MedCare's Thanksgiving Holiday Closures

In honor of the Thanksgiving holiday, MedCare Pediatric Rehab Centers and the corporate offices will be closed Thursday, November 28th and Friday, November 29th. 

Stafford, Spring and Northshore clinics WILL be open Saturday, November 30th normal business hours.

We wish everyone a safe and happy holiday!

En celebración del Día de Gracias, las clinicas de MedCare y las oficinas corporativas se cerrarán el Jueves, 28 de Noviembre y el Viernes, 29 de Noviembre.

Las clinicas Stafford, Spring y Northshore ESTARÁN abiertas el Sábado, 30 de Noviembre los horarios normales.  

Les deseamos a todo unos Días Festivos seguras y felices! 



MedCare Sponsors Trees for Tots 2013!

It is that time of year again! MedCare Pediatric Group is sponsoring the 8^th annual Trees for Tots event on Saturday, December 7^th, from 8am – 12pm, or until all Christmas trees are gone.  It will be held at our Stafford location. With the generous donations and contributions from our sponsors and fundraisers, there will be over 180 Christmas trees that will be given out to the families of children with special needs. Families will enjoy holiday treats and hot cocoa, as well as have their picture made with Santa and his elves. We are honored to be celebrating a part of this heartfelt gesture with all of the families in the community. The families’ gratitude and expressed appreciation each year keeps us wanting to do more. If you or your company would like to join MedCare Pediatric Group with this rewarding event in 2013, you can contact Karyn Jolly at 713-995-9292 X113. Sponsorships include logo/name on event shirts and banners, as well as on printed materials. For more information on MedCare Pediatric Group, LP, please visit our website at www.medcarepediatrics.com.

Please visit our Facebook page for pictures of the event:  www.facebook.com/medcarepediatrics

2014 Continuing Education Courses at MedCare!

MedCare is proud to be a host site for continuing education courses for therapists throughout the year.  We've expanded our CEU calendar for 2014 and will now be hosting courses at both our Stafford and Pasadena locations to make it easier and more convenient for clinicians from all areas of Houston to attend!  Please feel free to share this information with your friends and colleagues that are not MedCare employees as all courses are open to the public.

We are always looking to add more courses throughout the year so please check our Facebook page frequently for updates to this calendar!

For more information on any of the courses listed below, please contact Sommer LaShomb at (713) 773-5100 or s.lashomb@mpglp.com

MedCare's Upcoming Marketing Events!

The following is a list of upcoming events where MedCare will be present!  Feel free to stop by, say hello and get valuable information about the services we provide as well as current job openings with our company!

AUGUST

 

Texas Children's Health Plan Back-to-School Fair 2013

Date: Saturday, August 10th
Time: 10 a.m. to 2 p.m.

Location: Greenspoint Mall, 12300 IH-45 North Freeway, Houston, TX 77060

http://www.texaschildrenshealthplan.org/uploadedFiles/Global/Right_Column_Items/2013_Back_to_School_flyer-ENG.pdf

 

 

SEPTEMBER

Houston Walk Now for Autism

Date: Saturday, September 28th

Time: 10 a.m. to 11 a.m.

Location: Downtown Aquarium, 410 Bagby Street @Memorial Drive
http://www.walknowforautismspeaks.org/faf/home/default.asp?ievent=1062191 

 

OCTOBER

Texas Tech Job Fair

Date: Tuesday, October 22^nd

Location: Lubbock, TX

TPTA Conference

Date: Thursday, October 24th - Saturday, October 26th

Time: 11:00 a.m. to 2 p.m. Friday and Saturday

Location: Arlington Convention Center & Sheraton Arlington

http://tpta.org/displaycommon.cfm?an=1&subarticlenbr=267 

Family to Family Resource Fair

Date: Friday, October 25^th

Time: 9 a.m. to 2 p.m.

Location: United Way of Greater Houston (50 Waugh Dr, Houston, TX 77007)

http://familytofamilynetwork.org/events/parent-conference-a-resource-fair

 

Fort Bend Health and Wellness Expo

Date: Saturday, October 24th

Time: 9 a.m. to 5 p.m.

