- Newborn Home Visitation
- Supporting Families in Crisis
- HANDS Pediatric Dental Clinic
- Easter Seals' Early Steps
- PACE Center for Girls
Newborn Home Visitation Program
During a home visit with a first time mom who delivered by cesarean section, the RN noted an elevated blood pressure of 152/93. The patient was currently taking Labetalol 100 mg twice a day since her discharge from the hospital. The patient denied headache or visual disturbances, which are cardinal signs of high blood pressure. After reviewing signs and symptoms of elevated blood pressure with the patient, the RN instructed her to follow up with her OB the next day at her regularly scheduled appointment. The RN scheduled a second follow-up home visit to recheck the blood pressure.
The doctor doubled patient’s blood pressure medicine to 200 mg twice a day. However, at the second home visit, a recheck of the blood pressure revealed the following results: BP 165/112 and 164/111. The RN phoned the midwife on call to advise her of increased blood pressure. The midwife received orders from the doctor who increased medication yet again to 300 mg twice a day. RN instructed patient to take her medicine as ordered and to follow up with the doctor the next day.
Elevated blood pressure during the first six weeks after birthing a baby can occur in women with no prior history. The home visit program helps identify women with high blood pressure and facilitates coordination of care with the healthcare provider. In this particular case, even though the hospital discharged the patient with blood pressure medicine AND even though her doctor doubled the dosage after the first RN home visit, the second follow up visit by the RN identified continued high blood pressure.
The second home visit provides in-home follow-up to mothers with high blood pressure and infants with feeding problems, jaundice, respiratory distress, potential sepsis and infection, weight loss, preterm/early term, pyloric stenosis. With the second home visit, this patient received the medical intervention she needed without a visit to the Emergency Room or readmission to the hospital.
Supporting Families in Crisis
K, a single mother of two daughters contacted Supporting Families in Crisis (SFC) for assistance with either her rent or her utilities. She was behind on her bills because she was getting counseling services for her daughter without Medicaid and paying out of pocket for therapies 3 times per week. K was also utilizing neurologist services for her neurological disorder.
The SFC advocate assisted the family on completing a public assistance application and the family was approved for Medicaid and food stamps which will help the family on a monthly basis. The SFC advocate was also able to problem solve with K to get the rent paid with help from a family member and SFC was able to assist with part of the utility bill which avoided an eviction and kept her utilities from being shutoff. K had recently moved to the area from another state to get away from a violent relationship. K’s daughter was diagnosed with autism and an appointment was made for the daughter down in the Miami area, but she had no transportation. The SFC advocate was able to link the family with Medicaid transportation so the family can travel to the apartment.
K was also receiving services with Strengthening Families and was utilizing the behavioral analyst offered. K expressed difficulties following through with the behavioral plan and this advocate contacted the behavioral analyst and went over the behavioral plan with the analyst and then went over the plan with the family for several weeks. K started understanding the plan better and expressed improvement in her daughter’s behaviors. At time of the case closing K is all caught up with her household expenses and her daughter’s behaviors have improved greatly where the stress has been eliminated in the household.
HANDS Pediatric Dental Clinic
Recently, we screened a first grader named C. He presented with a few cavities, but was not in any pain so he was a Class 2. The problem was that the child did not have insurance. When we spoke to the family about his lack of insurance, we found out that C has two other siblings who are covered by Medicaid, but for some reason, C did not qualify.
We were quick to explain that coverage depends on how old the child is, because it may place them in a different financial bracket. We were able to speak to C's grandmother about applying for Healthy Kids coverage.
About a month later, C's grandmother called to tell us that he has gotten his Healthy Kids coverage and has an upcoming dental appointment. We followed up a few weeks later to see how the treatment plan was going. C's grandmother then shared with us that he had been to 3 dentists, but no one was able to help him due to a rare calcium deficiency. All of his developing permanent teeth were weak and breaking down. She shared that they finally found a dentist who would see him and he was scheduled for surgery.
Early one morning, a few weeks later, Ervin, our hygienist received a phone call from C's grandmother. He was scheduled for surgery the next morning and insurance was denying the coverage. Ervin was able to call the office and talk to the office manager about us and our program. The office manager agreed to bill HANDS the difference so this child could have his surgery.
