without sacrificing earlier success in Philadelphia, where 91 children received services. Last year, a total of 320 children and their families received services from CATIPIHLER, which is pronounced "caterpillar" and stands for CHOP's Assessment and Treatment Implementation Program for Infants and Toddlers with Hearing Loss � Enhancing Rehabilitation. CATIPIHLER provides 26 � CHOP 2011 Community Benefit Report Lucinana, 14 months, is a patient of CHOP's Center for Childhood Communication. services and support for children with hearing loss, and their families, from infancy through kindergarten. One component of CATIPIHLER is the Baby Loaner Bank, that provides loaner hearing aids for children 18 months and younger. The program also covers the cost of ear molds, which are changed three times or more in the first year because growth is so rapid. After an infant is identified with hearing loss, the sooner hearing aids are in place, the better for his or her development of auditory, speech and language skills. After insurance is in place and the child has his own hearing aids, the parents return the loaners, to be used by another child. With the help of the Baby Bank, babies receive hearing aids a month after their hearing loss is diagnosed -- among the fastest responses in the nation. Since its inception in 2006, CATIPIHLER has provided services to more than 500 children. n Learn more about CATIPIHLER at www.chop.edu/ communication or by calling 215-590-7612. Where CATIPIHLER patients live: Philadelphia Pennsylvania suburbs New Jersey Other TOTAL 91 109 96 24 320 Community Benefit Impact 2011 Financial Commitment to the Community* Charity Care (free or discounted healthcare provided to families that cannot afford to pay) Unpaid Cost of Medicaid Programs Unpaid Cost of Medical Education Programs Losses at Primary Care Practices (South and West Philadelphia locations) Subsidies for Research (investment and support to research programs that would otherwise go unfunded) Research In-kind Donations Cost of Community Benefit Programs Bad Debt (healthcare receivables that could not be collected) *Amounts include the physician faculty practice plans affiliated with The Children's Hospital of Philadelphia. All financial data is for fiscal year July 1, 2010 � June 30, 2011.. $6,025,000 $162,712,000 $21,540,000 $6,295,000 $49,095,000 $461,000 $6,095,000 $64,729,000 TOTAL u $316,952,000 Layan, 8 months, received expert care from the CHOP at Virtua partnership. CHOP 2011 Community Benefit Report � 27 CHOP in Your Community CHOP Care Network brings the best in healthcare to your community. No matter where you live in southeastern Pennsylvania or southern New Jersey, our network is close to home and convenient. www.chop.edu/govt-affairs 267-426-6904 Founded in 1855, The Children's Hospital of Philadelphia is the birthplace of pediatric medicine in America. Throughout its history, a passionate spirit of innovation has driven this renowned institution to pursue scientific discovery, establish the highest standards of patient care, train future leaders in pediatrics, and advocate for children's health. A haven of hope for children and families worldwide, CHOP is a nonprofit charitable organization that relies on the generous support of its donors to continue to set the global standard for pediatric care. �2012 The Children's Hospital of Philadelphia, All Rights Reserved. NEW CASTLE SALEM BUCKS MIDDLESEX MERCER MONTGOMERY MONMOUTH PHILA. OCEAN CHESTER DELAWARE BURLINGTON GLOUCESTER CAMDEN ATLANTIC CUMBERLAND facebook.com/ChildrensHospitalofPhiladelphia CAPE MAY twitter.com/childrensphila 28 � CHOP 2011 Community Benefit Report 5412/PDF/06-12 youtube.com/childrenshospphila For a complete listing of CHOP Care Network locations go to www.chop.edu/network.