Location: Stafford Centre 10505 Cash Rd

 

NOVEMBER

TOTA Conference

Date: Friday, November 8th - Saturday, November 9th

Time: Friday 12 p.m. to 4 p.m, Saturday 10 a.m to 4 p.m.

Location: Sugarland, TX

http://www.tota.org/ 

DSAH Buddy Walk

Date: Saturday, November 9^th

Time: 10 a.m to 2 p.m.

Location: Minute Maid Park

http://www.houstonbuddywalk.org/fr/DSAH/2013BuddyWalk

From the Speech Therapy Room to Daily Speaking Situations: Let’s Discuss Carryover!

                Often parents wonder how they can help their child incorporate skills from the speech therapy room into their daily lives.  This is known as the carryover process.  Carryover refers to a client’s ability to take an individual speech skill learned in the therapy room and to apply it broadly in all speaking situations (Marshalla, 2010).   Parents find this particularly difficult when their child avoids speech homework between sessions and/or while practicing the speech sounds in social interactions.  Therapists and parents are asked to work together to find ways to motivate the child outside of the therapy room.  It is the goal of our speech therapists at MedCare to find ways to make this process fun, functional and effective.  In order for us to meet this goal, we need the parents of our clients to work with their speech therapist to make sure the client completes his/her speech homework or uses his/her speech strategies in all speaking situations. 



                As a parent you will see your speech therapist demonstrate creative ways to promote carryover activities.  For example, your son may love sports.  An assignment may be to use the correct production of the /r/ and /l/ phoneme during short conversations about sports.  Or you may have a three year old working on producing two to three word phrases; the therapist may have your child say that phrase while playing his/her favorite game.  At MedCare we believe in a team effort, and as a parent of the client who receives therapy with MedCare you are on that team.  Please feel free to provide your therapist with  as much information as possible about your child so we can design treatment specifically for your child.  

 



Van Riper and several other researchers have suggested some speech production activities for the promotion of carry over including:

·         Describing objects as a way to begin the process of spontaneous productions.

·         Chanting to encourage memory and automaticity.

·         Playing with an error sound or word to facilitate control.

·         Tongue twisters to teach children to control their speech.

·         Storytelling and re-telling to cause stimulate spontaneity and to cause a breakthrough in carry over.

·         Singing to help children remember their speech work and to encourage effortless practice.

·         Create a script to practice at a favorite restaurant.

·         Use the carryover phrase at a department store. 

(Marshalla, 2010)

In 1947, Charles Van Riper wrote that “We cannot rush the carryover process.”  Therefore, a critical component to the carryover process is patience.  Your child may make mistakes, but eventually with practice and in their own time they will get better at this goal. Patience is the first step in the carryover process.  Please do not give up!  Practice, practice, and practice!!  If parents encourage their child to engage in carryover activities, the overall quality of your child’s understanding and speech production will improve.  Through games, books, and functional daily activities you are assisting with the growth of new neural connections.  This in turn will enhance the speech production in your child’s daily life, not just in the speech room. 

 

By: Brittney Donielle Goodman M.S., CCC-SLP

Backpack/School Supply Drive July 29-August 12!

It’s back to school time, which means it’s Backpack Drive time!  We will be hosting our annual backpack drive from Monday, July 29^th-Monday, August 12^th.  Backpacks and supplies will be distributed to needy families the week of August 12^th, just in time for school to start on the 26^th!

We will be accepting donations at the corporate office as well as at each of the clinic locations.  Our backpacks will be given out on a first come, first serve basis and we really want to make sure that we are targeting families who really have a need for assistance.   

Examples of some of the requested items include:

Crayons

Markers

#2 Pencils

Erasers

Glue

Hand Sanitizer

Tissue

Composition books

Colored Pencils

Scissors

If you have any questions, please contact Sommer LaShomb at (713) 773-5100 ext. 131!