We are very happy and proud to say that we helped this child avoid a big problem and help him live normal and healthy life.
As a new parent gazing into your baby’s eyes for the first time you realize quickly this is the greatest responsibility you will ever have. Imagine the apprehension of first-time parents, the excitement, and of course, the lack of sleep.
Now imagine as the baby grows, he fails to meet developmental milestones. At 10 months of age, he is not attempting to crawl or stand. A trip to the doctor’s office at his first birthday reveals that he is developmentally behind and there is reason for concern. At 18 months, trips to specialists indicate that perhaps the baby had a stroke in the womb, but the results are inconclusive. Imagine those feelings of excitement and wonder now being replaced with stress and concern and overwhelming helplessness, questioning “is my child normal?”
The family in this story is referred to Easter Seals’ Early Steps program. The Early Steps program provides guidance, support and education to children with special developmental needs and their families. Their services include testing and physical, speech and occupational therapies. Utilizing state and local match funds (from the Children’s Service Council of St. Lucie County), federal funds are drawn down to help work with families with children with developmental delays up to age 3, benefiting more than 40,000 families each year in Florida.
The child in this story receives multiple sessions a week of specialized therapies, while the parents are educated so that they can practice the same activities at home. Without Early Steps, these therapies would cost $175 per session and would be inconceivable for most working families.
After 18 months of therapy, the child is nearly caught up developmentally in speech, physical and occupational skills. The family is provided with a plan to work with their son at home and is referred to other community resources. And perhaps most importantly, the Early Steps program has provided the parents the reassurance necessary to guide their child preventing further delays for their son at his most vulnerable time.
I can write passionately about the Early Steps program because the child in this story is my son, Zane. Today, Zane has a diagnosis of muscular myopathy — a disease in which the muscle fibers do not function, resulting in muscle weakness. Because of the Early Steps program, their supportive staff, and ultimately the therapies provided, my son was able to largely catch up with his peers — and not slide further behind.
The Easter Seal’s Early Steps program is only possible because of the partnerships between organizations at the federal and state levels, as well as the Children’s Services Council. This program represents one part of a system of care developed by the Children’s Services Council that is available to all newborns in our community.
Beginning with the voluntary nurse home visitation program through all three hospitals providing needed information and checking on the health of the newborn and the mother, services continue with Helping People Succeed’s BRAIN program which educates parents about developmental milestones and ways they can stimulate brain development. If a milestone is missed, like with my son, there are supports like Easter Seals Early Steps program to address developmental issues. This support system is available to ALL children in St. Lucie County. Last year, 86 percent of all newborns received these critical services.
St. Lucie County is unique in the support it provides its newest residents. I can attest — my wife and I are forever grateful for the support provided to not only our son, but to our family.
PACE Center for Girls
Alicia embodies the true definition of the word resilient. Before returning to PACE for the second time, Alicia had dropped out of school for two years, and was on a downward spiral. She and her mother were constantly arguing, there was endless chaos and turmoil in her home, and she was arrested on a number of occasions for domestic violence and fighting. Alicia admits that she picked fights with people as a way of reliving the anger that she had built up inside of her. She realized that she had to turn her life around and get back into school as soon possible, and contacted PACE.
She was eager to return because of the smaller environment and individual counseling, which she felt would help her better focus on her academic studies, help her get back on track, and help her work on her anger management and help her strengthen her relationships with her loved ones. Since her return to PACE, Alicia has learned coping skills that have helped her better manage her anger. She has also used the supports at PACE to help her get back on track academically, and has now been able to catch up by two grade levels. If she hadn't returned to PACE, Alicia believes that she would have still been lost, and would still be making the same bad choices that kept getting her locked up and in and out of the detention center.
Throughout all the difficulties that Alicia has experienced, she has exemplified the PACE guiding value and principle of "exhibiting courage" by rising above the obstacles that she faced in her young life. Alicia has also "valued the wisdom of time" by understanding that it is never too late to get back on the right track and work hard towards her goals. Alicia has plans of becoming a registered nurse, as well as a business woman and a motivational speaker. She would also like to help others and give back to her community by opening up a homeless shelter and a group home for teens that in need of support, similar to the support that she is always so thankful for having received at PACE!