HHSC Proposes MORE Rate Cuts to Medicaid Reimbursement for Therapies in Home Health and Outpatient Facilities

The Texas Health and Human Services Commission (HHSC) has proposed MORE cuts to Medicaid reimbursement for Physical, Occupation, and Speech Therapy services in both home health and outpatient facilities. HHCS just cut the reimbursement rates in 2012 and now they want to cut reimbursement again! The proposed rate cuts are to go into effect September 1st, 2013.

There will be a public hearing to receive comments regarding the proposed Medicaid rates on July 10th, 2013 at 8:30 am in the Winters Public Hearing Room at 701 W. 51st St. Austin, TX 78751, with entrance through security at the front of the building facing 51st St. HHSC will consider concerns expressed prior to final rate approval.

As the CEO of one of the largest pediatric therapy organizations in Texas, I urge you to follow this story and I implore you to HELP! These proposed cuts will impact organizations and employers abilities to provide basic benefits to their e...mployees. Furthermore, there is no specific methodology used by the Texas Department of Health & Human Services to enforce such drastic reimbursement reductions. Home Health and Outpatient Rehab Centers took deep cuts in 2012 after a hard fought battle to maintain rates for Physical, Occupational and Speech therapy services for medically and/or developmentally delayed and fragile children. We urge all our friends and supporters to contact your local and state representatives to oppose these additional cuts! Please act today! All it takes is a few minutes of your time to call, email or fax your local representative and tell them TO STOP FURTHER REIMBURSEMENT CUTS to Home Health and Outpatient Rehab Facilities.

If you know even one child who has had a sports injury, Autism, Cerebral Palsy, Down Syndrome, cleft lip/palate, spinal cord injury, birth defect, motor vehicle accident or any other type of acute trauma or head injury that has needed physical, occupational or speech therapy you should care about this issue. Please don't ignore this call to action.

MedCare operates on very slim margins and due to government funding we are not even able to borrow working capital to run our business because banks will not lend against government reimbursement. Organizations like MedCare WILL BE FORCED to pass cuts on to our employees who work hard every day in this industry. These employees have student loans and families they must maintain. They work in this industry because they care about children and they want to help.

MedCare has been in business for over 22 years and today more than ever we need your support to STOP cuts that will negatively impact the children in the end. Health insurance costs for our employees will rise 13% beginning 9/1/13. Corporate merit increase for the cost of living for 2013 rose an additional 2% on average. Supplies and equipment costs to service and maintain our business rose across the board. Yet, we continue to be pounded with unmerited reimbursement rates.

In 2013, after an 8% reduction in our rates, we were promised a collaborative effort on any future rate reviews. Yet, here again, we find ourselves begging to keep our doors open alongside thousands of Texas families who are desperate for services. We, like our peer colleagues in the industry continue the struggle to treat the hundreds of children on wait lists because the demand is simply greater than the supply. Why would any intelligent individual choose a career in pediatric therapy when their very livelihood is threatened year after year? Because we truly care. Did you know plumbers with trade school training earn more per hour than a doctorate level Physical Therapist? The folks in Austin in charge of reimbursement continue to add insult to injury by yet again reducing the rates to provide this essential service. Please don't let Texas children suffer longer wait lists and continued government blocking of access to care through inadequate reimbursements leaving them doomed to a failed system. They need your voice!

Please keep updated on this critical issue on our FB page, MedCare Pediatrics. Like and share to stop the insanity!

 

Paige Kinkade, CEO

MedCare Pediatrics

Memorial Day Weekend Closures at MedCare

Saturday, May 25th both our Stafford and Northshore clinic locations will be open for regular business hours. 

Monday, May 27th the following locations will be CLOSED in observance of Memorial Day:

• Corporate Offices
• Northshore Clinic
• Spring Clinic
• Katy Clinic

If you receive home therapy or home nursing services, please check directly with your nurse and/or therapist to see if they will be working that day. 

Sábado, 25 de Mayo ambas nuestras clinicas Stafford y Northshore estarán abiertas horas regulares.

Lunes, 27 de Mayo las siguientes ubicaciónes estarán cerradas en conmemoración del Día de los Caídos:

• Oficinas Corporativas
• Northshore Clínica
• Spring Clínica
• Katy Clínica

Si recibe terapia en el hogar o enfermería en el hogar, por favor consulta directamente con su enfermera y / o terapeuta para ver si se va a trabajar ese día.



Atlanto-Axial Instability and Children with Down Syndrome

As therapists, we are always encouraging children to run, jump and play. There are times when physical activity could be dangerous to your child’s health, however, especially children with Down syndrome. Children with Down syndrome are at risk for developing a condition called Atlanto-Axial Instability (AAI). AAI is a condition in which the first and second bones of the neck have too much flexibility. These bones, called cervical vertebrae, can cause damage to the spinal cord when there is too much flexibility. 

How common is Atlanto-Axial Instability in children with Down syndrome?

Approximately 15% of children with Down syndrome have AAI and have no symptoms. Only 1-2% of children with AAI have symptoms.

What are the symptoms of Atlanto-Axial Instability?

Although physical symptoms of AAI are very rare, some symptoms that could indicate pressure on the spinal cord include:

▪ Neck pain

▪ Torticollis or tilting of the head and neck

▪ Loss of balance or changes in walking pattern

▪ Changes in sensation in the hands or feet

How do I know if my child has Atlanto-Axial Instability?
AAI is diagnosed through a series of neck X-rays. X-rays of the head and neck are taken from the side (lateral view), with the head bent forward (flexed), and with the head tilted backwards (extended). On X-ray, a space between the 1^st and 2^nd cervical vertebrae larger than 4.5 mm is positive for AAI.



Does my child need to have X-rays if they have no symptoms?

Previously it was recommended that all children with Down syndrome have X-rays taken during their preschool years (ages 3-5). Any child who wants to participate in sports should have X-rays prior to starting the sport as well, even if previous X-rays were negative. This will ensure that it is safe for your child to participate.  In 2011, the American Academy of Pediatrics released updated guidelines and the updated guidelines no longer recommend X-rays for all children with Down Syndrome.  The 2011 guidelines state "Children with Down syndrome are at increased risk of atlantoaxial instability. However, not until age 3 years will they have adequate vertebral mineralization and epiphyseal development for accurate radiographic evaluation of the cervical spine. Plain radiographs do not predict well which children are at increased risk of developing spine problems. Therefore, routine radiologic evaluation of the cervical spine in asymptomatic children no longer is recommended."

If my child is diagnosed with Atlanto-Axial Instability, are they restricted from physical activity?

Children with AAI can still participate in physical activity; however, they should avoid activities that put excess strain on the head and neck. Activities that should be avoided include:

▪ Gymnastics, tumbling and somersaulting

▪ Vigorous jumping/bouncing, such as trampoline activities

▪ Contact sports such as football, hockey and soccer

▪ Diving

Where can I find more information on Down syndrome or Atlanto-Axial Instability?

Your pediatrician and your child’s therapists are great resources for information. There are also several national and local agencies with excellent information, including:

▪ National Down Syndrome Society:

http://www.ndss.org/

▪ National Association for Down Syndrome:

http://www.nads.org/

▪ Down Syndrome Association of Houston:

http://www.dsah.net/

Sommer L. LaShomb, PT, DPT, PCS

Physical Therapist



Reasons for Discharging Patients from Therapy Services

As pediatric therapists, we treat many children who have disabilities or conditions that will affect them for the rest of their lives.  So why would we discharge a patient who has a life-long condition from therapy services?  This is a question that many parents and caregivers ask our therapists and our clinical directors, so we wanted to take some time to explain what the reasons are behind why we discharge patients from therapy.

1.       The child has met his/her goals:  As therapists, this is our ultimate goal!  We want every child that we work with to progress to the point where they no longer need our help.  When we do an initial evaluation, we establish individualized goals for each child and we focus our treatment on meeting and achieving those goals.  When your child meets his/her goals, it’s time for celebration and also time for graduation from therapy!  This can be bittersweet for both the families and the therapists at times.  Therapists can become like a part of the family, and it’s hard for us to say goodbye to patients that we’ve worked with.  But as the saying goes, all good things must come to an end!

2.       The child is functioning at a level that is appropriate for his/her age or diagnosis:  Therapists can’t “cure” children of any disability or condition.  What we can do is help a child reach what we call his/her “maximum functional potential”.  Maximum functional potential means that your child is functioning at a level that is safe and reasonable for them to complete their everyday activities given their disability or condition.  For example, not every child will have the ability to walk independently.  However, if a child is able to safely and independently walk with a walker at home, at school, and in the community, then they have reached their maximum functional potential for that skill.

3.       The child is not willing or able to actively participate in therapy:  The therapy relationship, like all relationships, requires the participation of both parties involved.  Children have to be capable of being an active participant in therapy in order to gain something from it.  Sometimes, children have behavioral issues or physical limitations that make it difficult or even impossible for them to participate in therapy.  When this is the case, we recommend the families address those issues first, before we attempt to provide therapy. 

4.       The child is not making progress in therapy:  In order for us to justify that what we are providing is helping the child, we have to be able to show progress.  As therapists, we understand that each child is different and will progress at different rates.  We’re not saying a child has to meet every goal every time we evaluate, but we do need to have documented evidence that the child is making progress towards his/her goals.  This is especially important for insurance reimbursement.  Insurance companies will not pay for therapy services for individuals if they do not show progress.

5.       The child no longer needs skilled therapy:  The services that we as therapists provide are considered skilled services.  Therapists have specialized degrees and are licensed by the state to provide therapy services, meaning that not anyone is able to perform the skills that a therapist does.  However, there are skills that do not have to be provided by a licensed therapist and can be taught to caregivers.  Skills like range of motion (ROM), therapeutic exercises, sensory integration techniques, etc. can all be taught to and performed by people who don’t have a license or a degree in therapy.  When a child just needs therapeutic interventions that are unskilled, the caregivers can provide those interventions and skilled therapy is no longer needed.

6.       The parents/caregivers do not follow through with therapy recommendations:  Therapy is just a small part of a child’s world, usually just a few hours a week.  So we need help from you, the parents and caregivers!  Caregivers are expected to work with their children outside of therapy on the same goals that we work on so that the child achieves something called carryover.  Carryover means that a child is able to perform a task not just in therapy, but anywhere they are asked to complete the task.  For example, a child may learn how to tie his/her shoe in Occupational Therapy, but if he/she can’t tie the shoe at home when the caregiver asks, outside of the therapy setting, then how will they be independent with their dressing skills?  When therapists give recommendations to caregivers and those recommendations aren’t followed, it can slow or even stop a child’s progress in therapy and if that is the case, we may need to discharge.

As pediatric therapists, our job is to make therapy fun for the child and we do our best to make sure that they are successful both in therapy and out in the real world.  Prior to discharging any patient, we look at all the factors affecting the child before we make a decision to discharge.  We hope this blog helps you have a better understanding of the reasons for discharge from therapy.

MedCare's Upcoming Marketing Events!

The following is a list of upcoming events where MedCare will be present!  Feel free to stop by, say hello and get valuable information about the services we provide as well as current job openings with our company!

Texas Job Fair

Texas Southern University

Tuesday, April 2^nd

10a-3p

http://www.tsu.edu/academics/colleges__schools/Jesse_H_Jones_School_of_Business/JHJ%20Flyers%20CPP3.pdf

Houston Children’s Festival

Saturday, April 6^th

10:30a-6:30p

Downtown Houston

http://www.houstonchildrensfestival.com/

ECI Project Grow Transition Meeting

Tuesday, April 16^th

4706 Airport, Rosenberg, TX

Physical Therapy Career Fair

University of North Texas Health Science Center

Wednesday, April 17^th

10a-1p

http://web.unthsc.edu/info/200573/physical_therapy/930/2013_career_fair

Student Night TOTA (Event Sponsor)

Wednesday, April 17^th  

5:30p-7:30p

Shriner’s Hospital for Children

http://www.tota.org/gulfcoe.html

1^st Annual Autism Conference

Saturday, April 20^th

8:30a-1:30p

Nolan Ryan Junior High

11500 Shadow Creek Parkway Pearland TX 77584

http://www.arcgulfcoastchapter.org/Events.html

MDA Muscle Walk

Saturday, April 27th

8a-10a

Houston Galleria

http://www2.mda.org/site/TR/Walk/77-716-HoustonMetroDistrict?fr_id=4341&pg=entry

NDTA Annual Conference

May 17^th-19^th

Marriott Houston Westchase

http://www.ndta.org/conferences/seminars.php?conference_id=1765

Long-Term Planning for Children with Special Needs

Long-Term Planning

Planning for the future is fun and exciting when planning for a vacation, wedding, or retirement. Planning for a future where we are absent from our loved ones’ lives is much more difficult but far more essential than planning for events! It all boils down to communication and having all the important documents in one place. A binder is a great way to organize and keep all important documents in one place that is accessible to family members or other designated caregivers as needed. Here are 10 must-have documents to include in your binder:

1.       Important legal papers:

a.       Birth certificate,

b.      Social Security card,

c.       Health insurance cards,

d.      Medicaid award letter

2.       Letter of Intent – this is a not a legal document but is a very important way to pass vital information about an individual with a disability to future caregivers. This important document should be updated once every year. Be sure to sign and date this document every time you update it! Information to include:

a.       People to contact if something happens to you (include names and relationship/role, addresses, mail and e-mail addresses of other children/individuals, extended family, case manager, and close family friends)

b.      Current situation and family life

c.       Daily routine

d.      Sleeping preferences

e.      Eating habits – food likes/dislikes

f.        Education performance/routine

g.       Strengths and preferences

h.      Future living plans

i.        Employment

j.        Medical Care

                                                              i.      Medical diagnoses

                                                            ii.      Medical Doctor(s) (contact information)

                                                          iii.      Eye doctor (contact information)

                                                           iv.      Dentist (contact information)

                                                             v.      Allergies and reactions

                                                           vi.      Drugs and adverse reactions

                                                         vii.      Medications currently taken

                                                       viii.      Therapies – types and schedule (contact information)

k.       Behavior Management (counselor and contact information)

l.        Social activities

m.    Religious/Spiritual Life

n.      Strengths and preferences

o.      Guardians and trustee

3.       Final arrangement written instructions:

a.       Burial/cremation preference

b.      Religious service or other services

4.       Advance health care and financial directives:

a.       Powers of attorney

b.      Living wills

c.       Health care proxies

5.       Trusts and wills (copies of):

a.       Special needs trusts

b.      Living trusts

c.       Insurance trusts

d.      Location of signed copies or originals so they can be accessed if needed to complete property transfers

6.       Major assets list with policy and account numbers, and names of any brokers, insurance agents, or investment advisers:

a.       Insurance policies

b.      Stocks

c.       Mutual funds

d.      Bank accounts

7.       Guardianship papers and advocacy organizations with your personal thoughts about these organizations.

8.       Government agencies you have dealt with and the caseworker or contact at the agency; include contact information.

9.       Government benefits the individual may or does receive, as well as copies of any completed application forms, include contact information.

10.   Miscellaneous papers such as tax returns filed for the individual, housing option information/applications, school applications, documents referenced to in the Letter of Intent, and/or photos.

Add other “must-have” documents to your binder according to your individual with special need’s unique needs and future plans. For more resources related to long-term planning for your child, contact MedCare's Social Worker, Karen McWhorter, LMSW-IPR, CPS.

Information adapted from www.friendshipcircle.org and http://specialchildren.about.com/od/longtermplanning/a/letterofintent.htm.